Welcome back to Spine IQ’s Back Blog! In May we reviewed one of the most important tools conservative care providers can offer their patients: education. For the month of June we’re going to dive into the research behind group exercise and how you can effectively use this treatment strategy in your spine care practice! Numerous clinical practice guidelines for musculoskeletal conditions suggest exercise as a first line treatment (1). There are many barriers to being able to provide exercise as an intervention, such as time constraints and cost to the patient. One way to address these barriers is by providing group exercise classes in your clinic.

High-value care is about providing the right care for the right patient at the right time. There will always be people in need of individual care for their musculoskeletal complaints especially patients with more complex conditions. However, research has shown that group exercise can be a cost-effective option for treating low back pain and in fact results in similar clinically important effects on pain and disability (2–4). This effect is thought to be at least partially due to the opportunity for enhanced social interaction (5).

Take home message? Adding group exercise to your treatment toolbox provides clinicians and patients with an effective, relatively low cost intervention that is supported by evidence and guidelines (6). Curious about whether or not you could try this in your clinic? Stay tuned for next week’s blog when we dive the how to incorporate group exercise in your practice!


  1. Qaseem A, Wilt TJ, McLean RM, Forciea MA, Clinical Guidelines Committee of the American College of Physicians. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017 Apr 4;166(7):514–30.
  2. O’Keeffe M, Hayes A, McCreesh K, Purtill H, O’Sullivan K. Are group-based and individual physiotherapy exercise programmes equally effective for musculoskeletal conditions? A systematic review and meta-analysis. Br J Sports Med. 2017 Jan;51(2):126–32.
  3. Toomey E, Currie-Murphy L, Matthews J, Hurley DA. The effectiveness of physiotherapist-delivered group education and exercise interventions to promote self-management for people with osteoarthritis and chronic low back pain: a rapid review part I. Man Ther. 2015 Apr;20(2):265–86.
  4. O’Keeffe M, O’Sullivan P, Purtill H, Bargary N, O’Sullivan K. Cognitive functional therapy compared with a group-based exercise and education intervention for chronic low back pain: a multicentre randomised controlled trial (RCT). Br J Sports Med. 2020 Jul;54(13):782–9.
  5. Tiffreau V, Mulleman D, Coudeyre E, Lefevre-Colau MM, Revel M, Rannou F. The value of individual or collective group exercise programs for knee or hip osteoarthritis. Clinical practice recommendations. Ann Readaptation Med Phys Rev Sci Soc Francaise Reeducation Fonct Readaptation Med Phys. 2007 Dec;50(9):741–6, 734–40.
  6. Cobiac LJ, Vos T, Barendregt JJ. Cost-Effectiveness of Interventions to Promote Physical Activity: A Modelling Study. PLOS Med. 2009 Jul 14;6(7):e1000110.