The focus of this paper is to review literature around the use of core stabilization in treating low back pain. Specifically, the work explores studies reporting the efficiency of core stabilization in the treatment of low back pain. It begins off by giving a background to the topic of research. It reports that low back pain is a common problem because it affects about 5-15 per cent of the population and could be a cause to most forms of disability. The work also highlights the concept of core stabilization and reports on its usage in the mitigation of low back pain. It is reported that low back pain can be managed through core stabilization though there is not one study used in this review that reports the exact efficiency rate. However, efficiency in the reported pieces of literature is achieved by the comparison between core stabilization and traditional back exercise methods. It is noted that core stabilization can be used to effectively manage both low back pain and disability resulting from the same. In comparison, literature reports that as much as exercise is critical in rehabilitating from back injury, it is not proved to be useful in the management of disability.
Low Back Pain: What it is, Prevalence Rates and its Causes
Chronic low back pain relates to lower back pain, which is persistent for a period of more than twelve weeks (Wen-Dien, Hung-Yu and Ping-Tung, 2015). Low back pain is a major concern in the healthcare field as the prevalence in the recent years has gained much discussion. For instance, low back pain is the most commonly reported indication of orthopedic disease both in the US and Europe (Wen-Dien, Hung-Yu and Ping-Tung, 2015). Evidence in literature on the topic of low back pain indicates that it is one of the primary causes of permanent disability and absence from work (Wen-Dien, Hung-Yu and Ping-Tung, 2015). In the US, more than 50 per cent of the populace suffer from low back pain (Wen-Dien, Hung-Yu and Ping-Tung, 2015). It is also reported that approximately 5-15 of people will experience chronic low back pain problems during their lifetime (Kumar et al., 2015)
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Low back pain affects the core muscles; these are the primary muscles involved in the maintenance of spinal disability. These muscles are categorized into two in relation to their attributes and stability (Wen-Dien, Hung-Yu and Ping-Tung, 2015). The first category is referred to as the deep core muscles otherwise called the local stabilizing muscles and the second group is called shallow core muscles (Wen-Dien, Hung-Yu and Ping-Tung, 2015). When these core muscles function properly, they ensure the control of segmental stability, reduction of stress that impacts the lumbar vertebrae and the intervertebral discs and protection of the spine. Several causes of low back pain are in existence, some of which are unknown. However, one of the major causes of the problem is the weakening of abdominal muscles and the shallow trunk.
Efficiency of Core Stabilization in Dealing with Low Back Pain
Dealing with the problem of low back pain, therefore, entails the strengthening of the muscles and one such way is core stabilization (Wen-Dien, Hung-Yu and Ping-Tung, 2015; Nandi et al., 2016; Lew, 2013). Core strength training is a method which attempts to train the muscles of the deep trunk. The topic of core stabilization or strengthening is a hot topic of discussion because many people experience some sort of low back pain daily. Core stabilization is widely reputed as having the ability to help reduce and sometimes eliminate back pain for many of those who suffer from it. However, the main challenge to the use of core stabilization is that independent training for people suffering from low back pain is quite problematic. This conclusion is drawn from the fact that numerous strategies are in existence for core stabilization (Lew, 2013). It is also reported that a standardized system for the analysis and comparison of outcomes of core stabilization techniques is yet to be developed. Therefore, it still remains a mystery about the effectiveness of using core stabilization in curing low back pain.
Literature on the effectiveness of core stabilization in the treatment of low back pain is consistent in reporting that core stabilization is effective in dealing with low back pain. For example, Nandi et al. (2016) reports that core stabilization programs have a significant effect in the reduction of disability, pain and in the improvement of functional status in people suffering from non-specific low back pain in comparison to traditional spinal exercises. About the effectiveness of the stabilization techniques in comparison to conventional spinal exercises, it is reported that taking stabilization exercises consistently for a period of four weeks produces a beneficial effect on population of people with low back pain (Inani and Selkar, 2013).
It is also reported that the treatment of people who suffer from low back pain with extended rest periods raises the disability and that treating them with high levels of activity reduces the levels of disability (Inani and Selkar, 2013). This finding is consistent with another one, which considers that the absence of activity or exercise could be a critical pre-disposing factor to injury of the spine (Inani and Selkar, 2013). It is posited that activity helps in healing and that it should be encouraged for the fact that its effect is to accelerate the pumping of fluid to circulate around the body (Inani and Selkar, 2013). This happening is considered useful in improving the homeostasis of nervous system, intervertebral discs, cartilage and muscles. With this piece of finding, Inani and Selkar (2013) concludes that exercise (which includes core stabilization) is fundamental to the rehabilitation from back injuries as well as management of low back pain.
Another study reporting the effectiveness of core training on the management of low back pain gives a slightly different perspective. George et al. (2005) (cited in Inani and Selkar, 2013) reports that having trunk exercise alone produces more desirable results for people suffering from recurrence of non-specific sub-acute or chronic episodes of low back pain but with no symptoms of disability or overt signs. However, one of the limitations of this study is that as much as exercise was prescribed within the framework of biochemistry, the researchers failed to a strictly adopt strategies of effective delivery of exercise.
The present research has explored the problem of low back pain including its rates of prevalence, the causes and how it can be managed. However, the focus of the study has been core stabilization but not other methods of management of low back pain. Literature reports that core stabilization is effective in the mitigation of low back pain, the improvement of the functional status of patients and the reduction of stability of people with low back pain problems when compared to the traditional back exercises. Both previous and the presented studies do not report the exact rates of efficiency of core stabilization, but only compare the outcomes in patients where core stabilization was used and in which conventional back exercises were used. However, it is noted that most of the studies on the topic used relatively small samples of respondents, which makes such findings to be further researched.
Inani, S. B., & Selkar, S. P. (2013). Effect of core stabilization exercises versus conventional exercises on pain and functional status in patients with non-specific low back pain: A randomized clinical trial. Journal of Back &Musculoskeletal Rehabilitation, 26 (1), 37-43.
Kumar, T., Kumar, S., Nezamuddin, M., & Sharma, V. P. (2015). Efficacy of core muscle strengthening exercise in chronic low back pain patients. Journal of Back & Musculoskeletal Rehabilitation, 28 (4), 699-707
Lew, M. (2013). Core Stabilization for Low-Back Pain. Journal of the American Chiropractic Association, 50 (2), 8-14.
Nandi, B., Muthiyalu, A., Yeole, U., Gawali, P., & Adkitte, R. (2016). Effect of Segmental Stabilization Exercises in Mechanical Low Back Pain. Indian Journal Of Physiotherapy & Occupational Therapy, 10 (2), 49-53.
Wen-Dien, C., Hung-Yu, L., & Ping-Tung, L. (2015). Core strength training for patients with chronic low back pain. Journal of Physical Therapy Science, 27 (3), 619-622. doi:10.1589/jpts.27.619