Post-treatment exercises effective for prevention of recurrences of low-back pain

Clinical question: 
How effective are exercises for prevention of recurrences of low-back pain?
Bottom line: 
There was moderate quality evidence post-treatment exercises (provided to patients after their regular treatment for an episode of low-back pain had been finished) were more effective than no intervention for reducing the rate of recurrences at 1 year. There was moderate quality evidence from 2 studies that the number of recurrences was significantly reduced at 6 months to 2 years’ follow-up. There was very low quality evidence the days on sick leave were reduced by post-treatment exercises at 6 months to 2 years’ follow-up. There was conflicting evidence for the effectiveness of treatment exercise (exercise as part of treatment for a current episode of low-back pain with the aim to also prevent new episodes of low-back pain) in reducing the number of recurrences or the recurrence rate.
Caveat: 
Adverse effects of exercising were not mentioned in any of the studies. Limitations of this review include the difference in exercises used across studies, thus making it difficult to specify the content of such a programme to prevent low-back pain recurrences.
Context: 
Low-back pain is a common disorder that has a tendency to recur. Episodes of low-back pain can be very debilitating and impose a heavy burden of cost internationally.
Review CD#: 
CD006555
PEARLS No: 
254
Date: 
May, 2010
Authored by: 
Brian R McAvoy