Aquatic Exercise in Patients With Chronic Non-specific Low Back Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials .

This review pulls together evidence from 14 RCTs to see whether aquatic exercise truly helps people living with chronic non-specific low back pain. Across studies—most of which involved women—water-based programs consistently outperformed land exercise or no exercise for reducing pain and improving disability, with seven outcomes reaching statistical significance. Still, the certainty is low: benefits often fell short of what’s considered clinically meaningful, sample sizes were small, and reporting quality varied. Only one trial even reported safety data, though no major concerns emerged. With mostly low to very low-quality evidence, this analysis raises critical questions about methodological rigor, safety reporting, and how we define meaningful improvement in CNLBP care.