A common question among those experiencing back pain is this: What is the best exercise for back pain?
There is no single exercise that can be considered “the best” for back pain. According to an extensive review of research studies, an exercise program that combines muscular strength, flexibility, and aerobic fitness is best to manage nonspecific chronic low back pain.
Increasing core muscular strength helps support the spine and prevent low back pain. They have a positive impact on the flexibility of the muscle, tendons, and ligaments in the back area thus helping improve the range of motion.
Aerobic exercise increases the blood flow, and the blood carries nutrients and oxygen to the spine and surrounding tissue. Therefore this form of exercise promotes faster recovery and reduces muscle stiffness associated with back pain. In addition, a 30-40 minutes session of aerobic exercise increases endorphins levels. Endorphins are feel-good chemicals with painkiller qualities, working similarly with prescription drugs morphine and codeine. Aerobic exercise also reduces fear of movement which is experienced by many individuals with disability and physical limitations. For low back pain rehabilitation, experts recommend moderate-intensity aerobic (40%–60% heart rate).
There are plenty of studies that found that exercise is beneficial for managing low back pain. For example, one study found that an 8-week moderate-intensity aerobic exercise significantly reduces chronic low back pain (non-specific cause) by 47%. Another study found similar improvements in back pain when comparing aerobic exercise with strength training.
Individuals with low back pain tend to restrict body movement in order to reduce the low back pain. However, this leads to reduced core strength and flexibility in the lower part of the spine. Core strength exercise helps counteract these problems. Whether using weights or bodyweight, strength training is a great choice for individuals with low back pain. This form of exercise increases core strength as well as flexibility and stability of the lumbar spine (low back area). Strength exercise is considered the best exercise to improve walking speed and functional gait, helping a person complete activities of daily living (ie showering, grooming, dressing, doing housework chores, walking, moving from one position to another, etc.)
Stabilization training using stability balls or Bosu balls can be useful for chronic back pain but show limited benefits in the case of acute low back pain. Core stabilization exercises help reduce chronic back pain by almost 77 % compared to almost 63 % improvement seen with conventional exercises, according to one study.
Flexibility training involves stretching exercises targeting the back, legs, and buttocks. They help improve flexibility, range of motions of the joints and decrease muscle stiffness. Along with strength exercise, flexibility training improves low back pain and makes daily activities easier and more comfortable to perform. One study reports a 54% significant increase for low back (lumbar) flexion and 98% for lumbar extension, as the back pain improved by 58%.
Back pain sample exercises
It is best to consult a physiotherapist or personal trainer who specializes in back pain, to learn the proper techniques and also get a customized fitness plan based on age, physical limitations, and preferences. Yes, preferences matter too, because the best exercise is the one you enjoy. The more enjoyable the fitness routine, the more likely it is to be consistent and work out regularly, long term.
Here are a few exercises that can help prevent or manage low back pain. Make sure you ask the fitness instructor or the trainer to provide alternate options/ postures suitable for individuals with low back pain. Do not skip the warm-up and cool-down parts of the workout, as they are important to prevent injuries. Ease off the workout if you start to experience pain.
Aerobic exercises. Brisk walking for 30 minutes, biking 4 miles in 15 minutes, water aerobics for 30 minutes, swimming laps for 20 minutes, gardening for 30 minutes are all considered moderate intensity physical activities. There are special cardio workouts using bicycles, treadmills or other equipments at the gym.
A yoga, pilates or tai chi session include plenty of stretching/flexibility exercises and also target core strength. Aim for a 30-45 minute workout, 2-3 times a week
The following exercises are often included in an exercise program designed for back pain. They are quite effective to alleviate pain and they help prevent future episodes of back pain, as well.
Pelvic tilts. Lie on your back on the floor and keep your knees bent. Keep your back flat on the floor by tightening the muscles of the abdomen and slightly bending your pelvis. Hold this position for 10 seconds and repeat 20 times
Abdominal curls. Lie down on your back, with the knees bent and feet on the floor. Put your hands across the chest. Tighten your abdominal muscles, and your shoulders will raise about 10 inches from the floor. Keep your head back. Relax the abdominal muscles and gradually lower the shoulder. Do three sets of 10.
Knee to chest stretch. Lie down on your back, keep the knees straight. Put your hands behind your right knees and bring it to your chest. Hold for 10 seconds. Repeat with the left leg. Do this exercise 10 times.