In this study, physiotherapists assess the benefit of neutral zone (NZ) exercises to prevent low back pain. Exercises to preserve the NZ of lumbar motion keep the natural low back curve during movement and function. The natural curve is similar to the spine's position when in the upright or standing position.

Two groups of middle-aged, working men were included. All men had a recent episode of low back pain (LBP). The men were divided into two groups. One group (the training group or TG) did 10 exercises twice a week for 12 months. The exercises were designed to improve movement patterns of the spine. The goal was to get better control of the NZ and improve spinal stability.

The men in the second (control) group were told to continue with their usual activities. They did this for 12 months. Afterwards, they were invited to do the training exercises, too.

Results from both groups at the end of one-year were measured by any change in their level of pain and fitness. Potential for return to work (RTW) and level of disability were also measured.

The authors report pain intensity decreased much more for men in the TG. Negative thinking about RTW decreased in both groups. More men in the TG improved in this area compared to the control group. Most of the men in the TG did the exercises for the first six months. After that, compliance was much less.

The authors conclude that NZ exercises decrease pain intensity by unloading the spine. Controlling the lumbar spine in the NZ during daily activities is a valuable tool in preventing future episodes of LBP.

Jaana Suni, PT, PhD, et al. Control of the Lumbar Neutral Zone Decreases Low Back Pain and Improves Self-Evaluated Work Ability. In Spine. August 15, 2006. Vol. 31. No. 18. Pp. E611-E620.