Core Exercises for Chronic Low Back Pain… Think Again.

Every week at least one of my patients will remark that they think that their back still hurts because they have a “weak core” or they just have “a bad back.”

You already know that your x-ray and MRI show may have absolutely nothing to do with your pain, so it must be a problem with your “core”, right?

First, there is no area of the trunk that is designated as “the core.” Many will use the term “core” as a substitution for the abdominal muscles but even these muscles are not limited to some magical protectors against lower back pain.  Muscles tend to be called upon in many different patterns depending on what activity you’re performing and may even change their strategy during repetitive tasks that appear to be the same thing done over and over.

Second, weakness of muscles most likely is not the cause of chronic lower back pain.  During normal activities and even some activities involving extra weight added to the body, these muscles only use about 5% of their available strength.

What about spine or lumbar stabilization exercises?

Compared to other physical therapy treatments, education, and general exercise, spine stabilization exercises show no greater benefit than the other options. This is rather interesting when you consider that lower back pain does appear to alter how the muscles of the trunk work.

What frequently occurs in people with lower back pain is that the muscles of the trunk tend to be used in the same patterns over and over.  Instead of having many different strategies of trunk muscle activity, oftentimes sufferers of lower back pain only show a limited variation in muscle activity.  Even after their back pain resolves, many back pain sufferers continue to show the limitation in muscle activity strategies. Research indicates that this may be a potential cause of recurrent or chronic back pain (aka a “bad back”).

IFAST Physical Therapy has recognized these patterns for years and our patient evaluation system is specifically designed to determine how your movement is limited by your back pain.

Whether you’ve had physical therapy before, seen countless back doctors, tried spinal injections, or even had surgery, there may still be an answer to why your back still hurts.

Call IFAST Physical Therapy for your free injury consultation and find out why your back still hurts.

Behavioral Neuroscience
2006, Vol. 120, No. 2, 474–476
Journal of Bodywork & Movement Therapies (2010) 14, 84-98
PAIN 155 (2014) 944–953
SPINE Volume 32, Number 14, pp 1474–1481