Therapeutic exercise in the treatment of chronic lower back pain: a review of literature

Chronic lower back pain is highly prevalent, generating relevant social costs. Exercise therapy is a type of conservative treatment widely used in various application forms. Therefore, the objective of this study was to review the literature of therapeutic exercise approaches in populations with chronic low back pain. A literature review between 2005 and 2010 in MEDLINE, LILACS, SciELO, Cochrane and the directory of CAPES. 24 studies were found divided into three categories. General therapeutic exercises that include training for flexibility, aerobic or for strengthening; this proves to be more effective than aerobics, but not superior to the multidisciplinary approach. Exercises of segmental stabilization for the spine that prioritize the activation of the transversal abdominal muscles, multifidus and internal oblique; these are more effective than minimal intervention techniques to reduce pain in the short, medium and long term and improve functional capacity over the long term; more than manual therapy for pain relief, functional capacity and quality of life in the medium term, than other forms of exercise in reducing disability in the short term. Other forms of therapeutic exercise, namely: Pilates, Yoga, Alexander Technique, Swiss Ball, Isostretching, Global Posture Reeducation, Mckenzie and proprioceptive neuromuscular facilitation, each one described with positive results for at least one study. The application of therapeutic exercise has been described in the literature by a wide variety of techniques. The review showed that there are still conflicts in the results, preventing the conclusion about the superiority of one program over another. However, lower back pain usually has a multifactorial etiology and that requires extending the knowledge of the various modalities of therapeutic exercise so that in clinical practice there are more chances of success.