Is Core Strength Really Enough For Back Pain?
Is core strengthening really the solution for low back pain?
It’s advice that seems to be mentioned everywhere…”Got back pain? You need core strength.”
Is developing abs of steel really the solution for eliminating your suffering? Unfortunately it is never that easy. Although it can be beneficial, hitting the gym to strengthen your core is not a magic bullet for back pain. Before you assume your friend’s back pain is due to their weak abs, remember that the causes and treatment of back pain, either acute or chronic, may be much more complicated.
Reviewing the Research on Low Back Pain and Core Strength
A review of the current research does not prove that core strengthening is the cure. In fact it shows that while general exercise is good for back pain, core strengthening alone is not the solution. One study found in the Journal of Physiotherapy, found that chronic low back pain patients were unaffected by eight weeks of core stability training (1). In another, published in the Australian Journal of Physiotherapy, core strengthening was no more effective than walking for exercise (2). Finally, in a review of randomized control trials, published in Clinical Rehabilitation, it was found to be helpful, but no more effective than other physiotherapy interventions (3). There is value in core strengthening exercises, and anyone with back pain would do well to implement it into their routine, but low back pain is not synonymous with a weak core.
Why Strengthening Alone May Not Be Enough
Causes of low back pain can vary, so proper diagnosis is important. Excluding metabolic disorders, organ dysfunction, and psychological factors, there are many musculo-skeletal issues to consider. Structural variations are very common, including leg length inequality, scoliosis and abnormal frontal curvature, and hypo or hyper lordotic curvature (4). Core strengthening cannot correct these structural variations. This is a key concept. You cannot build a house on a bad foundation. Strengthening the walls of that house will not fix the bad foundation. Neither can strengthening your core fix an abnormal spinal structure.
The Need For Structural Correction
Since abnormal spinal structure is a key cause of low back pain, the logical conclusion is that correcting the structure will eliminate that pain. How then is correction achieved? Physical therapy that emphasizes core strengthening will always fall short as you can’t strengthen a spine on a faulty foundation. Standard chiropractic adjustments, although very beneficial, also falls short as they are not able to create long term changes to the ligaments of the spine. Structural or postural correction actually offers a unique solution. It offers a method to actually remodel the spine, shore up leg length inequalities, and create lasting correction of structural changes (5). Patients who have not had success with other therapies, including physical therapy and chiropractic, often do very well with this spinal remodeling method.
If you or someone you know suffers from low back pain, getting a comprehensive structural exam by a doctor of chiropractic who specializes in structural/postural correction techniques is highly recommended. Here at Limitless Health Chiropractic, we make sure our patients have a comprehensive understanding of the changes to their structure, and create a plan on how to correct those imbalances.
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1. J Physiother. 2012;58(3):200. doi: 10.1016/S1836-9553(12)70114-5. “Abdominal muscle feedforward activation in patients with chronic low back pain is largely unaffected by 8 weeks of core stability training.”
2. Aust J Physiother. 2009;55(2):138. “Do lumbar stabilising exercises reduce pain and disability in patients with recurrent low back pain?”
3. Clin Rehabil. 2006 Jul;20(7):553-67. “Segmental stabilizing exercises and low back pain. What is the evidence? A systematic review of randomized controlled trials.”
4. Spine (Phila Pa 1976). 1983 Sep;8(6):643-51. “Clinical symptoms and biomechanics of lumbar spine and hip joint in leg length inequality.”
5. J Can Chiropr Assoc. 2005 Dec;49(4):270-96. “Evidence-based protocol for structural rehabilitation of the spine and posture: review of clinical biomechanics of posture (CBP) publications.”