Do lower back pain exercises prescribed by therapists actually work?

Research indicates that as many as 7 out of 10 people prescribed exercises for their lower back pain fail to continue doing them as early as 2-3 days after their consult. There are mixed views as to why this is the case, however the one perspective we plan to focus on in this article, is the view that the exercises do little or nothing to help the back pain sufferer, so they do not see the benefit in doing them.

Let's look at the most common back pain exercises prescribed by therapists;

1. Lower back stretches
2. Core stabilising exercises
3. Range of Movement exercises, such as back extensions

Lets now look at what these prescribed exercises are aimed to achieve for the back pain sufferer.

1. Lower back stretches are designed to elongate the tight (or shortened) muscles of the lower back. Elongating muscles will promote blood flow, produce heat and assist with tension that is producing pain.
2. Core stabilising exercises are aimed at facilitating (or turning on) muscle groups widely believed to assist with good posture. The view is that back pain sufferers core stabilising muscles are not working, by facilitating them this will turn them back on.   
3. Range of movement exercises can be prescribed for different reasons. One reason is similar to stretching, elongated tight or shortened muscles and promoting blood flow to the back. Another reason is to assist with a diagnosed herniated disc. Opposite movements to the repetitive actions believed to have brought on the herniation are believed to assist the disc in returning to its midline position.

Whilst all of the above exercises are effective at carrying out their aim, there is a valid reason why back pain sufferers fail to continue doing them. At best, they only offer short term relief from pain. In most cases the pain relief is minimal or not at all.

Let’s take a closer more critical look at the exercises and why they fail to assist back pain sufferers:

1. Lower back stretches only assist the larger more superficial muscles of the back. They have very minimal effectiveness in elongating the deeper intrinsic muscles of the back, the exact areas where people feel their pain.  
2. Core stabilising exercises do not offer any pain relief. To be effective requires consistency over a period of time. Our concern with the majority of core exercises prescribed by practitioners is they fail to address the major muscle groups that support the pelvis and back. So even for most back pain patients who do carry out their prescribed core stabilising exercises over many months, they receive very little if any pain relief whatsoever.
3. Range of movement exercises similar to stretching only assist broader muscles. For many back pain sufferers they comment that movements prescribed to them actually make them feel worse, hence why they stop doing them.  

Upon interviewing hundreds of back pain patients who had previously failed to adhere to the prescribed exercises, almost all advised they only reason they stopped was because they felt they did nothing. Almost all advised if they were given exercises that actually made them feel better, then of course they would do them as prescribed.