Which physical activities and sports can be recommended to chronic low back pain patients after rehabilitation?

Background: Physical exercise is widely prescribed in rehabilitation programmes for low back pain (LBP). The LBP patient often asks whether this physical activity should be maintained and, in some cases, whether he/she should resume or take up a sport.

Purpose: To answer these two questions by performing a review of literature on the efficacy and safety of post-rehabilitation physical activities and sport in LBP.

Method: A systematic search of computerized databases from 1990 to 2011 was performed using grade 1 to 4 studies articles in English or French.

Results: Of the 2583 initially identified articles, 121 articles were analysed. Globally, physical activities like swimming, walking and cycling, practiced at moderate-intensity help to maintain fitness and control pain. Inconsistent results were found for avoiding recommendations according to the nature of PA. Sport activities, except ballgames, can be easily resume or take up as tennis, horse riding, martial arts, gymnastics, golf and running which can be performed at a lower intensity or lower competitive level.

Discussion and conclusion: Moderate but regular physical activity helps to improve fitness and does not increase the risk of acute pain in chronic LBP patients. The resumption of a sport may require a number of adaptations; dialogue between the therapist and the sports trainer is therefore recommended.