In a systematic review involving 20,969 adults suffering from chronic low back pain, researchers have identified the most effective exercise treatments to alleviate pain intensity and improve functional limitations. The study, which utilized network meta-analysis of 217 randomized controlled trials, has shed light on the promising approaches for managing this common and debilitating condition.

The aim was to assess the impact of specific types of exercise on pain and functional limitation outcomes in those experiencing non-specific low back pain for at least 12 weeks. The researchers evaluated exercise treatments prescribed or planned by healthcare professionals, involving specific activities, postures, and movements aimed at enhancing the outcomes of low back pain.

Pain intensity and back-related functional limitations were assessed using well-established measures, such as the visual analogue scale (VAS), numerical rating scale (NRS), Roland Morris Disability Questionnaire, and Oswestry Disability Index, each standardized on a scale from 0 to 100. The findings indicated that most exercise types exhibited greater efficacy than minimal treatment in minimizing pain and functional limitations. However, three specific exercise treatments stood out as particularly effective:

• Pilates: This exercise regimen demonstrated significant improvements in pain intensity and functional limitation outcomes compared to minimal treatment and other exercise types.
• McKenzie Therapy: Similar to Pilates, McKenzie therapy displayed substantial benefits in reducing pain intensity and functional limitations.
• Functional restoration (pain only) and Flexibility exercises (function only): Both of these exercise approaches showed notable improvements in their respective outcomes compared to minimal treatment and other effective treatments.

The network meta-analysis indicated mean differences for these exercises, ranging from -15 to -19 for severity of pain and from -10 to -12 for functional limitations in comparison with minimal treatment. Hence, some types of exercise are more efficacious when compared to others to relieve back pain. Encouraging individuals with chronic low back pain to choose enjoyable exercises can enhance adherence to treatment.