Low Back Pain: Current Evidence and the Role of Digital Physiotherapy

Low back pain is one of the most common reasons for healthcare visits worldwide and represents both a clinical and social challenge. Despite its high prevalence, recent research has shifted our understanding of mechanical factors—especially lumbar flexion and its relationship with pressure on the intervertebral discs. In this article, we review the latest evidence and explore the role of digital physiotherapy platforms, such as TRAK, in assessing, monitoring, and treating this condition.

Studies such as Callaghan & McGill (2015) have shown that different ways of bending down do not create major differences in intervertebral disc pressure. This challenges the traditional belief that there is only one “correct” way to lift objects. In reality, repetitive and cumulative loading appears to be the real risk factor.

The evidence suggests that:

• Occasional flexion is not harmful by itself.
• Constant repetition of flexion movements under heavy load may increase the risk of injury.
• There is no single ideal technique: the best posture depends on the person, the task, and the load.

A common mistake is assuming you must squat perfectly to pick up something light, like a pen. Recent studies (Hartvigsen et al., 2022) show that movement variability is not harmful and that avoiding lumbar flexion may backfire if it creates fear of movement (kinesiophobia).

The key takeaway: safety in movement depends not on a single posture but on progressive adaptation to load.

Beyond mechanics, low back pain is a multifactorial problem:

• Biological: disc degeneration, muscle imbalances, heightened sensitivity.
• Psychological: fear of movement, anxiety, work-related stress.
• Social: job conditions, sedentary lifestyle, poor treatment adherence.

The modern approach to low back pain focuses on movement education, therapeutic exercise, and self-management strategies. Physiotherapy provides practical tools to:

• Reduce pain and stiffness through progressive exercise.
• Retrain movement patterns without fostering fear.
• Improve strength and endurance of stabilizing muscles.
• Support early return to work and sport.

One of the biggest challenges in low back pain is exercise adherence. This is where digital platforms like TRAK add significant value:

• Digital exercise library: tailored to patient level and based on scientific evidence.
• AI-powered correction: detects and adjusts technique errors.
• Remote monitoring: video calls and real-time movement analytics.
• Personalization: programs adapted to each condition, load, and progression.

This allows professionals to deliver treatment plans that are scalable, safe, and accessible, even for patients with limited access to in-person physiotherapy.

Low back pain should not be viewed solely as a mechanical disc issue. Current evidence shows that there is no single “correct” posture, but rather the need to adapt movement to context and individual factors. A comprehensive approach includes exercise, education, and adherence, with TRAK positioned as a strategic ally to deliver personalized, sustainable treatment over time.