Lower Back Pain and Exercise

If you have simple or non-specific lower back pain then exercise may be one of the most helpful ways for you to manage it. The best research evidence we have shows that that if you have back pain for a short while you need to keep moving and exercise and keeping active may be the best thing for you.

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What type of exercise is best?

I have to be 100% honest here and say that the research is showing us that any exercise is good for you. It doesn't really matter what you do as long as you move, there is no single type of exercise that is rising above the rest as better for back pain.

In time the research may help us pin down the perfect exercise for certain types of back pain but until that day my advice is talk it through with your doctor or physio and discover what suits you the best and that helps the most. I have seen many of my patients get fantastic relief with core stability work, others have done well with stretching exercises, others haven't bothered with specific exercises but have taken up swimming or cycling and that has done the trick. Find out for yourself what works best for you.

what type of exercise for back pain

In the meantime I have created the sections listed below which containing some of the most helpful exercises in each category that I use and which will give you some ideas to get started.

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Movement or Stretching Exercises

These stretch and move stiff areas of your back. They also lengthen muscles and soft tissues allowing greater movement and often reducing pain.
lower back pain exerciseStrengthening Exercises
These aim to strengthen the muscles that support your spine. A good strengthening programme should include some exercises for your 'core' muscles or 'core stability' work.


Physical Fitness Exercises
If you have back pain then getting fitter is really important. Improving you physical fitness means you increase the blood supply to all the tissues in your body, not just your heart and lungs.This improves your back fitness at the same time.

How does exercise help my back pain?

There are lots of different reasons why exercise helps these vary from direct effects on the spine i.e. moving sore joints and muscles through to more general system wide effects like improved mood and hormonal changes.

  • They improve your flexibility and strength, when you are sore you tend to stiffen up and muscles and joints become stiff and weaker.

  • Exercises give you relief from postural stresses and strains - if you get pain if you stay in one position for long periods (like many of us do -computer use for e.g.) some stretching can really help ease up the soreness.

  • Exercise causes the release of endorphins, your bodies own natural pain killer, this can make a world of difference by reducing your pain and cheering you up.

  • I especially like this one - exercise puts you in charge of the problem. Control your back pain, don't let your back pain control you.

  • If you are scared to move in case you make the pain worse then that will more than likely make the whole problem worse over time and makes it more likely that you will go on to have a a more longstanding problem. Graded exercise can help you get past your fear and get moving again.

When shouldn't you exercise?

There are lots of different types of lower back pain, but the most common by far, is simple or non specific back pain. 90% of people with back pain have this type of problem, and many will feel much better with exercise. These less common types of back pain may not be helped by specific exercise or may need more careful supervision.

  • If you have a serious back problem
  • If you have acute sciatica or a disc bulge some exercises may aggravate the problem
  • If you have acute pain - or pain that has lasted only a few days

There is no evidence that specific exercise are helpful in the first few days of an episode of back pain. However, keeping generally active is the way forward.

There has been some published research (2) which has some interesting findings about managing acute back pain and lower back pain exercise.

Other things to think about

Pace yourself
Learn about pacing so you don't 'flare up' the problem

How long and how often should I do lower back pain exercise?
I'm often asked this and the honest answer is there is no rule. I generally say 'little and often' but you ned to find a level for yourself - your physio or doctor can help you with this.

What type of movements take place in your back?
Your spine can move in many different directions - a healthy back is able to move in all these different ways. Knowing what the different movements are can help you understand what you are doing with different exercises.

References

(1) Non Specific or Simple Lower Back Pain Guidelines

(2) Hancock, M. J. et al. Assessment of diclofenac or spinal manipulative therapy, or both, in addition to recommended first-line treatment for acute low back pain: a randomised controlled trial. The Lancet 370, 1638–1643 (2007).

(3)  Balagué, F., Mannion, A. F., Pellisé, F. & Cedraschi, C. Non-specific low back pain. Lancet 379, 482–491 (2012).

Lower Back Pain Toolkit Home Page

02-Mar-2015

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