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Chronic Low Back Pain - The Exercise Prescription

Ahimsa Porter Sumchai

Chronic low back pain is a potentially disabling comorbidity of the obesity epidemic. Defined as pain in the lumbar region lasting more than three months, it can occur secondary to acute occupational, recreational or sports injury or as the result of cumulative trauma from occupational repetitive strain. CLBP may be aggravated by occupational demands that promote poor posture and load the lumbar intervertebral discs - from heavy labor to extended sitting and standing. The accumulation of adipose tissue in the central abdominal region further loads the lumbosacral spine contributing to malalignments and chronic pain. Exercise has been proven to be a safe and effective first line intervention in the treatment, rehabilitation and prevention of CLBP. Exercise can promote fat burning. Evidence based research using performance outcome measures, electromyography and ultrasound imaging is reviewed. A deficit in strength of core musculature has been proposed as contributing to CLBP. Core strengthening and hypertrophy of key muscle groups can be achieved using an array of modalities including isometric exercise, stability balls and the Pilates method.