Blog Post

Brace For It!… Do We Actually Need Core Stability Exercises For Back Pain?

After decades of research and vigorous debate on the topic (in the physio world, at least), the answer to that question appears to be NO.

Now, it’s key to remember that this doesn’t mean training core muscles is not important. The devil is in the details, and I will attempt to explain some of this complex topic for you now.

The Role of Core Stabilisation Exercises

An extensive research review has concluded that core stabilisation exercises may improve low back pain symptoms but are not superior to any other form of general activity such as a simple walking program, in the long term. Moreover, increasing deeper core muscle activation in our attempts to get stronger or more stable may actually increase back pain in certain individuals.

Overactivity of Inner Core Muscles

Current research has highlighted that even the inner core, such as our corset muscle (transversus abdominus) and multifidus, are commonly OVER-active when reacting to pain and pathology. These little muscles can squeeze and compress back joints and nerves with a vice-like grip. Even when they are relatively weak, the fact that they can’t switch off properly when needed can lead to increased pain and a relentless compressed feeling in the low back.

The Impact of Compression on Healing

When the discs are already slightly swollen and sensitised, even light contractions can irritate them further. To some degree, the joint stiffness created by this vice grip mechanism is necessary for some stages of the injury and inflammation healing cycle. If a joint were allowed its full range of motion and activity levels, more damage or delayed healing might occur. This is often why some early exercises, over-stretching, deep tissue massage, and joint manipulation attempts can hinder more than help recovery.

Don’t always be in a hurry to attack your muscle “knots” and force joint range of motion!

Adjusting Your Approach

If we back off and adjust our approach for a short period, the body is able to address deeper spine inflammation and pathology (this may take days to weeks). As things settle, guarding muscles start to release their grip (without being forced) and we can gradually regain our normal joint range of motion and activity levels again.

The Verdict on Core Stability Exercises for Back Pain

What’s the take-home message?

Don’t feel bad if you choose not to focus on core exercises to address your back pain, and if you suspect they are not helping or even increasing your pain and discomfort, then immediately stop and discuss symptoms with your therapist or trainer.

Customising to the individual is vital, and Adam Physio Cairns can help guide you through the process, so you can get back to what you enjoy sooner.

Ryan Adam


1. Smith BE, Littlewood C, May S. An update of stabilisation exercises for low back pain: a systematic review with meta-analysis. BMC Musculoskelet Disord. 2014;15:416. http:// 44.

2. Brown, S.H., F.J. Vera-Garcia, and S.M. McGill, Effects of abdominal muscle coactivation on the externally preloaded trunk: variations in motor control and its effect on spine stability. Spine, 2006. 31(13): p. E387-93.

3. Marras, W.S., et al., Functional impairment as a predictor of spine loading. Spine, 2005. 30(7): p. 729-37.

4. Davis, K.G., et al., The impact of mental processing and pacing on spine loading: 2002 Volvo Award in biomechanics. Spine, 2002. 27(23): p. 2645-53.



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