In short
Exercise is one of the best-supported treatments for back pain that lasts more than a few weeks. No single type is clearly best, so the right exercise is one you can do regularly. Start gently, build up slowly, and stop anything that causes sharp or spreading pain.
On this page
Does exercise help lower back pain?
Yes, particularly for pain that has lasted more than six weeks. A 2021 Cochrane review of 249 trials found that exercise probably reduces pain in chronic low back pain compared with no treatment, usual care or placebo, and improves how well people function. Guidelines in Australia and overseas recommend exercise as a first-line treatment.
For a new episode of back pain, the most important thing is staying active and getting back to normal activity. Specific exercises become more useful if pain lingers.
Which exercises are best?
The research hasn’t found one type that clearly beats the others. Pilates, strengthening, stretching, walking, yoga, tai chi and motor control exercise have all shown benefits in trials. The best exercise is the one you’ll keep doing. A physiotherapist or exercise physiologist can tailor a programme and help you progress it.
Pain that isn’t settling?
Talk it through with an Australian doctor online. No referral needed.
Gentle exercises to start with
These are commonly used starting points. Move slowly, breathe normally and stay within a comfortable range. Mild discomfort is fine; sharp, worsening or spreading pain is a sign to stop.
- Knee to chest. Lie on your back with knees bent. Bring one knee towards your chest, hold for 20 to 30 seconds, then swap. Try both knees together if that’s comfortable.
- Pelvic tilt. Lie on your back with knees bent. Gently flatten your lower back into the floor by tightening your stomach, hold for a few seconds, then relax. Repeat 10 times.
- Cat and camel. On your hands and knees, slowly round your back up towards the ceiling, then let it gently sag. Repeat 10 times.
- Bridge. Lie on your back with knees bent and feet flat. Squeeze your buttocks and lift your hips until your body forms a straight line from shoulders to knees. Hold for a few seconds and lower. Repeat 10 times.
- Bird dog. On your hands and knees, reach one arm forward and the opposite leg back, keeping your back level. Hold for a few seconds, then swap. Repeat 5 to 10 times each side.
- Walking. Short, regular walks are one of the simplest ways to keep moving. Start with what you can manage and add a few minutes every few days.
How often, and how much?
- Most programmes in trials ran for at least six to eight weeks, with exercise two to three times a week or more.
- Start low and build up gradually. Doing a little most days is better than overdoing it once and paying for it.
- Expect some discomfort as you get going. Pain that settles within a day or so is usually not a sign of harm.
- Combine exercise with your normal daily activities rather than resting in between.
When not to exercise without advice
Check with a doctor before starting if you have pain after a significant fall or accident, numbness or weakness in your legs, a fever, unexplained weight loss, or a history of cancer. Numbness around the groin or new bladder or bowel problems need emergency care. See back pain red flags.
Getting help with an exercise plan
If you’ve tried exercising and your pain isn’t improving, or you’re worried about doing damage, a GP can assess you and refer you to a physiotherapist or exercise physiologist. People with chronic conditions may be eligible for some Medicare-subsidised allied health sessions through their GP.
Next step: talk to a doctor
Answer a few quick questions and you’ll get an email about your eligibility. A consultation doesn’t guarantee any particular treatment.
References
- Hayden JA, Ellis J, Ogilvie R, et al. Exercise therapy for chronic low back pain. Cochrane Database Syst Rev. 2021;9(9):CD009790.
- Qaseem A, Wilt TJ, McLean RM, et al. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017;166(7):514-530.
- Foster NE, Anema JR, Cherkin D, et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet. 2018;391(10137):2368-2383.
- Geneen LJ, Moore RA, Clarke C, et al. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. Cochrane Database Syst Rev. 2017;4(4):CD011279.
- Australian Commission on Safety and Quality in Health Care. Low Back Pain Clinical Care Standard.
This guide is general information, not medical advice. It doesn’t replace a consultation with a doctor who knows your history. In an emergency, call 000.