Effects of Physical Exercise on Low Back Pain and Cortisol Levels: A Systematic Review with Meta-Analysis of Randomized Controlled Trials

Abstract

Aim: To verify the effects of physical exercise on low back pain (LBP) and serum cortisol levels in individuals with chronic LBP. Materials & methods: Randomized controlled trials evaluating the effects of exercise on LBP perception and cortisol levels in adults with nonspecific chronic LBP were included. Results: Four randomized controlled trials were included, with a total of 85 participants in the exercise group and 84 in the control group. The interventions reduced -1.61 (95% CI: -2.36 to -0.85) with inconsistency I² = 72% (p = 0.031) the LBP level and increased 1.05 (95% CI: 0.22–2.32) with inconsistency I² = 86% (p < 0.0001) the cortisol levels. Conclusion: The practice of physical exercise for 6 weeks or more reduced LBP levels, whereas the rate of progression of an exercise-training program in people with chronic LBP is greater than 4 weeks, but increased the cortisol serum levels in individuals with LBP.

Keywords::

• chronic pain
• cortisol
• exercise
• low back pain
• pain perception
• physiological stress
• rehabilitation
• spine

Author contributions

Each author contributed individually and significantly to the development of the manuscript. AOB Santos contributed in writing, intellectual concept and preparation of the entire research project, and final approval of the manuscript version to be published. JBP Castro contributed in writing, data analysis, formatting and final approval of manuscript version to be published. VP Lima contributed in writing, data analysis and final approval of manuscript version to be published. EB Silva contributed in writing, data analysis, interpretation of data for the paper, review and final approval of the manuscript version to be published. RGS Vale contributed in writing, data analysis, review and final approval of the manuscript version to be published.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.