Exercise still eases chronic low back pain after 60

Exercise is an established treatment for chronic low back pain, but the evidence has mostly been built in younger and middle-aged adults. Older people are comparatively neglected by this research despite being among those most affected, and the effect of exercise interventions in this group has been genuinely controversial. Age brings extra considerations too: frailty, safety and the question of which types of exercise are realistic. This review set out to compare how different forms of exercise therapy affect pain, disability, quality of life and mobility specifically in people aged 60 and over.

The researchers searched six databases, in English and Chinese, up to the end of December 2022 for randomised controlled trials of exercise interventions in people aged 60 or over with chronic low back pain. Sixteen articles covering 18 trials and 989 participants were included, with two reviewers independently extracting data and rating study quality using the revised Cochrane risk of bias tool. Outcomes covered pain on a visual analogue scale, disability on the Oswestry index, quality of life on the SF-36 survey and mobility via the timed up and go test.

Exercise therapy improved every headline outcome. Pain scores fell by 1.75 points on the visual analogue scale and disability dropped by 9.42 points on the Oswestry index. Quality of life rose on both fronts, by 7.07 points on the physical summary of the SF-36 and 7.88 points on the mental summary. The mobility result was less convincing: the timed up and go test improved by 0.92 seconds on average, but the range of plausible values crossed zero, so that benefit remains unconfirmed. Subgroup analysis pointed towards aerobic, strength and mind-body exercise, sustained over at least 12 weeks at three or more sessions weekly.

This pooled analysis extends what was already established in younger adults to a group the research had largely skipped, and it does so with studies the reviewers rated as relatively high quality. The improvements span not just pain but disability and mental wellbeing, which strengthens the case that exercise is a whole-person treatment rather than merely an analgesic. The unconfirmed mobility finding is the main loose end, and the authors call for more high-quality trials on both the SF-36 and timed up and go outcomes before those effects are settled.

If you or a parent are past 60 and assume a chronically sore back is simply the price of age, this evidence pushes back: structured exercise reduced pain and disability and lifted quality of life in exactly this age group. The pooled results favoured programmes combining aerobic work, strength training and mind-body approaches, kept up consistently for months rather than weeks. The findings describe supervised trial programmes, so they are a reason for optimism and a conversation with a professional rather than a plan in themselves.