Trunk stabilization among women with chronic lower back pain: a randomized, controlled, and blinded pilot study

Treatment for mechanical lower back pain is a challenge in Western society, in which its occurrence can now be considered to have reached epidemic proportions. The origin of such pain and the factors that cause it to become chronic and recurrent remain poorly understood. Abnormalities in motor control and trunk muscle function have been found in individuals with chronic lumbar pain. Many studies have demonstrated that the deep muscles of the lumbar column and abdomen, especially the multifidus and transversus abdominis, present late activation, weakness, and diminished resistance during episodes of lower back pain. These changes persist even when the painful condition goes into remission, and they contribute to episodes of lower back pain recurrence. However, it is still difficult to determine whether the neuromuscular imbalance occurs because of the pain or whether the imbalance causes the pain. Although the mechanisms that lead to these abnormalities are incompletely understood, rehabilitation programs aiming to stabilize the lumbar spine and improve its musculature and proprioceptive action have been used with positive effects on pain and functional capacity in individuals with mechanical lower back pain. This pilot study compared stabilization exercises with strengthening exercises for the trunk and hips in women with chronic lower back pain in terms of their effects on pain, functional capacity, and postural balance.