Is a Weak Core Really the Villain in Low Back Pain?

Low back pain (LBP) is a common complaint among otherwise healthy adults, and most often it is not caused by direct trauma, but rather by overuse or misuse of the muscles that contribute to spinal stability.

During physical activity, the muscles of your core fire in a synchronized way to control the motion and position of your trunk, to maintain it over your legs and pelvis as your arms and legs move in various ways. In effect, the core forms a natural girdle or brace that supports and protects your spine as you move.

In the 1990s, research conducted by Hodges and Richardson (1996, 1998) indicated that dysfunction of the deep core muscles, particularly the transversus abdominis, may lead to inefficient stabilization of the spine. The physio and fitness communities ran with that information, and much ado was made about core stabilization training to both prevent and treat LBP.

Since the ‘90s, however, further research has emerged that fails to give credence to the notion that core strengthening exercises are the most effective treatment for LBP. In fact, a number of studies assert that core stabilization and strengthening exercises are no more effective than other types of physical activity for treating or preventing LBP.

That being said, the human body is made to move, and insufficient physical activity can lead to a number of imbalances and motor deficiencies that interfere with the efficient production, transfer and control of forces in your low back and pelvic region, and that in turn can lead to LBP.

Having a weak core may certainly be among the factors contributing to LBP, but it would be remiss to place all the blame on core dysfunction. After all, spinal stability and alignment can be affected by a number of things, including:

• Poor posture
• Lack of flexibility
• Tight hamstrings
• Poor respiratory patterns
• Low endurance of trunk extensors
• Excessive sitting
• Poor stabilization strategies
• Obesity

Taking a one-size-fits-all approach to treating LBP by zeroing in on core strength alone makes little sense, when multiple other factors might be at play.

Your nervous system coordinates posture, muscle activation, respiration, and other factors to produce efficient movement. Your muscles, joints, bones, connective tissue and nerves all work together to form a kinetic chain whose links are interdependent.

And we all know that a chain is only as strong as its weakest link.

A physical therapist can assess and analyze the way you move, and help pinpoint the factors that are most likely contributing to your LBP. They can then design a corrective exercise and treatment program to stretch, strengthen and stabilize your body to restore balance, relieve pain and promote optimal function.