Exercises To Help With Lower Back Pain

Introduction

Suffering from lower back pain is a major health issue, with around 15-20% of adults reporting lower back pain at some point during their lives.^1,2 For many, their pain will diminish with very little medical attention within a few weeks. However, for some, it can persist over long periods of time or become reoccurring.

Lower back pain can be defined as either acute (less than 3 months) or chronic (lasting more than 3 months). Both types of back pain have very similar causes.

For both acute and chronic lower back pain, an effective exercise programme has been shown to ease lower back pain and speed up healing. Therefore, it has become a key component of a multimodal approach to lower back pain management.

Although it can be tempting to lie in bed when suffering from lower back pain, it is critical that you remain active. According to Arthritis Research UK, bed rest for more than a few days can be detrimental. Therefore, it is essential to stay active when suffering from back pain and gradually return to more strenuous exercise.  

The exercises detailed below aim to condition the muscles so they are better equipped to support the spine and withstand stress, resulting in pain relief. Although some of the exercises mentioned in this article do not require equipment, others require some small weights.

Read on to learn more about specific exercises you can do to help ease your lower back pain. 

Causes of lower back pain

The lower back is the anatomic region between your lowest rib and the upper region of the buttock. The lumbar spine can be located here. This area is susceptible to injuries, the most common cause being strains or sprains.

Although symptoms differ between individuals, general lower back pain symptoms include:

• Dull ache in your hips or pelvis
• Muscle spasms or tightness
• Sciatica (pain that moves from the lower back down to the legs)
• Pain that improves whilst walking
• Pain that is worse first thing in the morning

For some, the cause of their lower back pain is obvious, you twisted your back, fell over or lifted something too heavy. However, sometimes the cause of your lower back pain is not as apparent. In this case, it could be a more severe condition called chronic lower back pain.

Common causes of chronic lower back pain are:

• Herniated disc
• Facet joint (located in the spine) damage
• Compression fracture
• Spinal stenosis
• Spondylolisthesis
• Scoliosis

Risk factors

Research has shown a clear association between sitting behaviour and lower back pain. Leading a sedentary lifestyle, such as sitting in an office chair for long periods of time, can lead to atrophy (wasting away) of the lower back muscles. This manifests as greater stiffness and fatigue. In this case, it is beneficial to pay more attention to them as keeping your lower back strong helps reduce the risk of developing lower back pain. 

Benefits of exercises for lower back

Exercise is a key component of effective lower back pain management. Weak back and core muscles can cause or worsen lower back pain. A growing body of evidence suggests that long-term training of your back, abdominal and buttock muscles can help to alleviate some of your pain.

A key benefit of training your lower back muscles is that it can help prevent strains and sprains that could cause pain following an accident.

Although back exercises may not eliminate back pain, they may improve your functioning and alleviate some pain.

Exercising your lower back muscles can lead to improvements in mobility and balance.

The key benefits of exercising your lower back include:

• Strengthens muscles which are responsible for supporting the spine, which reduces pressure on the spinal discs and joints
• Reduces stiffness
• Improves mobility and balance
• Exercise releases endorphins which help relieve pain
• Helps protect from back pain and injury
• Improves posture

Types of exercises for lower back

There is a huge range of exercises that you can undertake to improve the condition of your lower back, but only a small number will be mentioned here. However, a comprehensive lower back workout should include exercises that aim to strengthen and stretch the following muscles: 

• Transverse abdominis 
• Quadratus lumborum
• External & internal obliques
• Gluteus maximus and medius
• Lumbar multifidus
• Pelvic floor muscles
• Rectus abdominis

It is often reported that these exercises increase your symptoms slightly in the beginning, however, after some time they should help to strengthen your lower back and help you gain mobility. 

The NHS estimates that it can take up to 12 weeks for you to notice any improvement.

Stretching exercises

Stretching exercises are important for individuals suffering from lower back pain. Muscles that are less flexible are more prone to injuries such as sprains and strains due to the restricted joint mobility. 

When carrying out these stretches, you should start by holding the stretch for a short period of time before building up to 30 seconds in hold. It is important that you do not bounce as that has the possibility of causing tissue injury.

Knee roll

This exercise requires you to be lying down, for example on your bed. 

1. Whilst lying down, point your knees towards the ceiling. Roll your knees to the right
2. Roll your knees back to the centre
3. Now repeat but to the left-hand side

Remain on each side for around 10 seconds. Repeat around 3 times for each side. 

Single or double knee hug

Again for this exercise you should be lying down, for example on your bed. 

1. Whilst lying down, bring either one knee or two knees up towards your chest
2. Hold for a few seconds then release in a slow and controlled manner

Repeat around 5 times. 

The back stabiliser

This exercise involves you being on all fours with a straight back. 

1. Tighten your abdominal muscles
2. Whilst your back remains straight, lift one arm directly in front of you for 10-15 seconds, whilst keeping your pelvis level
3. Release in a slow and controlled manner

Repeat around 10 times on each side. If this exercise is not challenging enough, you can raise the opposite leg simultaneously. This variation is called a bird dog.  

Pelvic tilt

This exercise will work the muscles around the pelvis. 

For this exercise, you should be lying down and have your knees bent. 

1. Tighten your stomach muscles, causing your back to flatten against the floor
2. Hold for a few seconds, then release in a slow and controlled manner

Repeat around 5 times. 

Deep stomach muscle tone

This exercise requires you to be on all fours with a small curve in your lower back. 

1. Let your stomach relax
2. Bring your stomach upwards so that you lift your back - don’t arch it. 
3. Hold your back in this position for 10-15 seconds
4. Release in a slow and controlled manner

This exercise should be repeated around 10 times. 

Strengthening exercises

It is important to maintain strong abdominal, buttocks and upper leg muscles. This is because when these are weak or tight, they are more susceptible to injury. 

Plank

The plank exercise helps to keep your core strong and stable. It is important for reducing pain in your lower back, as a strong core can reduce the stress placed on your spine and in the long run help you to achieve better posture. 

1. Lie on your stomach and lift both your hips and knees off the floor. 
2. Ensure you maintain a straight line from your knees to your shoulders.
3. Hold the position for 10-30 seconds depending on your fitness capability. 
4. Release in a slow and controlled manner.

If the plank is too difficult, you can make it slightly easier by keeping your knees on the ground. 

Squats

Squats help to exercise your glutes, hamstrings and back. 

1. Begin by standing with your feet about a shoulder width apart. 
2. Whilst looking ahead, tighten your abdominals
3. Hinge at your hips and bend your knees to a sitting position. 
4. Return to the starting position using your legs first then follow through with your glutes.

If you wish to make this exercise a little bit harder, you can add in weights. 

Abdominal crunches

Abdominal crunches help you develop your core muscles, which in turn help to stabilise your spine and improve hip alignment. 

This exercise requires you to lie with your back flat against the floor. 

1. Lie on the floor with your back against the floor, your knees bent and your feet hip-width apart. 
2. Place your hands across your chest. 
3. Tighten your abdominal muscles and lift your head and shoulder blades off the floor. 
4. Then release and return to the starting position. 

Repeat this exercise 10-15 times. 

Low-impact aerobic exercises

Aerobic exercises are beneficial to people suffering from lower back pain. 

Activities that are high-impact should be avoided until your pain has reduced significantly. 

High-impact activities include: 

• Running 
• Any sports that involve jumping, such as basketball
• Step aerobics

Instead, you should engage in low-impact activities, such as: 

• Swimming
• Yoga
• Walking
• Spinning bike

Remember to continue this exercise regime after your bout of back pain is imperative, as evidence shows it to be a preventative measure against future episodes of pain. 

Tips for doing lower back exercises safely

Consultation with a doctor or a physical therapist

It is advised to consult your GP or physiotherapist before you begin any lower back workout to help with pain. This is even more important if there is any doubt about your fitness. A physiotherapist can help you develop a safe exercise programme to help with your lower back pain. 

Additionally, if you begin to experience any discomfort whilst carrying out any of these exercises, you should consult your GP or physiotherapist for further information. This is critical because not adhering to the exercise programme could increase pain. When pain is preventing you from continuing an exercise programme, your physiotherapist should be able to incorporate pain reduction into your exercise programme. 

Finally, it is important to check with your doctor if:

• The pain is not going away after treating it at home for a few weeks
• The pain is constant
• The pain is preventing you from sleeping at night
• The pain radiates into your leg
• The pain is a result of an injury or trauma such as a car accident or a fall. 
• You experience numbness or tingling

Proper warm-up and cool-down

It is imperative that you warm up before carrying out any of the exercises mentioned in this article. This is because warm-ups are important in helping increase your range of motion. This enables you to carry out each exercise fully. 

A warm-up can just be a quick stretch and a 5-10 minute form of cardio such as walking. This can help to get your blood circulating and help you avoid injuring your back in the first place.  

Use of proper form and technique

When carrying out any exercise programme. it is important that you do so in a safe environment with proper technique. Failure to do either can result in increased pain or injury. If you find yourself unable to maintain good form, you should decrease the weight you are using or the number of repetitions you are carrying out. 

Summary

Lower back pain is a global health issue. Research has shown that an effective exercise programme can result in some pain relief. There are 3 important aspects of exercising your lower back: stretching, strengthening and aerobics. Remember: if you experience any significant discomfort whilst exercising, you should stop immediately and consult a doctor or physiotherapist.