Current Evidence and Intervention Approaches for Physical Activity and Low Back Pain in Older Adult Populations: A Narrative Review

Low back pain (LBP) is a common and severe musculoskeletal ailment that disproportionately affects the elderly. Some of the top causes of disability and impaired functional independence occur worldwide. As populations age and chronic diseases increase, controlling LBP in the elderly is a public health issue. Polypharmacy and age-related vulnerabilities make widely recommended pharmacologic methods risky for older persons. Physical activity is a favored first-line remedy due to its safety and multidimensional advantages, especially in the elderly. This review synthesizes the literature on elderly LBP prevention and management through physical exercise. Recent evidence (2020-2024), biological underpinnings of exercise-related pain regulation, and practical applications of aerobic, resistance, flexibility, and neuromuscular training are highlighted. The biopsychosocial and Kinesio pathophysiological frameworks that inform LBP rehabilitation therapeutic thinking are also reviewed. Fear of pain, social isolation, comorbidities, and environmental limits are examined, along with ways to increase exercise engagement and adherence. This article also assesses literature discrepancies, identifies study gaps, and suggests further research. To help healthcare providers and researchers optimize exercise-based interventions for the elderly. Physical activity should be a standard therapy method for senior LBP patients, not an optional recommendation.