Exercise for the low back pain patient.

As 90% of patients with acute LBP recover within a 2-month period, irrespective of the type of treatment received, exercise probably plays little role in facilitating recovery from an acute episode of LBP. It may be a very important factor in both symptomatic and functional recovery in chronic LBP, as well as an integral factor in preventing recurrent injury. The most efficacious exercise regimen for treating LBP is currently unknown. Similarly, little is known about the efficacy of individual exercises. In certain patients, flexion or extension exercises may be inappropriate. A careful history and physical examination, observing the movements that cause pain, will assist the physician in tailoring the exercise programme to the individual patient to achieve the greatest likelihood of success. Communication between the patient, physician and therapist is vital to allow continual adjustment of the programme to best meet the patient's needs. As improvement occurs, more stressful exercises can be added to improve strength, endurance and aerobic fitness. Individualizing the exercise programme to the patient's symptoms and communication between the patient, therapist and physician lead to greater compliance with the exercise programme and a greater likelihood of improved outcome.