Low Back Pain Subjects Research Articles

Benefits of aquatic exercise therapy on locomotion in low back pain subjects: a narrative literature review

Le but de cette revue de littérature est d’analyser les effets de la balnéothérapie sur la lombalgie, en se concentrant particulièrement sur les troubles de la marche. Environ 80 % de la population connaîtra un épisode de lombalgie à un moment donné de son existence, particulièrement en lien avec le vieillissement. La lombalgie a un coût financier élevé, que ce soit au niveau social ou au niveau des soins de santé, à la fois à cause de sa fréquence mais aussi de la réduction ou de la perte de productivité qu’elle entraîne. L’étiologie de la lombalgie n’est pas encore entièrement comprise, mais certains facteurs comportementaux peuvent conduire à son développement et à sa persistance. Ce trouble de santé conduit à la douleur, au handicap et à des modifications dans les habitudes de marche et des niveaux d’activation musculaire lors de la locomotion. Les traitements possibles pour les personnes souffrant de lombalgie sont variés et présentent différents degrés d’amélioration. Ils comprennent les médicaments, la physiothérapie, la balnéothérapie, une large gamme de thérapies manuelles et des activités physiques adaptées. Le principal objectif du traitement doit être le soulagement de la douleur, le renforcement des muscles du tronc, la mobilité du tronc, le développement des capacités aérobie et l’apprentissage de nouveaux comportements. La balnéothérapie est une intervention non invasive, intéressante sous certains aspects et prometteuse pour les troubles de la marche des personnes atteintes de lombalgie, mais des études plus conséquentes et à forte méthodologie sont nécessaires pour juger de l’efficacité de ce traitement.

Reliability of COP Measures in Healthy and Low Back Pain Subjects During a Dynamic Task

Reliability of COP Measures in Healthy and Low Back Pain Subjects During a Dynamic Task

Nonspecific chronic low back pain and incapacity level: influence of walking performance

ABSTRACT BACKGROUND AND OBJECTIVES: Chronic low back pain syndrome promotes several functional losses which impact quality of life of patients, and walking is one of the most impaired functions. Being chronic low back pain a syndrome with multiple etiologies, efforts to understand the relation between functional losses and etiologic factors are justified. This study aimed at correlating walking speed with pain perception, incapacity level (I) and condition of having or not chronic low back pain (group). METHODS: Sample was made up of volunteers with nonspecific low back pain (LG/n=8) and healthy subjects (CG/n=8). Incapacity level was obtained by Oswestry Incapacity Index during evaluation. Tests battery was divided in three sessions according to walking intensity, as follows: preferred self-selected speed (VP) and faster and slower speeds as compared to VP. In each session, volunteers walked for five minutes and at every minute pain was quantified by the analog scale. Kendal Tau test was used with p=0.05. RESULTS: Walking speed was not correlated with pain intensity, with incapacity level or with the group. However, group versus incapacity level, group versus pain, incapacity level versus pain were correlated with one another. CONCLUSION: Walking performance was not influenced by nonspecific chronic low back pain and by incapacity level.

Prevalence of lumbar spondylosis and its association with low back pain among community-dwelling Japanese women.

BackgroundLumbar spondylosis is more prevalent among the middle-aged and elderly, but few population-based studies have been conducted, especially in Japan. The purpose of this study was to explore the prevalence of lumbar spondylosis and its associations with low back pain among community-dwelling Japanese women.MethodsLateral radiographs of the lumbar spine were obtained from 490 Japanese women ≥ 40 years old, and scored for lumbar spondylosis using the Kellgren-Lawrence (KL) grade at lumbar intervertebral level from L1/2 to L5/S1. Height and weight were measured, and body mass index (BMI) was calculated. Low back pain in subjects was assessed using a self-administered questionnaire. Stiffness index (bone mass) was measured at the calcaneal bone using quantitative ultrasound.ResultsPrevalence of radiographic lumbar spondylosis for KL ≥ 2, KL ≥ 3 and low back pain were 76.7%, 38.8% and 20.0%, respectively. Age was positively associated with radiographic lumbar spondylosis (KL = 2, KL ≥ 3) and low back pain. Greater BMI was associated with lumbar spondylosis with KL = 2, but not with KL ≥ 3. Stiffness index was associated with neither radiographic lumbar spondylosis nor low back pain. Multiple logistic regression analysis identified radiographic lumbar spondylosis (KL ≥ 3) at L3/4, L4/5 and L5/S1 was associated with low back pain, independent of age, BMI and stiffness index.ConclusionSevere lumbar spondylosis at the middle or lower level may contribute to low back pain.

Relationship between disc degeneration and facet joint arthrosis-a MRI study

IntroductionSpinal degeneration includes degenerative changes occurring in the anteriorly located fibro-cartilaginous intervertebral discs and posteriorly placed synovial facet joints. The stability of each spinal motion segment is dependent on both these components. Thus an MRI based study on low back pain subjects was undertaken to assess the association between disc degeneration (DD) and facet joint arthrosis (FJA). Materials & methodThe study was conducted on 50 low back patients selected on the basis of predefined questionnaire and taken up for MRI assessment for grading disc degeneration and facet joint arthrosis. The severity of DD and FJA was evaluated at each motion segment and assessed with respect to gender, spinal level and the interdependence of disc and facet joint degeneration was defined. ResultsThe degeneration process at the disc and facet joint was independent of gender (p>0.05) but dependent on the spinal level (p<0.05). Disc degeneration was seen at the caudal most level while facet joint degeneration was seen in the L4–L5 spinal level. FJA was evident even without evidences of disc degeneration and no significant association was observed between discs and the facet joints. DiscussionThe role of small facet joints should not be overlooked while defining low back pain etiology as these joints play a significant role in load transmission and rotational kinematics. This knowledge can be of help in defining appropriate treatment modality for better patient care.

Neuromuscular control strategies of the trunk antagonist muscles during the Biering-Sorensen test in individuals with recurrent low back pain and healthy subjects

OBJECTIVES To compare the activation pattern of the trunk antagonistic muscles and also the myoelectric manifestations of muscle fatigue between subjects with and without recurrent non-specific low back pain, during the fatigue provocation of the erector spinae. METHODS The study involved 19 subjects with recurrent low back pain with a non-specific cause (seven men, 12 women, 38.53 ± 8.12 years, 68.35 ± 18.12 kg, 1.66 ± 0.09 m), and 19 healthy subjects (seven men, 12 women, 40.42 ± 8.63 years, 69.57 ± 12.76 kg, 1.64 ± 0.07 m). The electromyographic signal of the internal oblique, lumbar multifidus, rectus abdominis and lumbar iliocostalis muscles, bilateral, were collected during Biering-Sorensen test execution. RESULTS The group with low back pain showed a lower co-contraction rate of the internal oblique/lumbar multifidus (p = 0.006) and lower activation amplitude of the internal oblique (p = 0.019), both on the right side when compared to the group without low back pain. No differences were observed between the groups for muscle fatigue indicators (p > 0.05). CONCLUSION When the erector spine muscle fatigue occurs - even when the groups were similar as to the ability of extensors muscles to resist fatigue - differences were found between subjects with and without low back pain regarding the recruitment pattern of the task antagonist muscle, because subjects with low back pain showed lesser activation and co-contraction in relation to the healthy group.

Static and dynamic balance deficiencies in chronic low back pain.

According to previously conducted studies, people with Low Back Pain (LBP) present with static balance deficiencies. The aim of the present study was to compare static, as well as dynamic balance ability between Chronic Low Back Pain (CLBP) and healthy subjects. The CLBP group comprised 17 subjects and the control group of 16 subjects, matched for age, BMI and gender. The protocol applied compared the balance ability when performing the Star Excursion Balance Test (SEBT) and the static 1-leg stance position. The innovation introduced in the protocol was that the participants performed not only the static 1-leg stance, but also the dynamic SEBT on a force plate which recorded the target sway (TS), i.e. the Center of Pressure (CoP) excursion. The CLBP group had significantly reduced performance in SEBT, coupled with greater static and dynamic TS values. Age and especially BMI also bear a significant effect on SEBT execution. The inclusion of SEBT and TS derived scores in a stepwise logistic regression equation lead to the correct classification of 85% of the subjects. Dynamic and static balance ability provide supplementary information for the identification of the presence of CLBP, with dynamic balance being more instrumental.

Development, validity and reliability of a new pressure air biofeedback device (PAB) for measuring isometric extension strength of the lumbar spine

This study describes the development of a new portable muscle testing device, using air pressure as a biofeedback and strength testing tool. For this purpose, a pressure air biofeedback device (PAB®) was developed to measure and record the isometric extension strength of the lumbar multifidus muscle in asymptomatic and low back pain (LBP) persons. A total of 42 subjects (age 47.58 years, ±18.58) participated in this study. The validity of PAB® was assessed by comparing a selected measure, air pressure force in millibar (mb), to a standard criterion; calibrated weights in kilograms (kg) during day-to-day tests. Furthermore, clinical trial-to-trial and day-to-day tests of maximum voluntary isometric contraction (MVIC) of L5 lumbar multifidus were done to compare air pressure force (mb) to electromyography (EMG) in microvolt (μV) and to measure the reliability of PAB®. A highly significant relationship were found between air pressure output (mb) and calibrated weights (kg). In addition, Pearson correlation calculations showed a significant relationship between PAB® force (mb) and EMG activity (μV) for all subjects (n = 42) examined, as well as for the asymptomatic group (n = 24). No relationship was detected for the LBP group (n = 18). In terms of lumbar extension strength, we found that asymptomatic subjects were significantly stronger than LBP subjects. The results of the PAB® test differentiated between LBP and asymptomatic subject’s lumbar isometric extension strength without any risk to the subjects and also indicate that the lumbar isometric extension test with the new PAB® device is reliable and valid.

Inflammation in low back pain may be detected from the peripheral blood: suggestions for biomarker.

Biomarker for prediction of development of low back pain, and disease progression in chronic conditions are virtually non-existent. In the present study, we examined evidence of inflammation in the peripheral blood and demonstrated significant changes in neuroinflammation markers in subjects with chronic low back pain in comparison with control subjects. The present study was performed using peripheral blood from subjects with chronic low back pain and age-matched control subjects. Western blotting, real-time RT-PCR, cell culture and invitro assays were incorporated to perform the current study. We obtained evidence that the balance between proinflammatory and anti-inflammatory cytokines is misaligned, with decrease in interleukin-10 (IL-10) expression and increase in interleukin-6 (IL-6) expression. Furthermore, we demonstrated increase in CD16 monocyte expression. Cells were cultured under differential conditions to generate M1/M2 macrophages. In the macrophages, opioid secretory capacity was shown to be diminished. Finally, Dragon (repulsive guidance molecule b, RGMb) expression was shown diminished in M1 macrophages, which serves as a key transcriptional inhibitor of IL-6 expression. These biochemical and cellular alterations in chronic low back pain can serve as potential biomarkers for assessing disease initiation, intensity and progression.

Comparison of novel kinematic variables between patients with different stages of low back pain and healthy subjects

Comparison of novel kinematic variables between patients with different stages of low back pain and healthy subjects

Efficacy of Neural Mobilization on Low Back Pain with S1 Radiculopathy

Background: A definite conclusion about the effectiveness of neural mobilization on patients with radiculopathy can’t be reached because of the lacks of well designed randomized controlled trials. The purpose of the study to investigate the effects of neural mobilization on low back pain subjects with S1 radiculopathy.Methods: Sixty chronic low back pain subjects with S1 radiculopathy participated in this study. The participants were suffering from varying degrees of unilateral pain and paresthesia in the lumbosacral region and lower limb. The causes of radiculopathy were bulged disc, herniated disc or neuroforaminal stenosis at L5-S1 level.The participants were randomly assigned into two equal groups with 30 participants in each group. The experimental group received neural mobilization and conventional rehabilitation program in the form of infrared, ultrasonic and general exercises that involved stretching and strengthening exercises for the back muscles for 6 weeks. The control group received the same conventional rehabilitation program only for 6 weeks. The outcome measures were H-reflex latency, amplitude, and H/M ratio for assessing S1 nerve root function, visual analog scale (VAS) for assessing pain level, and Oswestry Disability Index (ODI) for assessing functional disability. All the participants were evaluated pre and post 6 weeks of treatment.Results: Both groups showed significant improvements in all measured variables after 6 weeks, but neural mobilization showed more beneficial and statistically significant effect in all measured variables than the control group.Conclusion: Neural mobilization technique is an effective intervention for reduction of pain, functional disability and enhancing physiological function of the nerve root in low back pain with lumbosacral radiculopathy.

Prevalence and Location of Neuropathic Pain in Lumbar Spinal Disorders: Analysis of 1804 Consecutive Patients With Primary Lower Back Pain.

A cross-sectional study of 1804 consecutive patients. The aim of this study was to investigate the prevalence of pathological pain and its distribution features in patients with chronic lumbar spinal disorders. Clinical spinal disorders can involve pathological neuropathic pain (NeP) as well as physiological nociceptive pain (NocP), as they have varied pathology, including spinal cord injury, stenosis, and compression. A study conducted by the Japanese Society for Spine Surgery and Related Research (JSSR) has determined a prevalence of 29.4% for NeP in patients with lumbar spinal disorder. However, the data did not include information on pain location. Patients aged 20 to 79 years with chronic lower back pain (≥3 months, visual analog scale score ≥30) were recruited from 137 JSSR-related institutions. Patient data included an NeP screening questionnaire score and pain location (lower back, buttock, and legs). The association between the pain pathology and its location was analyzed statistically using the unpaired t test and Chi-square test followed by Fisher test. P < 0.05 was considered significant. Low back pain subjects showed 31.9% of NeP prevalence, and the pain distribution showed [NocP(%)/NeP(%)] low back pain only cases: 44/22, while low back pain with leg pain cases showed a prevalence of 56/78. This indicates that low back pain alone can significantly induce NocP rather than NeP (P < 0.01). Buttock pain was revealed to significantly induce both lower back pain and leg pain with NeP properties (P < 0.01). Leg pain was revealed to be predominantly neuropathic, especially when it included peripheral pain (P < 0.01). Low back pain with no buttock pain induces NocP rather than NeP. Buttock pain is significantly associated with NeP prevalence whether or not leg pain exists. Leg pain can increase the prevalence of NeP, especially when it contains a peripheral element. 3.

"Managing" the Placebo Effect: The Single-Blind Placebo Lead-in Response in Two Pain Models.

"Placebo effects" in analgesic medication trials for chronic pain are pervasive; however, little is known regarding mechanisms or factors that may influence the presence or magnitude of these effects. Our objective is to consider elements of the placebo response in the context of two pain models using a "single-blind placebo lead-in" design (SBPLI). As part of two pilot drug trials using knee osteoarthritis (KOA) and non-radicular low back pain (LBP) subjects, SBPLI protocols were conducted. We examined whether gender and/or diagnosis affected placebo responses as observed in changes in patient self-reported pain, depressive and pain anxiety symptoms. We also evaluated the placebo response on performance-based tests (stair climbing, range of motion (ROM), sit to stand repetitions, and 6-minute treadmill distance). VAS Pain Intensity (Now) values decreased significantly during the SBPLI for the sample as a whole, but the effects appeared stronger among LBP subjects. CES-D short form values (depressive symptoms) did not decrease significantly during the SBPLI for the sample as a whole, but some placebo effects appeared to emerge for women in the KOA group. PASS values (pain anxiety symptoms) decreased significantly, albeit mildly, during the SBPLI for the sample as a whole.Stair Climb (time) revealed no significant SBPLI effects. Bend Forward to Floor (ROM) increased significantly at the end of the SBPLI period for the sample as a whole, but the effects appeared stronger among KOA subjects. Sit to Stand Repetitions increased during the SBPLI for the sample as a whole. Treadmill Distance did not change significantly from Visit 1 to Visit 2; however, a significant Sex difference for the KOA group was found such that women showed greater Treadmill Distance at Visit 2. Placebo effects emerged across psychometric and performance-based measures, indicating the pervasiveness of this phenomenon. In this design, diagnostic and (to a lesser extent) gender categories differentials were observed during the placebo period. The SBPLI design may prove not only a robust method in studying the placebo phenomena, but also as a design element to mitigate some aspects of the placebo response in clinical trials.

Active–passive biodynamics of the human trunk when seated on a wobble chair

Unstable sitting on a wobble chair with different balance difficulty levels can be used as an effective tool in exercises as well as evaluation and therapeutic stages of rehabilitation. No data on muscle activity levels and spinal loads are however available to assess its safety compared to other regular daily activities. The goal of this study was to estimate muscle forces and spinal loads in a seated unstable wobble chair task. In vivo 3D kinematics of the trunk and seat collected in an earlier study were used here to drive computational trunk musculoskeletal models of 6 normal and 6 low-back pain subject groups sitting on a wobble chair for a duration of 10s. Results revealed no significant differences between kinematics, muscle forces, spinal loads and force plate reaction forces when comparing these two groups. The estimated muscle forces and spinal loads were moderate though larger than those in a stationary sitting posture. Local spinal forces at the L5-S1 disc varied with time and reached their peaks (1473N and 1720N in compression, 691N and 687N in posterior–anterior shear and 153N and 208N in right–left shear, respectively for healthy and CLBP groups) being much greater relative to those in the stationary sitting posture (means of 12 subjects: 768N, 284N and 0N, respectively). The wobble chair with characteristics considered in this study is found hence safe enough as a therapeutic exercise for both healthy and low-back pain subjects.

The effects of an 8-week stabilization exercise program on lumbar movement sense in patients with low back pain.

BackgroundLumbar stabilization exercises have gained popularity and credibility in patients with non-acute low back pain. Previous research provides more support to strength/resistance and coordination/stabilisation programs. Some authors also suggest adding strength/resistance training following motor control exercises. However, the effect of such a lumbar stabilization program on lumbar proprioception has never been tested so far. The present study investigated the effects of an 8-week stabilization exercise program on lumbar proprioception in patients with low back pain (LBP) and assessed the 8-week test-retest reliability of lumbar proprioception in control subjects.MethodsLumbar proprioception was measured before and after an 8-week lumbar stabilization exercise program for patients with LBP. Control subjects participated in the same protocol but received no treatment.ResultsThe lumbar proprioception measure showed moderate reliability. Patients with LBP and control subjects demonstrated no differences in lumbar proprioception at baseline. Participants from both groups showed better proprioception following the 8-week interval, demonstrating the presence of learning between testing days.ConclusionsThe improvement of lumbar proprioception seen in both groups was ascribed to motor learning of the test itself. The effect of lumbar stabilization exercises on lumbar proprioception remains unknown because the LBP group did not show lumbar proprioception impairments.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-016-0875-4) contains supplementary material, which is available to authorized users.

Serum levels of the proinflammatory cytokine interleukin-6 vary based on diagnoses in individuals with lumbar intervertebral disc diseases

BackgroundMany intervertebral disc diseases cause low back pain (LBP). Proinflammatory cytokines and matrix metalloproteinases (MMPs) participate in disc pathology. In this study, we examined levels of serum cytokines and MMPs in human subjects with diagnoses of disc herniation (DH), spinal stenosis (SS), or degenerative disc disease (DDD) relative to levels in control subjects. Comparison between subjects with DH and those with other diagnoses (Other Dx, grouped from SS and DDD) was performed to elaborate a pathological mechanism based on circulating cytokine levels.MethodsStudy participants were recruited from a spine neurosurgery practice (n = 80), a back pain management practice (n = 27), or a control cohort (n = 26). Serum samples were collected before treatment and were assayed by multiplex assays for levels of interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-13, interferon-γ, tumor necrosis factor-α, MMP-1, MMP-3, and MMP-9. Inflammatory and degradative mediator levels were compared for subjects with LBP and control subjects, by diagnosis and by treatment groups, controlling for effects of sex, age, and reported history of osteoarthritis. Spearman’s correlation coefficient was used to examine relationships with age, body mass index (BMI), symptom duration, and smoking history.ResultsSerum levels of IL-6 were significantly higher in subjects with LBP compared with control subjects. Participants with LBP due to Other Dx had significantly higher levels of IL-6 than DH and controls. Serum levels of MMP-1 were significantly lower in LBP subjects, specifically those with DH, than in control subjects. Positive correlations were found between IL-6 levels and BMI, symptom duration, and age. MMP-1 levels were positively correlated with age.ConclusionsThe findings of the present clinical study are the results of the first examination of circulating cytokine levels in DDD and SS and provide evidence for a more extensive role of IL-6 in disc diseases, where patients with DDD or SS have higher serum cytokine levels than those with DH or control subjects. These findings suggest that LBP subjects have low-grade systemic inflammation, and biochemical profiling of circulating cytokines may assist in refining personalized diagnoses of disc diseases.

Difference in sensory, motor and pain threshold for medium frequency electrical stimuli in different pain conditions-A pilot study

Background: Different current frequencies are considered to produce a different reaction in tissues. But there is still a lack of knowledge about the reactions of tissues on medium frequency electric currents with different frequencies in special groups of diseases or trauma. Objective: The main objective of the study was to find out the difference of physiological response between normal healthy, chronic low back pain and postoperative pain subjects for a medium frequency (4 KHz) electrical stimuli with 20, 50 and 100 Hz base frequencies. Method: Readings were taken for sensory, motor and pain threshold with three different frequencies 20 Hz, 50 Hz & 100 Hz for normal healthy, chronic low back pain and postoperative pain subjects. Electrodes were applied over the dorsal and ventral side of the ankle in all the maneuvers. For the normality of the data, Shapiro-wilk test was done. Statistical analysis was done using IBM SPSS version 20.0 and significance were set at “p Result: A multivariate ANOVA test showed significant difference statistically between groups; sensory and the motor threshold for back pain was less than normal and postoperative subjects, irrespective of the frequencies used for stimulation. The post hoc analysis between groups showed that chronic low back pain subjects differ from normal individuals in pain threshold (difference 1.617mA, p=.041). Conclusion: The sensory and motor response threshold was more in acute pain subjects and in normal individuals than chronic low back pain subjects. Reduced sensory motor threshold and increased pain threshold in chronic back pain subjects may indicate hyperalgesia and perceptual delay in processing of the electrical stimuli by the nerves system.

Trunk Balance Exercises and Strength Training Exercises in the Management of Pain and Disability Among the Chronic Low Back Pa in Individuals

LBP has been described as twentieth century health care disaster. Eighty percent (80%) of all adults have significant low back pain in their life time. The incidence of low back disability appears to have dramatically increased in Western society since about 1970. This is not indicative of an increase in prevalence of LBP but rather of an increase in work loss, sick certification, compensation, and a long-term disability awards. Almost anyone born today in Europe and North America has a great chance of suffering disabling back injury regardless of occupation. In the United States, LBP is the most common reason for activity limitation under the age of 45, and approximately 2% of the work force receives compensation for LBP annually. An estimated 1.3 billion days a year are lost from work because of LBP. Question and objective: To assess the role of exercises in chronic low back pain individuals. The purpose of this study: The purpose of this study is to validate and compare the effects of trunk balance exercises along with flexibility exercises and Strength training exercises along with flexibility exercises on pain and disability among chronic low back pain (CLBP) subjects. Design: Pre-test and post-test experimental study design. Participants: Chronic low back pain patients in the age group between 30-40 years, both males and females were included in the study predominantly White collar occupation. Intervention: Trunk balance exercises along with flexibility exercises for experimental group I and Strength training exercises along with flexibility exercises for experimental group II. Outcome measures: Pain was measured using visual analogue scale and Disability using Roland Morris Low Back Pain and Disability Questionnaire (RMQ). Results and Conclusion: Strength training exercises of the trunk and limbs along with flexibility exercises and Trunk balance exercises along with Flexibility exercises were effective in reducing pain and improving disability among CLBP subjects. When compared between groups between interventions there is no significant difference in reducing pain among chronic low back pain subjects (group A-trunk balance exercises along with flexibility exercises and group B-strengthening along with flexibility exercises) whereas there is significant difference between the groups in decreasing disability and so the trunk balance exercise with flexibility exercises is a superior choice in management of chronic low back pain.

Cross Friction Algometry (CFA): Comparison of pressure pain thresholds between patients with chronic non-specific low back pain and healthy subjects

Cross Friction Algometry (CFA): Comparison of pressure pain thresholds between patients with chronic non-specific low back pain and healthy subjects

Comparing the Effectiveness of Motor Control Exercises versus Mckenzie Exercises for Work Related Back Pain

Background: Work related low back pain has been identified as a one of the most costly disorders among the worldwide working population. This condition was highly prevalent that approximately 85% patients having back pain were brought on by prolonged sitting. With the rapid development of modern technology, sitting has now become the most common posture in today’s work- place. Idea of using motor control learning approach provides the optimal control and coordination of the spine. The McKenzie evaluation was received using repeated movements and sustained positions. Therefore high quality randomized clinical trial was required to compare the effectiveness of these treatments for work related low back pain. Objectives: To compare the effectiveness of motor control exercises and McKenzie exercises in reducing pain and disability in work related low back pain. Method: The study included 40 subjects with work related low back pain due to prolonged sitting. They were randomly allocated into two groups (Group A and Group B). Group A was treated with motor control exercises and group B was treated with McKenzie exercises for 4 weeks. Results: Both the groups have shown statically significant improvement in vas with p < 0.0001 and ODI with p < 0.0001. When the comparison was done after the 4 weeks, the percentage of improvement in group A was much higher than Group B. Conclusion: The study concluded that motor control exercises have shown statically and clinically significant improvement in reducing pain and disability when compared to McKenzie exercises among work related low back pain subjects.