Does resistance training improve pain intensity, quality of life, and disability in people with chronic nonspecific low back pain? A systematic review and meta-analysis

Systematic review with meta-analysis to evaluate the efficacy of resistance training (RT) in improving pain intensity, quality of life, and disability in people with nonspecific chronic low back pain (NSCLBP). Searches were conducted in April 2025 using MEDLINE, Scopus, Web of Science, and the Cochrane Library. Randomized controlled trials (RCTs) that compared RT interventions with any treatment and assessed pain intensity, quality of life, or disability in adults with NSCLBP were included. A pairwise random-effects meta-analysis was performed by subgroup according to the comparison treatment. Risk of bias was assessed with the Cochrane Risk of Bias 2.0 tool (RoB 2), and certainty of evidence was evaluated using the GRADE approach. Ten RCTs (<i>n</i> = 434) showed significant improvements in pain intensity (SMD = −1.15; 95% CI [−1.67, −0.62], <i>p</i> &lt; 0.0001), quality of life (SMD = 0.82; 95% CI [0.19, 1.46], <i>p</i> = 0.01), and disability (SMD = −2.76; 95% CI [−3.90, −1.62], <i>p</i> &lt; 0.00001) favoring RT. Only pain intensity reached clinical significance. The certainty of the evidence was rated as “moderate” for all variables. RT programs effectively reduce pain intensity and disability in patients with NSCLBP. Moderate certainty of evidence suggests that RT can be recommended for NSCLBP. Further research is required to confirm these findings. CRD42024505897. Resistance training is effective in improving pain intensity, quality of life, and disability in patients with nonspecific chronic low back pain.This study provides literature-based guidelines for prescribing resistance exercises in patients with nonspecific chronic low back pain.Exercise programs should be structured, progressive, and implemented for at least 12 weeks to achieve meaningful improvements in pain, disability, and quality of life in patients with nonspecific chronic low back pain. Resistance training is effective in improving pain intensity, quality of life, and disability in patients with nonspecific chronic low back pain. This study provides literature-based guidelines for prescribing resistance exercises in patients with nonspecific chronic low back pain. Exercise programs should be structured, progressive, and implemented for at least 12 weeks to achieve meaningful improvements in pain, disability, and quality of life in patients with nonspecific chronic low back pain.