Chronic low back pain and exercise: a molecular perspective on aerobic and anaerobic core training

Chronic low back pain (CLBP) remains a significant challenge for clinicians, and a substantial percentage of adults experience it at some point in their lives. Non-pharmacological treatments have gained attention for managing pain through aerobic and anaerobic core exercises. However, studies on humans and animals have yielded conflicting results regarding the type of exercise and its effect on pain sensation. The pain sensitivity of CLBP patients largely depends on their physiological and psychological conditions. The most studied and supported non-drug treatments for managing CLBP are aerobic core workouts. Recently, new research has also shown promising benefits of anaerobic core exercises, which can help reduce discomfort. Both aerobic and core anaerobic exercises have distinct yet complementary roles in managing CLBP. Aerobic training enhances overall health and endurance, while core anaerobic exercises focus on stabilization and muscular support. Understanding how they work individually and together can help create more effective, personalized exercise plans for long-term CLBP management. These exercises are especially effective in correcting postural issues and lowering mechanical stress on the lumbar spine. Although the exact mechanisms are still unknown, both types of exercises have the potential to lessen pain. This scoping review discusses the pathophysiological processes and exercise-induced hypoalgesia related to CLBP therapy. Additionally, it explores the pain-related molecular mechanisms associated with both aerobic and anaerobic core exercises.