Low back pain is the disaster of the century, with 80% of people experiencing it at least once in their lifetime. Non-specific, recurrent low back pain is the most common, and choosing among the many treatment options is difficult for spine specialists, patients, medical institutions, and the economy. Exercise is an effective treatment for chronic low back pain, with reduced effectiveness for subacute low back pain and, for acute low back pain, comparable to other non-surgical treatments. However, the parameters and types of correct exercise are inconclusive. These include lumbar back muscle strengthening and flexibility. The appropriate type of exercise for low back pain, parameters, including frequency, intensity and duration, urgently need to be defined. For a sudden load applied to the spine, it is likely that the spine will be lost because of the latency of the muscles (intrinsic resistance), which cannot counteract the external force for an initial period of 50-200 milliseconds. As a result, the spinal structures (discs, ligaments and attachment points) are susceptible to injury in that short period of time. Patients with low back pain have high spinal stiffness, but also increased spinal pressure. Trunk muscle exercises increase the stability of the lumbar spine, including contraction of the abdominal muscles, but their long-term effects are not known. A randomized prevention trial conducted by scholars from the Department of Physical Therapy and Rehabilitation at the University of Sofia Medical School in Bulgaria showed that regular trunk and abdominal muscle integration exercises are effective in preventing recurrent low back pain, and the article was published in Spine in June 2014. The study included 600 cases of recurrent low back pain, having had at least 2 episodes of low back pain, each lasting more than 1 day and at least 1 month apart. Four groups were randomized equally, 150 cases (mean age 42.5 years) to trunk muscle strength exercises, 150 cases (mean age 41.3 years) to trunk muscle flexibility exercises, 150 cases (mean age 41.0 years) to trunk muscle strength + daily abdominal muscle integration exercises, and 150 cases (mean age 40.6 years) to trunk muscle flexibility + daily abdominal muscle integration exercises. The trunk muscle strength exercise was a modified DeLorme method, i.e., trunk muscle isometric contraction exercise with force measurement by piezoelectric tonometer, abdominal muscle exercise in supine position, and back muscle exercise in prone position. The isometric muscle contraction was performed for 3 seconds with 3 seconds of rest and repeated 10 times as a cycle. Each patient performed 3 cycles of exercise with 2 breaks in between. Trunk muscle flexibility exercise for isometric contraction in the upright position and then relax, to the back muscles, maximum bend forward, look upward and inhale air for 10-20 seconds, then look downward and exhale air. Repeat 3-5 times. For the abdominal muscles, extend the back back, look down and inhale air for 10-20 seconds, then look up and exhale air. Repeat 3-5 times. Abdominal muscle integration exercises provide training to integrate the abdominal muscles during daily activities and workouts, moving the body weight away from the stressed surface during any activity/exercise that involves the entire body. Intensity and duration varied according to physical strength, with as many exercises per day as possible encouraged. The frequency, intensity and duration of pain and the frequency, intensity and duration of exercise were recorded at the beginning of the trial until 10 years of follow-up. The results showed that the frequency, intensity and duration of pain improved in all cases from the beginning to year 2, but worsened again from year 2 to year 10. There was no difference between the plyometric and flexibility exercise groups, and cases with integrated abdominal muscle exercise were better than those without integrated exercise. The frequency, intensity and duration of low back pain were correlated with each other and with the frequency of exercise, and not with the intensity or duration of exercise. The above results suggest that the frequency of exercise is more important than the type, duration or intensity of exercise. The abdominal muscle integration exercises increased the exercise effect and can be considered as “initial on-demand muscle straps”. The increased frequency of trunk stiffness and trunk muscle contraction/co-contraction without interfering with daily activities reminds/motivates patients to exercise more frequently. Regular trunk muscle and abdominal muscle integration exercises are effective in preventing recurrent low back pain.