Six simple exercises to prevent back and neck pain

If back or neck pain is slowing you down and curbing your days, you’re certainly not alone. The latest ONS figures paint a grim picture: in the UK, 2.9 million people report problems linked to their back or neck, and, between January and March last year, almost one million were classed as economically inactive because of it. Back and neck problems currently cost us £1.4 billion in welfare – up by more than a quarter since the pandemic. 

What is going wrong? Kevin Hunt, a physiotherapist at Spinal Physio, believes the biggest single factor here is lack of knowledge and understanding, which causes us to respond to back and neck pain in the worst way possible – by trying to stay very straight, spine aligned and avoiding moving as much as possible. “There’s an awful lot of misinformation out there,” says Hunt who has served on sporting teams at events, including the Olympics and the Grand National, and is the author of Pain: The Ultimate Mentor. “When we believe that pain means that our back must be damaged – or that ‘hurt’ means ‘harm’, we try to avoid bending and twisting and moving around. That makes us stiffer and weaker, and movement becomes harder.” 

It’s important to note that there’s a crucial distinction between ‘acute pain’ due to an injury which is less than six weeks old, and ‘chronic pain’ of over 12 weeks. There are also cases where back pain is a symptom of disease and infection. However, most long term spinal pain, stiffness and flare ups will result in no firm diagnosis and are instead vaguely termed ‘non-specific’ and ‘musculoskeletal’. “If it’s chronic and persistent, then it’s a complicated issue,” says Hunt. “The pain is probably trying to tell you something about your lifestyle.”

The pandemic has of course compounded what was already a growing problem. Rushed online GP consults and long referral waiting lists have limited access to proper assessment and expert advice, leaving many to ‘manage’ the problem alone. Working from home hasn’t helped either. “It means you don’t walk to the station or to meetings, or to get lunch, or get coffee. You’re just sitting at home on your computer,” says Hunt. “It also means we might not switch off. We don’t have natural breaks, we sleep less well, perhaps we’re bored, lonely, or anxious. All those things impact our pain experience – but it’s very easy to blame bad posture and the kind of chair we’re sitting on.” 

Though it sounds counter-intuitive when you are in agony, for most of us, movement is the way to a cure. Every clinical guideline relating to back pain promotes exercise as a high priority treatment. Start gradually and build it up over time, ideally including a mixture of stretching and strengthening exercises. There’s no one size fits all - if anything feels too uncomfortable, try something else, or do it less strenuously or with less repetitions. So what exercise works best? 

The six best exercises for back and neck pain

Walk

“It’s the first and best thing that we should be doing,” says Hunt. Walking strengthens the muscles which support the spine, as well as the legs which reduce stress on the spine. “It increases blood circulation, helps with bone density, delivers fresh air and sunlight which helps with our sleep and circadian rhythm. It’s a change of scenery, a break in the day. We should be walking for 40 minutes minimum every day – breaking it up to two 20-minute walks if necessary.”

Lying knee rolls 

“We spend a lot of life in straight lines – sitting, standing – but the spine is a collection of pivots that bend and rotate and need to move. We don’t rotate nearly enough, then when we do need to bend and twist, it comes as a bit of surprise to the body,” says Hunt. This is a gentle stretch that helps build flexibility.

Rotation in golf stance with stick behind neck

This is an effective way to rotate your thoracic spine – the spine in the upper back and abdomen - and it also gets the shoulders moving. “When we’re at our desk, or on our phone, we’re often curved inwards, looking down,” says Hunt. “This exercise makes us change our posture and really opens up the chest.” 

Buttock stretch

The piriformis is the muscle in the pelvis, located deep in the gluteus maximus, the biggest buttock muscle, close to the sciatic nerve. When the piriformis muscle spasms or becomes tight or inflamed, it can cause lower back pain and sciatica. Stretching the muscle often and consistently is one of the most important ways to prevent this. This exercise also gently stretches and relaxes the spine and helps open up the hips to improve range of motion in the lower back. 

Lie on your back and bend one knee so the ankle rests on the opposite thigh. Reach your hand around the other leg pulling the thigh stretching the leg towards you. Hold the stretch for 30 seconds. Aim to do this two to three times a day.

Kneeling neck stretch

This will work the group of muscles in the neck – the deep neck flexors – which form part of our core muscle system and are key for maintaining neck stability and supporting the head. “Many people know that we need a strong core to prevent back pain but tend to focus on the core muscles in the abdomen,” says Hunt. “These core muscles in the neck are important too – and we spend a lot of time with our heads down looking at phones.” Weakness in the deep neck flexors leads to neck pain, headaches and an over-reliance on other larger muscles in the neck to stabilise us. This exercise targets the deep neck flexors.

Side plank with leg raise

This is relatively advanced but really one of the best exercises for strengthening the lower back stabilisers that protect your spine. It might be something to work towards by starting with a knee side plank, with knees bent at 90 degrees. If you’re able to achieve the full plank, you know you have strength in your back.