COCHRANE

organisation

Cochrane Database of Systematic Reviews
TITLE

Exercise Therapy for Chronic Low Back Pain (Cochrane Systematic Review)

249 Trials, 24,486 Participants

SOURCE

REFERENCE
6
NICE
REFERENCE
123

organisation

Cochrane Database of Systematic Reviews

TITLE

Exercise Therapy for Chronic Low Back Pain (Cochrane Systematic Review)

249 Trials, 24,486 Participants

SOURCE

This Cochrane review pooled evidence from 249 randomised controlled trials, involving nearly 24,500 people, to assess how well exercise therapy works for chronic low back pain compared with no treatment, usual care, and other conservative treatments such as manual therapy.

What was studied?

The review compared exercise therapy against no treatment, usual care, placebo, and other conservative treatments including education, electrotherapy and manual therapy, measuring changes in pain intensity and day-to-day function across the pooled trials.

What did they find?

Exercise produced a clinically meaningful drop in pain compared with no treatment, usual care or placebo, around 15 points on a 100-point scale. It also outperformed education alone and electrotherapy, though not manual therapy, while its effect on function was smaller.

Why it matters

Exercise is one of the more effective tools for chronic back pain, particularly for reducing pain. Its effect on function is more modest, which is one reason it works best alongside other treatment.

Why we included it

It reinforces a wider principle in effective rehabilitation: active movement paired with hands-on treatment tends to outperform either approach alone, rather than one replacing the other.