Effectiveness of dosed physical exercise in patients with lumbar disc herniations

Abstract

Introduction. Low back pain is one of the leading causes of disability worldwide, with lumbar disc herniation being a highly prevalent condition due to its impact on function and quality of life. In this context, exercise therapy was proposed as a key strategy within conservative management. Objective. To analyze the effectiveness of done physical exercise in reducing pain and improving functional capacity in patients with lumbar disc herniation. Methodology. A systematized bibliographic review was conducted following PRISMA 2020 guidelines. The search was performed in scientific databases using MeSH descriptors and Boolean operators. Randomized controlled trials and systematic reviews published within the last five years were included. Methodological quality was assessed using the PEDro scale. Results. A total of 25 studies were included, showing that therapeutic exercise—particularly multimodal programs combining strengthening, motor control, and functional exercise—leads to clinically relevant improvements in pain, disability, and quality of life; however, no conclusive evidence was found supporting the superiority of a specific type of exercise over another. Additionally, benefits were associated not only with structural changes but also with central pain modulation mechanisms. Conclusion. Appropriately dosed physical exercise is an effective intervention in the conservative management of lumbar disc herniation. Its individualized and progressive application, combined with pain neuroscience education, represents a comprehensive approach within the biopsychosocial model. Future studies are needed to standardize protocols and evaluate long-term effects. General Area of Study: Health sciences. Specific area of study: Physiotherapy and musculoskeletal rehabilitation. Type of study: Systematized bibliographic review.