Abstract
The chronic non-specific low back pain (CNSLBP), the most common type of chronic pain is characterized by pain between the costal margin and gluteal folds, with or without leg pain, that lasts more than three months and has no obvious pathoanatomical explanation. Since there is no conclusive anatomical explanation for about 85% of cases of low back pain, conservative, non-pharmacological therapies are the mainstay of treatment. Although manual therapy (MT) and motor control exercise (MCE) are commonly suggested first-line treatments for CNSLBP, further more researches is needed to fully understand their mechanisms of action and wider clinical effects. This narrative review's goal was to investigate and gather the most recent data on the efficacy of manual therapy and motor control exercises in the treatment of persistent, non-specific low back pain. To find peer-reviewed English-language research published between January 2020 and December 2025, a thorough literature search was carried out using Google Scholar and PubMed. Included were studies that focused on manual therapy and/or motor control training for those with low back pain. Meta-analysis was not used in the qualitative synthesis of the data. With relatively modest and temporary side effects, manual treatment was shown to be equivalent to other conservative approaches in terms of increasing function and reducing discomfort. Additionally, there is evidence in favour of combining manual treatment, MCE, and patient education to maximize results.
In summary, manual therapy and motor control exercises are both safe, efficacious, and supported treatments for CNSLBP. In modern rehabilitation treatment, multidisciplinary approaches incorporating various modalities have to be given priority since they may offer improved clinical advantages. The results show that by improving deep trunk muscle activation and spinal stability, motor control exercises greatly reduce pain and disability and improve functional outcomes. When compared to traditional strength and flexibility exercises, person-specific motor skill training showed better short- and long-term functional benefits.