Background

Chronic low back pain is a common health problem and one of the leading causes of disability worldwide. It can significantly affect physical function, quality of life, and participation in daily activities. Therefore, effective and accessible treatment approaches are important in physiotherapy. (WHO 2023.)

Exercise therapy is an important part of physiotherapy for chronic low back pain and current guidelines recommend exercise-based interventions as part of management (WHO 2023). Strength training may be particularly useful because it can improve muscle strength, physical function, and confidence in movement while potentially reducing pain. Recent research suggests that resistance training can improve pain and disability in people with chronic low back pain. (Rodríguez-Domínguez et al. 2026.) However, it is still unclear whether strength training is more effective than other forms of exercise (Ranzani et al. 2025).

Strength training may also be a practical treatment option because exercises can be adapted to the individual’s abilities and progress over time. For physiotherapists, understanding the effects of strength training can help in planning safe and effective rehabilitation programmers for people with chronic low back pain. Therefore, this mini literature review examines whether strength training can help reduce pain and improve physical function in people with chronic low back pain. Based on three randomized controlled trials, this blog post looks at the effects of strength training on chronic non-specific low back pain in working-age adults.

This article was prepared within the Professional in Physiotherapy course included in the physiotherapy degree programme. The article represents students’ work completed as part of the evidence-based physiotherapy component of the course. During the course, students work collaboratively in small groups to practice the key stages of a systematic review process by conducting a mini review. This includes systematic literature searching, critical appraisal using the PEDro scale (n.d.), data synthesis, and reporting the findings in the form of a scientific manuscript.

Methods

The research question was structured using the PICO framework. The population (P) consisted of working-age adults with chronic non-specific low back pain. The intervention (I) was strength or resistance training, the comparison (C) was other exercise or usual care, and the outcomes (O) were pain and physical function.

The literature search was conducted in the PubMed database. The search terms included chronic low back pain, non-specific low back pain, strength training, resistance training, pain, disability, physical function, and randomized controlled trial. The terms were combined using the Boolean operators AND and OR.

Studies were included if they were randomized controlled trials involving working-age adults with chronic non-specific low back pain and investigated strength or resistance training. The studies also had to measure pain and/or physical function. Studies were excluded if they focused on acute or specific low back pain, children, non-randomized study designs, or interventions without strength or resistance training. After the screening process, three randomized controlled trials were included in the final review. The methodological quality of the studies was assessed using the PEDro Scale (n.d.).

Results

Overall, the results suggest that strength training can improve physical function and muscle strength in people with chronic non-specific low back pain. Improvements were also observed in areas such as core endurance, lumbar extensor strength and fear of movement. However, the effects on pain were less consistent. Some of the included studies reported significant improvements in pain, while others did not find a significant difference compared with the control intervention.

The quality assessment showed PEDro scores ranging from 5/10 to 7/10, indicating varying methodological quality among the included studies. The studies received points for several criteria, including randomization, allocation concealment, baseline comparability, statistical comparisons and reporting of results. Because the studies used different strength training programmes and had relatively small sample sizes, the results cannot be directly generalized to all people with chronic low back pain.

Summary

Based on the included studies, strength training appears to be a useful physiotherapy intervention for improving physical function and muscle strength in people with chronic non-specific low back pain. However, its effect on pain is still unclear, as the findings were inconsistent. The differences in training programmes and the relatively small sample sizes limit the strength of the conclusions. Therefore, larger and longer-term randomized controlled trials are needed to determine the effects of strength training on pain and functional ability more reliably.

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Authors

Anniina Rantala, Degree Programme in Physiotherapy, Savonia University of Applied Sciences

Nina Åman-Karjunen, Degree Programme in Physiotherapy, Savonia University of Applied Sciences

Silja Syrjälä, Degree Programme in Physiotherapy, Savonia University of Applied Sciences

Marja Äijö PhD, Principal lecturer of gerontology and rehabilitation, Savonia University of Applied Sciences

This article was prepared with the help of AI.

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References

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PEDro. (n.d.). PEDro scale. PEDro – PEDro scale. In available: https://pedro.org.au/english/resources/pedro-scale/ Accessed: 9.9.2026

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Ranzani, M., Pozzi, A., Fornasari, D., Ristori, D., & Testa, M. 2025. Is resistance training with external loads superior to unloaded exercise in the management of chronic low back pain? A systematic review and meta-analysis. Archives of Physiotherapy, 15, 297–313. https://doi.org/10.33393/aop.2025.3533. Accessed 6.10.2026

Rodríguez-Domínguez, Á.-J., Moral-Muñoz, J. A., Guzmán-Gómez, J.-D., Valero-Ortiz, J., González-Gómez, L., & Cardellat-González, M. 2026. Does resistance training improve pain intensity, quality of life, and disability in people with chronic nonspecific low back pain? A systematic review and meta-analysis. Disability and Rehabilitation, 48(6), 1532–1545. https://doi.org/10.1080/09638288.2025.2566275. Accessed 6.10.2026.

Sertpoyraz, F., Eyigor, S., Karapolat, H., Capaci, K., & Kirazli, Y. (2009). Comparison of isokinetic exercise versus standard exercise training in patients with chronic low back pain: A randomized controlled study. Clinical Rehabilitation, 23(3), 238–247. https://doi.org/10.1177/0269215508099862. Accessed 6.10.2026.

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WHO 2023. WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings. Updated 7.12.2023. https://www.who.int/publications/i/item/9789240081789. Accessed 6.10.2026.