Isolated Exercise Interventions for Acute Low Back Pain: Systematic Review and Meta-Analysis of Randomized Controlled
Melania Cardellat-González1, Luis González-Gómez2, Juan-David Guzmán-Gómez3
1Department of Health and Sports, Pablo de Olavide University, 41009 Seville, Spain.
Healthcare (Basel, Switzerland)
|September 13, 2025
Summary
Therapeutic exercise (TE) shows modest benefits for acute low back pain (LBP) when used alone compared to usual care. However, evidence quality is limited, suggesting caution and multimodal approaches for LBP management.
Area of Science:
- Rehabilitation Medicine
- Pain Management
- Evidence-Based Practice
Background:
- Therapeutic exercise (TE) is a first-line treatment for low back pain (LBP).
- Efficacy of TE in the acute phase of LBP requires further investigation.
- Current understanding of isolated TE effectiveness in acute LBP is limited.
Purpose of the Study:
- To evaluate the effectiveness of isolated TE in reducing pain and disability in acute/subacute LBP.
- To synthesize evidence from randomized controlled trials (RCTs) on TE for acute LBP.
- To assess the impact of TE as a standalone intervention.
Main Methods:
- Systematic review and meta-analysis following PRISMA guidelines.
- Inclusion of RCTs comparing isolated TE with various comparators (usual care, education, manual therapy, bed rest).
- Assessment of pain intensity and disability as primary outcomes; evidence quality evaluated using GRADE.
Main Results:
- Five RCTs were included in the meta-analysis.
- TE demonstrated statistically significant benefits over usual care (SMD = -0.23; p=0.04).
- No significant differences were found when TE was compared to education, manual therapy, or bed rest.
Conclusions:
- Isolated TE may offer short-term improvements in disability for acute LBP compared to usual care.
- Findings should be interpreted cautiously due to limited study quality and quantity.
- Exercise should be integrated into comprehensive, multimodal LBP management plans.
