Low back pain: Exercises to reduce pain

Key points

• Low back pain is very common among adults and is often caused by overuse and muscle strain or injury. Treatment can help you stay as active as possible, and it will help you understand that some continued or repeated back pain is not surprising or dangerous.¹
• Most low back pain can get better if you stay active, avoid positions and activities that may increase or cause back pain, use ice, and take nonprescription pain relievers when you need them.
• When you no longer have acute pain, you may be ready for gentle strengthening exercises for your stomach, back, and legs, and perhaps for some stretching exercises. Exercise may not only help decrease low back pain, but it may also help you recover faster, prevent reinjury to your back, and reduce the risk of disability from back pain.
• Exercises to reduce low back pain are not complicated and can be done at home without any special equipment.
• It's important that you don't let fear of pain keep you from trying gentle activity. You should try to be active soon after noticing pain, and gradually increase your activity level.¹ Too little activity can lead to loss of flexibility, strength, and endurance, and then to more pain.

 What exercises may reduce low back pain?
 Why is it important to do exercises for low back pain?
 How do I exercise to reduce low back pain?
 Where can I learn more about exercises to reduce low back pain?

More information about low back pain:

Return to topic:

Exercises that may help reduce or prevent low back pain include:

• Aerobic exercise, to condition your heart and other muscles, maintain health, and speed recovery.
• Strengthening exercises, focusing on your back, stomach, and leg muscles.
• Stretching exercises, to keep your muscles and other supporting tissues flexible and less prone to injury.

Some exercises can aggravate back pain. If you have low back pain, avoid:

• Straight leg sit-ups.
• Bent leg sit-ups or partial sit-ups (curl-ups) when you have acute back pain.
• Lifting both legs while lying on your back (leg lifts).
• Lifting heavy weights above the waist (standing military press or bicep curls).
• Toe touches while standing.

Continue to Why is it important to do exercises for low back pain?
Return to Low back pain: Exercises to reduce pain

Exercise and staying active may relieve low back pain and can help speed your recovery.^{2, 3} Stretching and strengthening your stomach, back, and leg muscles helps make them less susceptible to injury that can cause back pain. Strong stomach, back, and leg muscles also better support your spine, reducing pressure on your spinal discs. This may help prevent disc injury.

Aerobic exercises—such as walking, swimming, or walking in waist-deep water—also help you maintain a healthy back. Aerobic exercise makes your heart and other muscles use oxygen more efficiently. Muscles that frequently receive oxygen-rich blood stay healthier.

Continue to How do I exercise to reduce low back pain?
Return to Low back pain: Exercises to reduce pain

Most people who have back pain naturally feel better by doing certain motions. Some feel better sitting (their back and hips are flexed), while others feel better standing (back and hips are extended). Exercise that moves you toward your more comfortable position is usually more successful in treating your back pain.⁴ For example, if you are more comfortable sitting down, exercises that bend you forward—such as partial sit-ups (curl-ups) and knee-to-chest exercises—may help you.

Talk to your health professional before you start an exercise program, and only do exercises that do not increase your symptoms.

The most effective exercise programs for chronic low back pain are designed specifically for you and are supervised.⁵ For example, a physical therapist might instruct you in a home exercise program; then you would see the therapist every so often to check on your progress and advance your program.

• Talk to your doctor or physical therapist if you are unsure how to do these exercises or if you feel any pain as you are doing the exercises.
• Try to exercise a little bit every day.
  • Get some type of aerobic exercise, such as walking, every day. Even a couple of minutes will be helpful, and you can gradually increase your time.
  • Choose a couple of stretching and strengthening exercises that you enjoy doing, or vary them from day to day.

Ask your doctor or physical therapist whether there are additional exercises that will work best for you.

Stretching and strengthening exercises include:

• Extension exercises, which stretch tissues along the front of the spine, strengthen the back muscles, and may reduce pain caused by a herniated disc. These are generally a good choice for people whose back pain is eased by standing and walking.
  • Press-up back extension
  • Alternate arm and leg (bird dog) exercise
• Flexion exercises, which strengthen stomach and other muscles, and stretch the muscles and ligaments in the back. These are generally a good choice for people whose back pain is eased by sitting down.
  • Knee-to-chest exercise
  • Curl-ups
• Additional strengthening and stretching exercises.
  • Prone buttocks squeeze
  • Pelvic tilts
  • Bridging
  • Hamstring stretch
  • Hip flexor stretch
  • Wall sit

Aerobic exercise includes walking, swimming, running, and biking. Non–weight-bearing exercise, such as swimming, tends to be a better choice if you have back pain. Walking in water up to your waist or chest is also good aerobic exercise.

• You should keep taking easy, short walks when you have low back pain. You can likely start more intense aerobic exercise within 1 or 2 weeks after symptoms of back pain start.
• Start slowly so that you don't overdo it. For example, begin with 10 minutes a day. Build up your exercise program bit by bit. And aim for at least 2½ hours a week of moderate exercise.⁶ It's fine to be active in blocks of 10 minutes or more throughout your day and week.

Continue to Where can I learn more about exercises to reduce low back pain?
Return to Low back pain: Exercises to reduce pain

For more information about exercises to reduce low back pain, talk to:

• Your doctor.
• A physical therapist.

If you would like more information on exercises to reduce low back pain, the following organizations can provide information:

Organizations

Return to Low back pain: Exercises to reduce pain

Citations

1. Carragee EJ (2005). Persistent low back pain. New England Journal of Medicine, 352(18): 1891–1898.

2. Koes B, Van Tulder M (2006). Low back pain (acute), search date November 2004. Online version of Clinical Evidence (15).

3. Van Tulder M, Koes B (2006). Low back pain (chronic), search date November 2004. Online version of Clinical Evidence (15).

4. Long A, et al. (2004). Does it matter which exercise? Spine, 29(23): 2593–2602.

5. Hayden JA, et al. (2005). Systematic review: Strategies for using exercise therapy to improve outcomes in chronic low back pain. Annals of Internal Medicine, 142(9): 776–785.

6. U.S. Department of Health and Human Services (2008). 2008 Physical Activity Guidelines for Americans (ODPHP Publication No. U0036). Washington, DC: U.S. Government Printing Office. Available online: http://www.health.gov/paguidelines/pdf/paguide.pdf.