Background: Low back pain is a common symptom in the general population. There is considerable evidence for the effectiveness of exercise for chronic low back pain but long-term adherence rates can be poor. It may be important to gain a greater understanding of patients’ beliefs about exercise for low back pain and their adherence to it.

Objectives: To systematically review studies exploring low back pain patients’ beliefs about exercise as a treatment for their pain.

Method: We searched Medline, Web of Science, National Research Register, PEDro, PsycINFO, AMED, CINAHL and EMBASE. Retrieved titles and abstracts were combined and screened for inclusion in the review. We quality appraised the included papers and did a thematic analysis of the data extracted from them.

Results: Three studies were eligible for inclusion in the review. The main themes identified were barriers and motivators to exercise. Time was the main barrier patients perceived. Fear of pain acted both as a barrier and a motivator to exercise. Health professionals motivated patients to exercise when the patient had regular contact and felt they understood their situation. Exercise had both physical and mental benefits, with responders feeling enabled to self manage their pain.

Conclusions: The impact of the health professional on beliefs about exercise and adherence is already acknowledged in the recommendations for supervised exercises. There is a lack of exploratory research in the area of exercise beliefs, especially in primary care. Further research is needed to understand how people with low back pain view physical activity more generally especially prior to receiving exercise as a treatment.