Treating Low Back Pain Part 2 – Stabilization Exercises

By: admin Published: April 18, 2012

  By Lauren Shafer PT, DPT



Treating Low Back Pain is Not One Size Fits All

The second subgroup for treating low back pain is stabilization exercise. I find this to be an interesting category in the way it has evolved and what we are finding through research. It is commonly thought that “core training or stabilization” is the best way to treat low back pain, but this isn’t always the case. The literature over the past several years has prompted popularity in the prescription of stabilization exercise, however, results on its true effectiveness are inconclusive. While strong abdominal and back muscles definitely can help prevent and manage low back pain, it isn’t always the correct intervention for someone with low back pain.

The criteria for this subgroup include:

  • Age < 40
  • Greater general flexibility (straight leg raise >91°)
  • Positive prone instability test (locating a relatively more mobile segment of the lumbar spine that also reproduces symptoms when direct pressure is applied. The test is positive if pain is no longer reproduced while the patient performs a movement eliciting lumbar muscle contraction)
  • Aberrant movement when actively bending forwards and backwards, referred to as an “instability catch”, and the patient may perform “thigh climbing” when coming up.

 Is this the right intervention for me?

A person who meets at least three of the four criteria is 80% likely to report at least a 50% decrease in symptoms when a core stabilization program targeting both deep and superficial trunk muscles is utilized. What I find even more interesting is that when at least three of these factors are negative, the person is 86% likely to FAIL to improve with a stabilization program. If you currently have back pain and just can’t seem to get better no matter how strong you get, this may shed some light as to why! There is also an additional set of factors to identify women with pain who are postpartum and likely to benefit from a stabilization program.

For more information about classifications of low back pain, you can read the article here.

Call or e-mail CoreBalance Therapy to schedule an evaluation with a physical therapist so that we can determine the best approach for you!


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Treating Low Back Pain is Not One Size Fits All

By: admin Published: March 30, 2012

By Lauren Shafer PT, DPT

We have a significantly high incidence of low back pain (LBP) in our society, and it accounts for over 50% of complaints in a physical therapy office. There is a plethora of research investigating the most effective interventions for LBP, however, the evidence remains largely inconclusive on how to best treat it.

One proposed explanation for the lack of consistent evidence is that it is commonly treated as a homogenous condition, meaning, it is assumed all back pain is the same. Leading researchers in physical therapy are finding that all low back pain is not the same, and each person and episode needs to be evaluated and treated differently.

If you’ve been trying one approach to managing your back pain that doesn’t seem to be helping, there may be a reason why.

Currently, the literature suggests four subcategories of LBP, which all require a somewhat different approach to treatment. The four categories are: Manipulation, Stabilization, Specific Exercise and Traction. Thus far, the Manipulation category has been the most extensively researched, so I will begin here.

Manipulation is defined as a high-velocity low-amplitude thrust that is applied to the spine. Current studies show that a person who reports recent onset of symptoms (less than 16 days) and who does not have symptoms radiating past the knee is highly likely (95%) to have at least a 50% reduction in symptoms with manipulation. There is a slightly increased chance of success (97%) if that person also meets two other criteria involving hip mobility and low fear avoidance. When the specific factors are not present, the likelihood of success reduces to 9%.

What’s more, the evidence now suggests that treating an episode of back pain in that early 16 day window reduces the likelihood that a patient goes on to develop chronic lower back pain.  So please call or email us if you have an acute episode of back pain so we can get you on the right track quickly!

I’ll be posting blogs on the other treatment categories over the next few weeks, so please stay tuned!   And remember, no matter how long your back has been bothering you, there’s a lot that our expert physical therapists can do to help.

Call or e-mail CoreBalance to schedule an evaluation with a physical therapist so that we can determine the best approach for you!


[email protected]

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