Lower Back
This article is brought to you by ISSA (International Sports Sciences Association) 
Researchers estimate that as many as 84% of adults will experience lower back pain at some point in their lives. (1) That makes this topic important for personal trainers, no matter their client base. 
Here we share several exercises that are good for people dealing with pain in the low back. Knowing when to suggest or try these movements versus recommending medical attention begins with understanding what may be causing the lower back pain in the first place.
What Causes Low Back Pain?
There are two types of lower back pain: acute and chronic. Acute pain is pain that comes on suddenly and is generally short-lived. Low back pain after an auto accident or a slip and fall are examples of acute pain. So too is pain experienced after lifting something heavy or moving in an awkward position.
In these cases, pain may be caused by straining the muscles or ligaments in the lower back. It’s also possible that a vertebra could be fractured. If a disc in the spine becomes bulging, herniated, ruptured, or otherwise displaced, this can cause pain as well. 
Chronic low back pain is pain that occurs slowly over time and is long-lasting. Sometimes, this type of pain is caused by being physically inactive or sitting a lot. When you don’t move around, muscle tends to tighten. If it gets too tight, it leads to pain.
Other times, chronic pain is the result of a severe injury or disease. Diseases that can cause lower back pain include:
  • arthritis of the spine 
  • osteoporosis
  • degenerative disc disease
  • scoliosis 
  • spinal stenosis (narrowing of the spinal canal that causes pain in the nerves)
  • myofascial pain syndrome
How Physical Activity Helps Pain in the Lower Back
When your lower back hurts, exercise may be the last thing on your mind. But it is also one action you can take to start to get the pain to subside.
A review of the research published in the journal Healthcare shares that physical activity can be beneficial for pain in the lower back in numerous ways. (2) Improving muscle strength and flexibility with exercise aids in rehabilitating the damaged area, for instance. Improved flexibility of lower back muscles also makes functional movement easier, especially if movement is hindered by tight muscles. 
Another benefit of exercise is that increased back and core strength helps better support the spine. This makes it less susceptible to injury. It also helps correct poor posture issues, and poor posture can cause back pain. 
During aerobic exercise, the flow of blood and nutrients is increased to the low back. This helps reduce stiffness while improving healing.
These benefits are in addition to the fact that physical movement can help prevent pain in the lower back by keeping the body fluid. That’s why regular exercise is a critical part of a healthy lifestyle.
Treating Low Back Pain at Home vs. Seeking Medical Care
Although exercise can be beneficial for back pain, it’s important to recognize when medical care may be needed. Generally, if the pain is mild and doesn’t interfere with activities of daily living, it may resolve without outside intervention. Doing exercises like the ones mentioned below may help ease the pain.
However, if the pain is severe, long-lasting, or stopping you from doing your normal activities, medical attention is recommended. Medical attention is also encouraged if you hear or feel a noticeable pop or tearing sensation that preceded the back pain. It’s possible that you tore a muscle or ligament to the point where it won’t heal on its own, or you may have injured a disc. 
Depending on the injury, you may be referred to physical therapy. A physical therapist can work with you to rehab the affected area. If the damage is severe or the result of a disease, other interventions may be needed. This can include taking medications, surgery, or other treatments specific to the cause.
If pain occurs as the result of an accident or some other trauma, getting checked out immediately can also lead to faster treatment. Faster treatment helps lead to faster pain relief.
Exercises for Lower Back Pain
Now, let’s get to the main reason you’re here. Let’s talk about exercises that are good for pain in the lower back. 
Some of these exercises help by stretching tight back muscles. Performing 3-5 reps of these exercises daily can help elongate the muscles and improve flexibility. 
Other movements are designed to strengthen the lower back or other muscles in this area, such as the glutes and hip flexor muscles. This provides more support to the spine and surrounding areas, relieving pain in that way. Do 8-12 reps of these exercises two to four times per week.
What are the best exercises for low back pain? Here are several to consider.
  • Bridge. Lie on your back with your knees bent. Lift the hips until your body is in a straight line from your shoulders to your hips to your knees. Hold for 3 seconds and return to the starting position.
  • Cat stretch. Get on your hands and knees. Next, arch your back like a scared cat. (Imagine that a string is pulling your waist toward the ceiling.) Hold for 1 second, then lower your back, as if pushing your belly toward the floor. Return to the starting position.
  • Child’s pose. Get on your hands and knees. Move the hips back until your glutes are resting on your heels. Extend your arms in front of you and elongate your body. Hold for 30 seconds and return to the starting position.
  • Hamstrings stretch. Lie on your back with your knees bent. Grab a towel and loop the middle around the ball of the right foot. Straighten the right leg so the bottom of the foot is facing the ceiling. Pull back on the towel lightly to elongate the stretch down the back of the leg. Hold for 3 seconds and return to the starting position. Do the same movement with the opposite leg.
  • Knee-to-chest stretch. Lie on your back with your knees bent. Slowly, pull the left knee toward your chest. Hold for 3 seconds and return to the starting position. Next, pull the right knee to the chest and hold.
  • Knees-to-the-side stretch. Lie on your back with your knees bent. Keeping the knees together, rotate them to the right side until they are at a 45-degree angle to the floor. Hold for 3 seconds and return to the starting position. Do the same movement to the left side. 
  • Piriformis stretch. Lie on your back with your knees bent. Rest your right ankle in front of your left knee. Pull your left thigh toward your chest. Hold for 30 seconds and return to the starting position. Do the same move with the left ankle on the right knee.
  • Spine lift and fall. Lie on your back with your knees bent. Tighten the abdominal muscles and lift the lower back off the ground. Hold for 3 seconds, then relax. Next, push the lower back against the floor. Hold for another 3 seconds, then relax.
Exercises to Strengthen the Lower Back
  • Back press-up. Lie on your stomach. Put your hands under your shoulders, as if starting a push-up. Push the upper body up until you are resting on your forearms. Hold for 3 seconds and return to the starting position.
  • Bird dog yoga pose. Get on your hands and knees. Straighten the left leg and lift it behind you until your foot is at shoulder height. Hold for 3 seconds and return to the starting position. Do the same exercise with the right leg extended. Advanced exercisers can lift the arm opposite of the leg for greater intensity. (Lift the right arm while extending the left leg and vice versa.)
  • Crunch. Lie on your back with your knees bent. Place your hands behind your head, but don’t pull on the neck. Tighten the abdominal muscles and lift the shoulders off the floor. Hold for 1 second and return to the starting position.
  • Pelvic tilt. Lie on your back with your knees bent. Tighten the abdominal muscles and press the lower back against the floor. Hold for 3 seconds and return to the starting position.
  • Wall sit. Stand one foot in front of a wall, with your back facing the wall. Lean your shoulders back against the wall and slide down until you are in a sitting position. Both the knees and hips should be at 90-degree angles. Hold for 3 seconds and return to the starting position.
Ease Low Back Pain with Aerobic Exercise
Aerobic exercise helps improve blood flow to the low back, providing nutrients that can help the area heal, thereby reducing the pain. To keep from aggravating the lower back, low-impact exercises are best.
Options to try include walking, bicycling, and swimming. When swimming, just be careful to not twist the lower back. Stick to basic movements such as the breaststroke and backstroke. A less intense form of yoga can be helpful as well.
Additional Pain Relief Options
Beyond exercise, there are a few other things you can do to help tame pain in the lower back. If the pain is acute, applying ice to the area can help with inflammation and swelling. For chronic pain in the lower back, heat often works better.
Getting good sleep is also helpful as the Sleep Foundation reports that sleep issues and lower back pain is “a two-way relationship.” (3) Not only can pain in the lower back make it harder to sleep, but getting poor sleep can also contribute to back pain. 
If you find it difficult to sleep due to back pain, the best position is on your side with the knees partially bent. Placing a small pillow between the knees can increase your comfort in this position.
Pain is a common issue for many, not just in the low back but in other areas of the body as well. You can help clients ease their pain as a Corrective Exercise Specialist. This ISSA certification course teaches trainers how to work with people with various pain conditions. You also learn how to correct muscle imbalances, range of motion issues, and more.
1. Wheeler, MD, S. G., Wipf, MD, J. E., Staiger, MD, T. O., Deyo, MD, MPH, R. A., & Jarvik, MD, MPH, J. G. (n.d.). Evaluation of low back pain in adults. UpToDate. Retrieved March 28, 2023, from https://www.uptodate.com/contents/evaluation-of-low-back-pain-in-adults/print 
2. Gordon, R., & Bloxham, S. (2016). A systematic review of the effects of exercise and physical activity on non-specific chronic low back pain. Healthcare, 4(2), 22. https://doi.org/10.3390/healthcare4020022 
3. How to sleep with Lower back pain: Sleep foundation. Sleep Foundation. (2023, March 2). Retrieved March 28, 2023, from https://www.sleepfoundation.org/physical-health/how-to-sleep-with-lower-back-pain


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