Low back pain: Exercises to reduce pain

How do I exercise to reduce low back 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.

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Author:	Shannon Erstad, MBA/MPH	Last Updated: February 6, 2008
Medical Review:	William M. Green, MD - Emergency Medicine Robert B. Keller, MD - Orthopedics
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