The Role of Physical Activity in the Prevention and Management of Chronic Low Back Pain: A Health Education and Sport Science Perspective
DOI:
https://doi.org/10.12775/QS.2026.56.71985Keywords
chronic low back pain, physical activity, health education, sports science, core stabilization, health promotion, kinesiophobiaAbstract
Introduction: Chronic low back pain (CLBP) remains a critical challenge for public health and physical culture, significantly impacting quality of life and generating substantial healthcare costs. In the context of health education, a sedentary lifestyle is identified as a primary modifiable risk factor that requires targeted movement-based interventions.
Objective: This review aims to synthesize current evidence on the role of physical activity in both the prevention and management of CLBP. Particular emphasis is placed on the physiological mechanisms of exercise and the pedagogical effectiveness of various sports-related interventions.
Methods and Materials: A narrative review was conducted based on literature published between 2006 and 2026. The analysis included cohort studies, randomized controlled trials (RCTs), and meta-analyses focusing on diverse modalities, including core stabilization, aerobic training, Pilates, yoga, and aquatic exercises.
Results: Regular engagement in physical activity effectively reduces the risk of CLBP occurrence and recurrence by enhancing muscular endurance, spinal stability, and neurobiological pain modulation. Notably, the review finds that interventions integrating physical exercise with health education (e.g., postural awareness and movement ergonomics) yield superior outcomes in reducing kinesiophobia (fear of movement) and functional disability compared to exercise alone.
Conclusions: Physical activity should be promoted as a primary health-seeking behavior in CLBP care. To optimize public health outcomes, individually tailored exercise programs should be integrated with educational strategies, positioning sport and physical culture as essential components of modern spinal health management.
References
1. Zhang, C., Lv, B., Yi, Q., Qiu, G., & Wu, F. (2025). Global, regional, and national burden of low back pain in working-age population from 1990 to 2021 and projections for 2050. Frontiers in public health, 13, 1559355. https://doi.org/10.3389/fpubh.2025.1559355
2. Margetis K, Singh C, Casiano VE, et al. Low Back Pain: Evaluation and Management. [Updated 2025 Dec 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538173/
3. Koes, B. W., van Tulder, M. W., & Thomas, S. (2006). Diagnosis and treatment of low back pain. BMJ (Clinical research ed.), 332(7555), 1430–1434. https://doi.org/10.1136/bmj.332.7555.1430
4. Steven J Linton, Ida K Flink, Johan W S Vlaeyen, Understanding the Etiology of Chronic Pain From a Psychological Perspective, Physical Therapy, Volume 98, Issue 5, May 2018, Pages 315–324, https://doi.org/10.1093/ptj/pzy027
5. Matheve, T., Hodges, P., & Danneels, L. (2023). The Role of Back Muscle Dysfunctions in Chronic Low Back Pain: State-of-the-Art and Clinical Implications. Journal of clinical medicine, 12(17), 5510. https://doi.org/10.3390/jcm12175510
6. Low back pain. (b. d.). World Health Organization (WHO). https://www.who.int/news-room/fact-sheets/detail/low-back-pain
7. Chang, D., Lui, A., Matsoyan, A., Safaee, M. M., Aryan, H., & Ames, C. (2024). Comparative Review of the Socioeconomic Burden of Lower Back Pain in the United States and Globally. Neurospine, 21(2), 487–501. https://doi.org/10.14245/ns.2448372.186
8. Szyszka, J., Matuska, J., Szyszka, B. G., Walkowiak, D., & Skorupska, E. (2025). The Economic Analysis of the Overlooked Recurrent Low Back Pain: Three Years Retrospective Observational Study. Journal of pain research, 18, 61–71. https://doi.org/10.2147/JPR.S489806
9. GBD 2021 Low Back Pain Collaborators (2023). Global, regional, and national burden of low back pain, 1990-2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. The Lancet. Rheumatology, 5(6), e316–e329. https://doi.org/10.1016/S2665-9913(23)00098-X
10. Jiang, X., Tang, L., Zhang, Y., Bai, Y., Luo, H., Wang, R., Bi, X., Chen, R., & Wang, X. (2024). Does sedentary time and physical activity predict chronic back pain and morphological brain changes? A UK biobank cohort study in 33,402 participants. BMC public health, 24(1), 2685. https://doi.org/10.1186/s12889-024-20188-3
11. Liu, S., Reitmaier, S., Mödl, L., Yang, D., Zhang, T., Becker, L., Hoehl, B., Schönnagel, L., Diekhoff, T., Pumberger, M., & Schmidt, H. (2025). Quality of lumbar paraspinal muscles in patients with chronic low back pain and its relationship to pain duration, pain intensity, and quality of life. European radiology, 35(6), 3652–3660. https://doi.org/10.1007/s00330-024-11236-y
12. Ekşi, M. Ş., & Özcan-Ekşi, E. E. (2024). Fatty infiltration of the erector spinae at the upper lumbar spine could be a landmark for low back pain. Pain practice : the official journal of World Institute of Pain, 24(2), 278–287. https://doi.org/10.1111/papr.13302
13. Lis, A. M., Black, K. M., Korn, H., & Nordin, M. (2007). Association between sitting and occupational LBP. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 16(2), 283–298. https://doi.org/10.1007/s00586-006-0143-7
14. Smrcina, Z., Woelfel, S., & Burcal, C. (2022). A Systematic Review of the Effectiveness of Core Stability Exercises in Patients with Non-Specific Low Back Pain. International journal of sports physical therapy, 17(5), 766–774. https://doi.org/10.26603/001c.37251
15. Frizziero, A., Pellizzon, G., Vittadini, F., Bigliardi, D., & Costantino, C. (2021). Efficacy of Core Stability in Non-Specific Chronic Low Back Pain. Journal of functional morphology and kinesiology, 6(2), 37. https://doi.org/10.3390/jfmk6020037
16. Gordon, R., & Bloxham, S. (2016). A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare, 4(2), 22. https://doi.org/10.3390/healthcare4020022
17. Tottoli, C. R., Ben, Â. J., da Silva, E. N., Bosmans, J. E., van Tulder, M., & Carregaro, R. L. (2024). Effectiveness of Pilates compared with home-based exercises in individuals with chronic non-specific low back pain: Randomised controlled trial. Clinical rehabilitation, 38(11), 1495–1505. https://doi.org/10.1177/02692155241277041
18. Yu, Z., Yin, Y., Wang, J., Zhang, X., Cai, H., & Peng, F. (2023). Efficacy of Pilates on Pain, Functional Disorders and Quality of Life in Patients with Chronic Low Back Pain: A Systematic Review and Meta-Analysis. International journal of environmental research and public health, 20(4), 2850. https://doi.org/10.3390/ijerph20042850
19. Holtzman, S., & Beggs, R. T. (2013). Yoga for chronic low back pain: a meta-analysis of randomized controlled trials. Pain research & management, 18(5), 267–272. https://doi.org/10.1155/2013/105919
20. Sahu, S., Dhanasekaran, R., Chakravarthi, M., & Bhavanani, A. B. (2025). Effect of Yoga Therapy in Chronic Discogenic Low Back Pain. Journal of pharmacy & bioallied sciences, 17(Suppl 2), S1377–S1379. https://doi.org/10.4103/jpbs.jpbs_126_25
21. Shi, Z., Zhou, H., Lu, L., Pan, B., Wei, Z., Yao, X., Kang, Y., Liu, L., & Feng, S. (2018). Aquatic Exercises in the Treatment of Low Back Pain: A Systematic Review of the Literature and Meta-Analysis of Eight Studies. American journal of physical medicine & rehabilitation, 97(2), 116–122. https://doi.org/10.1097/PHM.0000000000000801
22. Wareham, D., Fuller, J., Graham, P., Doyle, E., & Hancock, M. (2026). The immediate effect of swimming stroke on pain in people with chronic low back pain: a crossover study. Annals of Physical and Rehabilitation Medicine, 69(1), 102030. https://doi.org/10.1016/j.rehab.2025.102030
23. Hernandez-Lucas, P., Leirós-Rodríguez, R., Lopez-Barreiro, J., & García-Soidán, J. L. (2024). Prevention of non-specific back pain through exercise and education: A systematic review and meta-analysis. Journal of back and musculoskeletal rehabilitation, 37(3), 585–598. https://doi.org/10.3233/BMR-230252
24. Peng, M. S., Wang, R., Wang, Y. Z., Chen, C. C., Wang, J., Liu, X. C., Song, G., Guo, J. B., Chen, P. J., & Wang, X. Q. (2022). Efficacy of Therapeutic Aquatic Exercise vs Physical Therapy Modalities for Patients With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA network open, 5(1), e2142069. https://doi.org/10.1001/jamanetworkopen.2021.42069
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Izabela Sieradzka, Katarzyna Wajda , Justyna Słowik
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 60
Number of citations: 0
