Effect of exercise interventions on clinical outcomes in patients with chronic low back pain and central sensitisation: A randomized controlled trial

J Bodyw Mov Ther. 2026 Jul;47:495-507. doi: 10.1016/j.jbmt.2026.04.024. Epub 2026 May 8.

ABSTRACT

INTRODUCTION: Exercise may reduce pain and central nervous system sensitivity by activating endogenous analgesia and spinal inhibitory mechanisms. This study examined the effects of different exercises against patient education on pain sensitivity and clinical outcomes in patients with chronic low back pain (CLBP) and central sensitisation.

METHODS: The study population included 172 central sensitisation-positive CLBP patients who were randomised to receive aerobic exercise, motor control exercises, muscle-strengthening exercises, and patient education. Forty-three healthy volunteers served as controls. The outcomes included changes in pressure pain threshold from the cold pressor test [CPT], pain intensity, disability, the letter-number sequencing subtest, the Stroop neuropsychology test, quality of life [QOL}, and isometric muscular strength of the spine and hips, which were evaluated at baseline [T0], after the 12-week intervention [T1], and 3 months after the completion of treatment [T2].

RESULTS: Compared to the healthy volunteers, the patients with CLBP showed lower conditioned pain modulation [CPM] as measured by the CPT [p < 0.05]. Post-measurement readings revealed improvements over time [p < 0.05] and no differences between experimental groups [p > 0.05] in improving pain intensity, disability, QOL, and isometric muscular strength. The effect sizes between the treatment groups were small.

CONCLUSIONS: All the exercises evaluated were able to improve clinical outcomes, despite minimal improvement in pain modulation compared to healthy volunteers. There was however no differences between the various interventions studied.

PMID:42264831 | DOI:10.1016/j.jbmt.2026.04.024