I see that more and more fitness groups and health clubs are offering spinal stabilization classes. What are these exercises and how do they work?

In the early 1990s, scientists studying muscle (motor) control made some new discoveries. They found out that the stabilizing muscles of the spine didn't always contract or contract on time during certain motions in patients with chronic back pain.

A series of exercises were developed to rehab the motor control system. Retraining the abdominal muscles (transversus abdominis) and deep muscles of the spine (multifidus) came to be known as stabilization exercises or core training.

This program has been expanded by some to include retraining the diaphragm and pelvic floor muscles, too. The diaphragm is a dome-shaped muscle inside the body between the chest and abdomen. A program to teach back pain patients how to contract the core muscles in everyday postures and positions forms the basis of the spinal stabilization program.

It's not clear yet just how these exercises really work at the physiologic level. We do know that contracting muscles on both sides of the spine at the same time helps hold the spine steady or stable. Perhaps traction of the spinal segments helps reduce pain, too.

Lucy Jane Goldby, PhD, et al. A Randomized Controlled Trial Investigating the Efficiency of Musculoskeletal Physical Therapy on Chronic Low Back Disorder. In Spine. May 1, 2006. Vol. 31. No. 10. Pp. 1083-1093.