Expert opinion and controversies in musculoskeletal and sports medicine: core stabilization as a treatment for low back pain.

Abstract

Although there are a wide variety of therapeutic exercises that have been proposed as treatments for low back pain (LBP), the last 20 years have seen the development of a substantial focus on the use of exercises that are intended to address intersegmental stability in the lumbar spine. These exercise programs are varyingly referred to as lumbar stabilization, segmental stabilization, or core stabilization, among other terms, and are aimed at improving the neuromuscular control, strength, and endurance of a number of muscles in the trunk and pelvic floor that are believed to play important roles in the dynamic stability of the spine. Although it is difficult to quantify, there appears to have been a tremendous degree of penetration of these treatment concepts into the therapeutic arena, the medical literature, and the lay press. Despite this, there are few prospective studies on patients with LBP, and there is even more limited discussion of the concepts of patient selection, dose-response, and long-term outcome associated with these approaches. There also is a significant lack of uniformity regarding the meaning of "core stabilization" and what therapeutic exercises may be most effective.