The McGill Approach to Core Stabilization in the Treatment of Chronic Low Back Pain: A Review

IntroductionLow back pain (LBP) is a major cause of disability and is progressively becoming worse on a global scale. [1,2] The prevention and rehabilitation of LBP lacks clarity in part due to the heterogeneity of the exercise programs prescribed to treat low back pain. Some authors have proposed stabilizing exercises for lower back pain which exert minimal loads on the spine. [3,4,5] Despite a multitude of existing exercise therapies, McGill has introduced three exercises for rehabilitating lower back pain, termed the McGill Big Three (MGB3). [6,7,8,9,10] These include the curl-up, side plank and bird-dog. The purpose of this review is to investigate the clinical outcomes from prescribing the MGB3 to individuals with chronic LBP. MethodsInclusion criteria were randomized control trials that involved an intervention with MGB3 core stabilization exercises for patients with chronic low back pain. The research included articles published during any period in full English text. Studies were critically reviewed by two authors EL and GG independently and collaboratively. ResultsIn total, four randomized control trials were included in this review. Multiple cohorts, with varying age, demographics and occupation were studied. Outcomes studied included various pain scores, patient reported functional and performance measures. DiscussionControlled clinical trials employing this method in low back pain treatment showed low quality data with mixed statistical significance, and little to no clinical significance irrespective of the measure used or even when compared to baseline. Limitations of these trials are detailed herein. ConclusionCurrently there is limited data supporting the clinical benefit of the McGill approach for the treatment of low back pain based on the available randomized clinical trials. More study is required prior to widespread adoption into clinical practice.