Back Pain and Exercise: What Works, What Doesn’t
Back pain is one of the most common reasons people stop exercising, or avoid it altogether. But avoiding movement often makes the problem worse. Research shows that the right type of exercise is one of the most effective tools for reducing back pain, improving mobility, and preventing future episodes. The challenge is knowing what works and what doesn’t.
What Works for Back Pain
Evidence supports structured, progressive exercise as the best approach:
- Core stability training → planks, bird-dogs, dead bugs strengthen supporting muscles.
- Mobility exercises → gentle stretches for hips, hamstrings, and thoracic spine reduce stiffness.
- Strength training → controlled lifts (e.g., hip hinges, glute bridges) build resilience.
- Aerobic activity → walking, cycling, and swimming improve circulation and reduce stiffness.
- Gradual progression → start light, increase slowly to avoid flare-ups.
What Doesn’t Work (or Works Poorly)
- Complete bed rest → prolongs recovery and increases stiffness.
- Relying only on passive treatments (e.g., massage, heat, braces) → can help temporarily but don’t fix the root
problem. - Jumping into high-intensity training too soon → often aggravates symptoms.
- Generic, one-size-fits-all routines → back pain is individual; what helps one person may hurt another.
Practical Recommendations
- Begin with low-load, controlled movements, then progress.
- Include core stability and hip mobility work regularly.
- Monitor pain: discomfort is normal, sharp pain is not.
- Combine exercise with lifestyle changes (posture, movement breaks, ergonomic setup).
Common Misconceptions
- “Exercise makes back pain worse.” → The wrong exercise might, but the right plan reduces pain long-term.
- “I just need to rest.” → Rest may help initially, but prolonged inactivity delays recovery.
- “Only surgery or medication can help.” → For most cases, exercise is more effective and lower risk.
Takeaway
Exercise is not the enemy of back pain. It’s the solution. With the right plan, back pain sufferers can regain strength, mobility, and confidence. A structured, individualized approach is key.
Reference Studies
- Qaseem A, Wilt TJ, McLean RM, Forciea MA. 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.
- Hayden JA, van Tulder MW, Malmivaara A, Koes BW. Exercise Therapy for Treatment of Non-specific Low Back Pain. Cochrane Database Syst Rev. 2005;(3):CD000335.
- Shnayderman I, Katz-Leurer M. An Exercise Program for the Treatment of Low Back Pain: A Randomized, Controlled Trial. J Pain. 2013;14(5):475–483.