[Conservative therapy of backache. Part 3: Physical therapy]

Physical exercise is accepted by many as the first line of treatment of low back pain. Nevertheless, hard data published so far have failed to demonstrate its benefit as clearly as we would wish. A wealth of exercise programs is available that escape systematic classification. The authors differentiate between general endurance training, and stretching, flexion and extension exercises. Whether endurance training is of benefit has not yet been unequivocally established. In contrast, stretching exercises have been shown to be effective. Flexion exercises have both proponents and opponents, while most randomized studies on extension exercises appear to demonstrate their effectiveness. Thus, physical exercise may be considered, at least in part, an effective form of treatment. Further research is needed to define the optimal exercise program for the individual patient as accurately as possible.