Ten Minutes of Core Stabilisation Exercise Result in Local Exercise-Induced Hypoalgesia in Patients With Chronic Unspecific Low Back Pain.

Background: Core stabilisation training is known to be effective in managing pain in patients suffering from chronic low back pain (CLBP). Yet, acute effects of core stabilisation exercise on exercise-induced hypoalgesia (EIH) are largely unknown. This study aimed to examine the EIH effects of an easy-to-perform core stabilisation exercise in CLBP patients and to explore associations between EIH and potential influencing factors (i.e., physical activity, catastrophizing, kinesiophobia, subjective pain state and exercise exertion).
Methods: Thirty patients with unspecific CLBP finished this randomised controlled crossover trial. Patients performed a 10-min isometric core stabilisation exercise and a 10-min control session. Before and after, pain sensitivity was measured via pressure pain thresholds [Newton/cm ² ] locally (low back; PPT _local ) and remotely (forehead, thumb; PPT _remote ). Correlation analyses were performed between EIH and influencing factors.
Results: A 'Time' × 'Intervention' interaction (p < 0.001) was observed for PPT _local with post hoc analysis revealing higher values post exercise (p < 0.001; pre: 56.6 ± 20.6, post: 67.5 ± 26.1). No differences were observed for the control session (p = 0.894; pre: 58.5 ± 24.0, post: 58.4 ± 23.3). No such effect was observed for PPT _remote (p = 0.014). Post hoc analyses showed no differences following the exercise session (p = 0.103; pre: 41.3 ± 12.5, post: 42.5 ± 13.6), while lower PPT _remote post values were observed post control compared to pre values (p = 0.031; 42.5 ± 14.5, post: 41.3 ± 13.7). The only significant moderate correlation was observed between ΔPPT _local of the exercise session and catastrophizing with rho = -0.381.
Conclusion: A 10-min isometric core stabilisation exercise results in local lumbar EIH, while no systemic effects are observed. A higher degree of catastrophizing is associated with lower hypoalgesic responses.
Significance: This study shows for the first time that a brief and easy-to-perform 10-min core stabilisation exercise produces significant local pain relief (EIH) in patients with unspecific CLBP. The effect is localised to the lumbar region, with no observed impact on remote sites. Higher pain catastrophizing seems to be linked to reduced hypoalgesic response. These findings support the use of short core stabilisation exercises as an effective, immediate, non-pharmacological pain management strategy for these patients.
(© 2025 The Author(s). European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation ‐ EFIC ®.)