Home›Rheumatology› Meta-analysis of core muscle training for chronic non-specific low back pain shows low-quality evidence of benefit
Meta-analysis of core muscle training for chronic non-specific low back pain shows low-quality evidence of benefitCore muscle training may help reduce pain and disability in chronic low back pain patients
Frontiers in MedicinePublished April 20, 2026DOI ↗Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease
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Key Takeaway
Note low-quality evidence supporting core training for chronic low back pain pain and function.
This systematic review and meta-analysis examined the efficacy of core muscle training, either alone or combined with other therapies, for individuals with chronic non-specific low back pain. The analysis pooled data from 15 randomized controlled trials to assess impacts on pain intensity and disability scores. The study setting was not reported, and follow-up duration was not reported for the overall synthesis.
Key findings indicated that core training significantly improved pain, with a standardized mean difference (SMD) of -0.56 (95% CI: -1.08 to -0.03). Function also improved significantly, showing an SMD of -0.81 (95% CI: -1.38 to -0.25). In a subgroup analysis, combined interventions significantly improved function with an SMD of -0.96 (P = 0.002). Additionally, intervention durations of ≥ 8 weeks were associated with more pronounced analgesic effects, though specific effect sizes for this duration were not reported.
The authors noted significant limitations, including risk of bias and high heterogeneity among the included trials. Safety data, such as adverse events or tolerability, were not reported. Consequently, the overall quality of evidence was rated as low. These methodological constraints suggest that the observed benefits, while statistically significant, require cautious interpretation.
Regarding practice relevance, the authors recommend that clinical decisions regarding training modality selection should be individualized based on the patient’s primary treatment goal. Due to the low quality rating and lack of reported adverse events, clinicians should not infer causality beyond the reported associations or overstate the evidence strength.
Researchers conducted a systematic review and meta-analysis to evaluate the effects of core muscle training for chronic non-specific low back pain. The analysis combined data from 15 randomized controlled trials involving individuals with this common condition. The goal was to see if strengthening core muscles could reduce pain intensity and disability scores.
The study found that core training led to significant improvements in both pain and function. When core exercises were combined with other therapies, the improvement in function was even more pronounced. Additionally, longer intervention durations of at least eight weeks were associated with stronger pain-relieving effects.
No adverse events or safety concerns were reported in the included studies. However, the overall quality of evidence was rated as low because of a high risk of bias and significant differences between the studies. Readers should understand that clinical decisions regarding training modality selection should be individualized based on the patient’s primary treatment goal.
What this means for you:
Core training may help pain and function, but evidence quality is low; individualize treatment goals.
ObjectiveTo systematically evaluate and compare the relative effectiveness of different core muscle training modalities in alleviating pain and improving function in individuals with chronic non-specific low back pain (CNLBP).MethodsChinese and English language databases were systematically searched for randomized controlled trials involving individuals with CNLBP. Intervention groups received core training either alone or combined with other therapies, while control groups received usual rehabilitation or other exercise interventions. Primary outcomes were pain intensity and disability scores. Risk of bias was assessed using the Cochrane RoB 2.0 tool. A random-effects meta-analysis was performed using RevMan 5.4 software, with subgroup analyses conducted to examine the moderating effects of intervention type and intervention duration. Forest plots and funnel plots were generated using MATLAB-R2024.ResultsFifteen randomized controlled trialswere included. Meta-analysis revealed that core training significantly improved pain (SMD = –0.56, 95% CI: –1.08 to –0.03) and function (SMD = –0.81, 95% CI: –1.38 to –0.25). subgroup analyses indicated that combined interventions significantly improved function (SMD = –0.96, P = 0.002), although the test for subgroup differences between combined and single-modality interventions was not statistically significant (P = 0.96), and intervention durations of ≥ 8 weeks were associated with more pronounced analgesic effects. The overall quality of evidence was rated as “low,” primarily due to risk of bias and high heterogeneity.ConclusionCurrent direct comparative evidence suggests that augmenting core training with additional rehabilitative components may confer greater benefits for functional improvement, while extending the intervention duration beyond eight weeks may optimize pain relief. Clinical decisions regarding training modality selection should be individualized based on the patient’s primary treatment goal. Further high-quality research is warranted to strengthen the evidence base for comparisons between specific training modalities.Systematic review registration[https://www.crd.york.ac.uk/PROSPERO/view/CRD420251031252], identifier [CRD420251031252].
