The Role of Core Stability Exercise in the Treatment of Chronic Non-Specific Low Back Pain

The strength of the underlying muscles of the torso is referred to as core strength. This section aids in developing strong abdominal, spinal, pelvic, and hip muscles, as well as increasing the core muscles’ potential. It allows to keep your back straight and prevents low back pain problems, and guides you in optimal spinal alignment. Physiotherapy brings forth effective treatment approaches to alleviate back pain and restore mobility to normal without causing any adverse effects.

Introduction

Low back pain is a very frequent patient complaint, with an estimated 80% of the world’s population experiencing it. Every year, one-third of the people of the United Kingdom suffer from back discomfort. It is the leading cause of years spent disabled, and it is one of the top ten causes of patient visits to medical institutions. Non-specific low back pain is defined as tension/soreness and stiffness in the lower back pain area for which no reason can be identified. Although most instances are resolved promptly, a considerable proportion of people experience chronic lower back discomfort. Patients suffer from unrelenting agony and are frequently unable to function. Chronic Low Back Pain (LBP) imposes a significant financial burden in the form of direct expenditures incurred due to lost productivity.

Prevalence

There is a general shortage of medical data collection on chronic low back pain frequency and incidence, partially due to a deficiency of consensus on what constitutes chronic low back pain. Chronic low back pain is generally characterized as discomfort that occurs on most days and lasts for more than three months. Others indicate it as pain that lasts longer than usual healing intervals and recurrent low back pain over a lengthy period. Acute and chronic Low Back Pain (LBP) should be treated separately since they may respond differently to the same treatments.

Risk Factors

Many distinct patient features have been identified as predictors of chronic LBP development, and only a handful have been reliably repeated in several trials. Increasing age, past back pain, job unhappiness, discomfort below the knee, and depression are only a few. Depression has long been linked to various chronic Low Back Pain (LBP) syndromes, and numerous studies have found a link between depression and chronic back pain in particular. According to case report survey, persistent back pain was linked to “premorbid variables” such as poor baseline functional status, high levels of psychological stress, poor self-rated health, low physical exercise, smoking, and obesity. Multiple epidemiological studies have shown smoking to be a risk factor.

Core Stability

Initially, they proposed that the surrounding superficial muscle groups were in charge of maintaining alignment and a “neutral spine.” The muscles they referred to were the erector spine, hamstrings, abdominals, and hip flexors. Following this, it was proposed that pelvic tilt was defined as pelvic movement that differed from the neutral position.

The idea of core stability has evolved through time, with authors such as Paul Hodges emphasizing the importance and contribution of the Transverse Abdominus muscle, particularly in lumbopelvic stability. It has now evolved into a significant aspect of the care of spinal stability, with workouts focusing on the activation, recruitment, and strengthening of the core becoming a frequent therapy option.

Typical Core Exercises

There are three parts to a lumbopelvic stabilization program.

• Section 1 — Includes segmental control and active recruitment of global mobilizers such as the transversus abdominus, pelvic floor, and diaphragm.

• Section 2 — Introduces closed chain exercises with low velocity and low load while maintaining segmental control.

• Section 3 — Introduces open-chain exercises with high velocity and load while maintaining segmental control. The fundamental structures can be stressed by moving nearby body segments.

Many of the activities indicated here have improved overall health, athletic performance, and pain relief.

Conclusion

According to a meta-analysis, patients with persistent low back pain benefit significantly from core stability training compared to general exercise. On the other hand, these findings were only meaningful in the near term. Even though both therapies improved low back pain and function, research released after this meta-analysis has indicated no significant difference between core stability and general workouts in the short or long term. However, it should be emphasized that no study found that core stability training had negative impacts on pain and function compared to general exercise.

In conclusion, our data suggest that when a patient has persistent non-specific low back pain, doctors have the option of prescribing core stability training or general exercise. If the patient is more suited and if it would promote cooperation, core stability exercise chronic non-specific low back pain can be employed instead of general strengthening and stretching. However, doctors should not expect a major improvement in pain and function by adopting core stability, especially over time.

References

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2. Patel AT, Ogle AA. Diagnosis and management of acute low back pain. American family physician. 2000 Mar;61(6):1779–86.