Let’s start with a generic yet simple answer to the question of which exercises are beneficial for low back pain.
Research is clear that general exercise is beneficial for low back pain. It is the most important thing you can do for back health. Understanding pain is a close second. With that, let’s look at the five best exercises you can do for low back pain.
1. Anything you enjoy that is challenging
Ok, I cheated and went generic again. I think it is important to stress some of the foundational concepts for treating back pain.
Back pain is a part of life. You will experience it at some point. Perhaps the pain starts after sitting at a desk all day or after helping a friend move apartments. Here’s the good news. Most low back pain goes away within a couple of days, a few weeks at most.
One of the primary reasons for pain sticking around is a fear of activity. Anxiety and fear of current or future damage fuel inactivity.
Not moving is one of the worst things you can do for back pain. This is why my #1 exercise for low back pain is enjoyable activities.
If we enjoy the exercise, we are more likely to complete it. Don’t like lifting weights? No problem. Like hiking? That is great for your low back.
By resuming activity after feeling pain, you are telling your brain the pain is not to be feared. Movement stimulates recovery processes as well.
If the activity you love worsens the pain, ease into it or make a switch before trying again in a few days. Don’t worry about the type of activity being dangerous because it bends the back (e.g. bowling) as your spine is strong and resilient. It can handle the activities you throw at it.
Walking is one of the best forms of exercise, regardless of your current fitness level. Research shows walking is just as effective as other forms of exercise for treating low back pain. The benefits include building endurance, improving bone quality, and helping control blood sugar levels. Walking also helps with mental health. Studies have shown walking can be used to help treat depression, anxiety, low self-esteem, psychological stress, social isolation, and loneliness. It a great exercise option for people with chronic low back pain.
People often find walking programs more enjoyable than typical gym exercises leading to better consistency, which is key for any exercise program. If you want to learn more about the benefits of walking, check out this article.
Squatting is a daily occurrence and one the most fundamental movements you do in life. You squat to sit in a chair, use the bathroom, and pick up items from the floor. You will be hard-pressed to avoid the movement.
The squat is also considered the king of exercises. It is a fundamental movement that trains the whole body. If you add weight – carrying or on your shoulders – you are building upper body strength. The goal of any exercise is to challenge the body. The squat does that. It is safe and effective.
Squatting can be completed in many ways. Here are some variations ranging from easy to hard:
- Mini air squats, sit to stand, form a chair, full air squats, squats with weights in each hand, goblet squats, sit to stand from low bench or chair, squat with weight in only one hand, back squat, box squat, front squat, Zercher squat, pause squat, split squat, rear-foot elevated split squat
I did not list all the variations, but these are a good starting point. A quick Google search will show examples for any you are unfamiliar with.
If the squat is the king, the deadlift is next in line for the throne.
Deadlifts are safe and great for building back and leg strength. They also reinforce the message that your back is robust and healthy. Research looking specifically at the deadlift has found the exercise to be beneficial for patients with low back pain.
If the pain is severe, the deadlift may not be the best option. There is no need to grit through the pain. But deadlifts should not be avoided altogether. They are something to work towards.
You can start with deadlifts from a raised position or use lighter weights. Like squatting, deadlifting is a daily activity. A deadlift is essentially picking something off the floor. Training your body to improve endurance and strength with lifting will help with many everyday activities. The deadlift is also one of the best ways to build low back muscle, which often reduces following the onset of low back pain.
5. Aerobic Exercise (Cardio)
Aerobic exercise – also known as ‘cardio’ – is any type of exercise that conditions the cardiovascular system. The most common forms of aerobic training are running, biking, and rowing. Walking fits into this category as well, provided it is challenging. As I have already covered walking, I’ll focus on the traditional cardio exercises.
Aerobic training stimulates endorphin release – a chemical produced by the brain that reduces perceived pain. Along with directly reducing pain, aerobic training has psychological benefits. As a safe and effective way to encourage movement, it can reduce fear of movement (kinesiophobia) and increases self-confidence.
Research studies tend to use either cycling, walking, or running to test the effects of aerobic training for people with low back pain, but rowing and running are occasionally used as well. Benefits can be seen across a variety of intensity levels, too. This study showed 12 weeks of high-intensity running reduced low back pain, disability, and psychological strain. Another study found similar results one year later.
Like walking, enjoyment and consistency are important factors. If you hate running, it will not be the best option for treating your low back pain. Conversely, if you crave running and feel all other exercises are inferior, don’t worry about the impact of running. You are not creating any damage. Running is safe and effective.
Taking a long-term outlook
This article has focused on the benefits of exercise for the immediate treatment of low back pain. Exercise shouldn’t stop once the pain resolves.
There are several reasons I didn’t provide a list of 5-10 gimmicky exercises to ‘fix’ your alignment or improve your low back stability. First, there is nothing to fix. Your back is stable and is never out of alignment. Second, exercise is most beneficial when it challenges the body – heart rate is elevated – and you enjoy it. Most exercises with a band or contorting your body into a goofy position is neither enjoyable nor taxing to your body. Third, the message of the overall importance of exercise is lost.
Exercise is one of the best methods to prevent low back pain. The goal is to establish a regular exercise routine that will improve your strength, endurance, and resilience. The exercises I provided are not intended to be short term solutions, but rather, fundamental exercises to use regularly.
If you have concerns about beginning an exercise program, consult with one of our highly-trained physical therapists. They will conduct a comprehensive evaluation and develop a personalized program for you.
ABOUT THE AUTHOR
Zach Walston, PT, DPT, OCS serves as the National Director of Quality and Research at PT Solutions. Zach grew up in Northern Virginia and earned his Bachelor of Science in Human Nutrition, Foods, and Exercise at Virginia Polytechnic Institute and State University. He then received his Doctorate of Physical Therapy from Emory University before graduating from the PT Solutions’ Orthopaedic Residency Program in 2015. Zach now serves as the Residency Program Coordinator and the director of the practice’s Clinical Mentorship Program providing training for over 100 physical therapists a year.
Zach has numerous research publications in peer-reviewed rehabilitation and medical journals. He has developed and taught weekend continuing education courses in the areas of plan of care development, exercise prescription, pain science, and nutrition. He has presented full education sessions at APTA NEXT conference and ACRM, PTAG, and FOTO annual conferences multiple platforms sessions and posters at CSM.
Zach is an active member of the Orthopedic and Research sections of the American Physical Therapy Association and the Physical Therapy Association of Georgia. He currently served on the APTA Science and Practice Affairs Committee and the PTAG Barney Poole Leadership Academy.
Zach currently lives in Marietta, GA with his wife, son, and two dogs. Connect with Zach on Twitter, LinkedIn, and Instagram. To access more content on Living Clinically and resources on critical thinking and career growth, visit his website. You can also sign up for a bi-weekly newsletter to receive his latest blog posts, podcast episodes, research recaps, and recommended readings.