What are good exercises for lower back pain?

It was a typical Sunday morning until you picked up that box full of books. Now, three days later, your back is still throbbing. Everything – from tying your shoelaces to driving your car – is posing a problem.

Lower back pain can be crippling and hard to manage, yet one in three of us experience it every year, according to Bupa. Muscular damage is the most common cause –  although you can also damage the disk and facet joints in your back. The pain you feel can then spread to your hips, buttocks and legs.

Most of the time, the pain will ease within two weeks, and you should experience a full recovery within 4-6 weeks. If the pain is still severe after 6-8 weeks, the Chartered Society of Physiotherapy (CSP) say you should see a doctor.

What causes lower back pain?

“There are multiple causes of lower back pain but the most common one is inactivity,” Lucy Macdonald, physiotherapist at Octopus Clinic, explains. If you don’t do enough exercise, your muscles are not strong enough to withstand strenuous activity, so you are more likely to strain your back.

In 98pc of cases, lower back pain is caused by a sprain or strain that resolves itself within a few weeks, according to the CSP. However. However, even after the sprain or strain heals, the pain can persist due to psychological and lifestyle factors, including stress, tiredness and lack of exercise. “Most people think pain only occurs because something is damaged,” Macdonald says. “Initially that is what’s happening but, as time goes by, the pain can take on a life of its own – it becomes established in the nervous system of the body.”

This pain is “not by any stretch in your head,” asserts Jack Chew, physiotherapist at Chews Health. However, a positive attitude can help with lower back pain. “There is conclusive evidence to show that if you believe you are going to recover fully, you are more likely to recover,” Macdonald says. If you believe you are fighting a lost cause, you will restrict your activity, which worsens the pain.

Does exercise help with lower back pain?

When you have a sore back, you may be tempted to stay in bed for the indefinite future. However, this can make your back pain even worse and cause long-term damage. “Your muscles start to waste – to become weaker and smaller – after 48 hours of inactivity,” Macdonald warns. This means you are more likely to strain them in the future.

Bed rest can also cause stiff joints, which worsens the pain. The facet joints in your back are full of liquid that lubricates your joints as you move, so by staying in bed you lose that lubrication and the joints become stiffer.  

Exercise, therefore, is essential for recovery. “The best thing people can do if they have lower back pain is to keep moving,” Macdonald advises. This helps the blood circulation, nerve recovery and ensures the muscles stay active.

It’s important to keep exercising, even if your back hurts. “It may be sore to start with, but this will often ease with light activity,” says Matthew Rogers, osteopath at Netherne Osteopathic Practice. Macdonald agrees that exercising while in pain is normal and beneficial – but only if you rate the pain a 3 or 4 out of 10, and it only lasts 2-3 hours after you stop exercising.

What are the best exercises for lower back pain?

Consider what triggers your back pain and then tailor your technique. “Identify things that you struggle to do, break them into chunks and gradually expose yourself either to the constituent parts or the movements of the whole,” Chew advises. If you can’t lift objects off the floor, for instance, start by lifting an object from a chair.

You should not engage in strenuous exercise, such as heavy lifting, as “that may aggravate your back further,” according to Stewart Tucker, consultant orthopaedic and spinal surgeon at The Wellington Hospital. “Aim for exercises that improve spinal posture and the strength of core muscles,” he suggests.

The following are some of these gentle exercises that have been approved by our experts for helping with lower back pain. They can be completed at home and/or at your desk at work.

1. Squat

What to do: Stand with your feet hip-width apart, then bend your knees, maintaining the small curve in your back. When you have a sore back, you should bend at less than a 90 degree angle.

Where can you do it?: At home, in the office or even in a toilet cubicle.

How often should you do it?: Do 10 repetitions of the squat at least four times a day to begin with, then build it up to 30 repetitions.

How it works: “It starts to train the stability muscles in your lower back, it works your buttocks muscles, works your quads and increases the whole circulation of the body,” Macdonald says.

2. Twist and grab the back of your chair.

What to do: Keep your feet on the ground and twist your body ¾ of the way towards your chair, so you can grab the back of it. Don’t hold the stretch – just move as far as you can go, then switch to the other side.  

Where can you do it? On your desk chair at work.

How often should you do it? Do 10 repetitions (five for each side), at least four times a day.

How it works: “It stretches your middle back. If your middle back is stiff then your lower back ends up taking more of the strain, so if you can get your mid-back moving, that can give immediate relief to your lower back,” Macdonald says.

3. Pelvic tilting

What to do: Tip your stomach forwards so you’re arching your lower back as much as you can, then slowly rock your pelvis the other way. Stretch out the lower back as much as possible.

Where can you do it? Either lying in bed or sitting at your desk.

How often should you do it? Do more than 10 repetitions - preferably 30 - four times a day.

How it works: “The fluid inside those facet joints is swished around to make the joints move more freely. The muscle spasms in the back can be gently eased, you get an increase in blood supply to that specific area and a reduction of sensitivity in your nerves,” Macdonald explains.

4. Knee hugs.

What to do: Lie on your back with your knees bent and your feet on the floor. Bring your knees to your chest and hold for 30 seconds, then slowly return to the start position, using your hands to lower your legs.

Where can you do it? On the floor at home (with a pillow under your head, of course)

How often should you do it? You should do it around 3-4 times a day, with three repetitions per session.

How it works: “You’re stretching out those muscles in the hip - around the buttocks area - and you’re stretching all the fibres in the back of the body,” says Catherine Quinn, a chiropractor at The Waldegrave Clinic.

5. Lying spine twist

What to do: Lie on your back with your knees bent and feet firmly on the floor. Slowly drop both of your knees to one side as far as possible - but don’t force it, just let gravity do the work. Hold for 10-30 seconds, then return to the starting position.

Where can you do it? Lying on the bedroom floor.

How often should you do it? Do 6-10 repetitions (so, 3-5 times each side) twice a day.

How it works: “Such gentle movements may help to loosen things up and ease the symptoms,” Rogers says.

6. Roll down your chair.

What to do: Sit on your chair with your feet firmly on the ground, then run your hands down the front of your shins towards your ankles until you are in a crouched position. Then roll out of it again.

Where can you do it? Sitting on your desk chair.

How often should you do it? Do eight repetitions around three times a day.

How it works: “People indicate sitting for too long in one position triggers lower back pain, so moving more regularly will help reduce that,” says Quinn.

7. Cat stretch

What to do: Start on all fours on the floor. Arch your back up and then, within 30 seconds, return to the start position.

Where can you do it? On the (carpeted) floor at home.

How often should you do it? Around 3-4 times a day, or every 3 hours.

How it works: “By slowly moving in and out of the reflection and extension position, you’re getting all the muscles and joints to move more freely and in a more controlled way, which can help to reduce the pain,” Quinn explains.

When should you see a doctor for lower back pain?

While these exercises can assuage lower back pain, nothing can substitute a trip to the doctor’s. If the pain is severe or does not seem to be recovering after a week, you should see your GP or another medical professional.

You must see your doctor immediately if you have any of the following symptoms: pins and needles or weakness in both legs, bladder or bowel symptoms, reduced sensation in the inner thighs area, progressively worsening pain, or if you feel unwell - including a fever or losing weight.

How can you prevent back pain?

Exercise can prevent back pain, as stronger muscles as less likely to be strained. “Those who take regular exercise and who are physically active tend to get less back pain and recover faster if they do get it,” Rogers advises.

Adults between the ages of 19 and 64 should try to do at least 150 minutes of moderate aerobic exercise (cycling or brisk walking) every week, as well as strength exercises at least twice a week that work on building hips, back, abdomen, chest, leg, shoulder and arm muscles.