How Effective Is Resistance Training as a Treatment for Low Back Pain? A Systematic Review With Meta-Analysis of Randomized Controlled Trials

OBJECTIVE: To assess the effectiveness of resistance training for low back pain (LBP) and resistance training reporting quality.

DESIGN: Intervention systematic review with meta-analysis of randomized controlled trials (RCTs).

LITERATURE SEARCH: Five databases were searched until April 2026.

STUDY SELECTION CRITERIA: RCTs examining the effects of resistance training on pain intensity and disability for LBP compared with passive, active or no intervention/usual care.

DATA SYNTHESIS: Means, standard deviations, and participant numbers were combined for meta-analysis. We calculated and presented pooled effect estimates with 95% confidence intervals. Resistance training reporting quality was evaluated using the Consensus on Exercise Reporting Template (CERT). Outcome level risk of bias was assessed using the Cochrane RoB2 tool and the certainty of evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.

RESULTS: Compared with no intervention/usual care, the evidence was very uncertain about the effects of resistance training on pain and disability. Effect estimates suggested resistance training may have a medium to large effect on pain (-1.33 (-1.90 to -0.76)) and a large effect on disability (-1.75 (-2.47 to -1.04)) at 3 months. Compared with passive or active interventions, the evidence was very uncertain about the effects of resistance training on pain and disability. CERT reporting completeness was ‘good’ in 25%, ‘moderate’ in 42% and ‘poor’ in 33% of resistance training interventions.

CONCLUSION: Resistance training may reduce LBP intensity and disability compared with no intervention/usual care at 3 months. Very low certainty evidence limited confidence in findings. Clinical translation was limited by inadequate reporting of key intervention components.