Chronic low back pain is a confounding problem. Every time we think we've got it figured out, something comes along that trips us up again. Three recent studies indicate that scientific exercise programs like physical therapy ("PT") are not all that good at controlling chronic low back pain, and that Yoga and Pilates might be better.
The new issue of Physical Therapy, (Nov.2009) found that twelve sessions of physical therapy, including core-strengthening exercise, produced benefits in people's perception of their recovery and their activity, but did not reduce pain. At least these benefits seemed to last at least a year.
On the other hand, an older study in Annals of Internal Medicine (2005) found that Yoga was more effective against low back pain than either PT or a self-help book. The superiority started at twelve weeks, PT caught up over the next twelve, but after that, Yoga pulled out in front again. And Pilates turns out to be even better than Yoga. The Journal of Orthopedics and Sports Physical Medicine, (2006) found that a four-week program of Pilates (on their specialized training equipment) significantly helped people with chronic low back pain. Better yet, the improvement was maintained over a twelve-month follow-up period.
So what does all this tell us? First of all, do things that are known to prevent low back pain in the first place. An important thing to remember is that the ligaments that hold your spine together actually stretch while you're sitting, and they take 10-20 minutes of activity to regain their former tautness. During this period, your spine is less stable and more prone to injury. Therefore, if you sit a lot, or especially if you drive a lot, do NOT just stand up and start deep stretches! Instead, start off with walk-around breaks before you stretch.
Keep yourself in shape with regular strenuous exercise (if it's safe for you,) while avoiding jarring or one-sided motions. I don't think you'll be surprised if I suggest Yoga or Pilates.
If you already have low back pain, there are many necessary and important therapies that Chiropractors or PT's can offer. There are many causes of low back pain that are well-understood, and respond remarkably well to manual medicine. But in addition, a Yoga or Pilates program is likely to be a real benefit to you.
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