Exercises for back pain

The best way to deal with back pain is to stay active and continue doing regular exercise.

“The advice given 20 years ago was to rest, but research has shown that inactivity only makes things worse,” says Dries Hettinga of BackCare, a charity that offers support and information to people with back pain.

“When you’re in pain you may want to stay in bed and not move around, but that leads to further loss of mobility and will only prolong the pain.”

Staying active means continuing with regular day-to-day activities to avoid becoming sedentary. Examples include walking to the shops rather than taking the car, getting off the bus one stop early, gardening and taking the dog for a walk.

If you experience mild pain, take over-the-counter painkillers from your pharmacist or supermarket. Your pharmacist or GP can advise on which medication is best for you.


Yoga and other exercises


If your back pain is mild, try to exercise as well as maintaining an active lifestyle. You can do any activity that gives your body a good workout.

“It’s important to pick an exercise you enjoy,” says Hettinga. “If you do something you enjoy, you’re more likely to stick with it."

There's some evidence that regular yoga practice is beneficial for people with high blood pressure, heart disease, aches and pains, including low back pain, depression and stress. Find out more in a guide to yoga

There's also some research to show that pilates can provide pain relief to people with non-specific low back pain. Find out more in a guide to pilates.

Some studies suggest that the Alexander technique, a method for improving posture, can help to relieve persistent and recurring low back pain. However, the Alexander technique is not recommended by NICE as a treatment for back pain.

Ideally, your choice of activities should involve elements of endurance, as well as strength and flexibility.

Examples include walking, running or jogging, cycling, dancing, swimming, hydrotherapy (exercising in water) and aquarobics.

For low-impact exercise ideas, read our page on easy exercises.

Hettinga says that exercise programmes are most effective if performed regularly and over prolonged periods of time.

Aim for at least 150 minutes of exercise a week. You may want to build up to this gradually over several weeks.

Hettinga says an individually designed exercise programme gives the best results. It is advisable to seek medical advice before starting an exercise routine for back pain.


Manual therapy


Hettinga suggests combining an exercise programme with a course of manual therapy, especially when the pain is persistent. Manual therapy is provided by physiotherapists.

“Evidence suggests manual therapies can be effective. Your back is examined to see if any joints need to be freed up.

"They can do it with a gentle massage, mobilisation or manipulation. It’s especially helpful if your back is stiff and flexibility is an issue," he says.

Manual therapists are also qualified to advise you on the type of exercises that will be most effective at dealing with your type of back pain.

“You should see improvements after a few weeks,” says Hettinga. “If the pain hasn’t disappeared after a few weeks of treatment, seek further medical advice to explore alternatives.

"There is always something that can be done about back pain, but it requires some work and dedication from you.”

 

Back pain

Back pain is the largest cause of absence from work in the UK. Philip Sell, consultant orthopaedic and spinal surgeon, discusses the causes of and treatments for back pain.

Media last reviewed: 21/07/2013

Next review due: 21/07/2015

Page last reviewed: 18/09/2014

Next review due: 18/09/2016

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Comments

The 14 comments posted are personal views. Any information they give has not been checked and may not be accurate.

coplani said on 29 June 2014

I exercise.
I used the cross trainer over several months with no problem...
However last week, I increased the level to quite high aerobic...which meant using my arms more...

Result...backache...RHS middle...Muscle spasms due to using my arms...especially my left arm. My right arm and left back OK.

Recommendation...
Be careful with the cross trainers...Do not go to high levels until fully appreciative of the damage that can be done to back muscles.

One lives and learns...

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Matthew Henson said on 24 June 2014

Regular practice of Pilates and Feldenkrais Method over the last year have changed the way my back works. There's much more flexibility, the anterior pelvic tilt while sitting has reduced by around 5% and my kyphosis (rounding of the upper back) is beginning to go. My intuition is that this is effective preventive maintenance, and at age 55 am surprised how much my body has changed.

This is no quick fix. I started going to subsidised pilates classes at work but felt I wasn't getting some exercises right. I tried a private lesson, found it effective, and have one most weeks as well as group classes and homework. It is expensive. Feldenkrais is a good complement, too difficult to explain in a comment, so please see http://www.feldenkrais.co.uk for information, and you can try a lesson there for free.

I contrast this with a friend's experience: he wants the problem fixed by a professional and won't hear anything said about exercise.

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ScoopD said on 06 June 2014

Just wanted to redress a balance on some of the comments so far.

I have suffered from a prolapsed disk sustained by injury (heavy lifting whilst twisting spine). I am 9 weeks in.

From the NHS I was referred to an MSK CATS team (muskoskeletal specialists). I received appropriate instruction from the NHS doctors and physios.

The advice has been great, hopefully I'm well on road to recovery. In my case I have done as much as I can but listen to my body too. I haven't rushed back to work as I normally do as this was a real scare - frightening - and I am hoping the time to date has been well spent. I've just had a return to work plan arranged.

I am really writing as I think the NHS is a fantastic service, many of my family would not be here if it didn't exist (heart ops etc).

Fair praise where it is due, I am sure it gets the logs where people are unhappy and others don't bother. It is something worth fighting fpr and people dont praise it enough.

Heartfel thanks to all the wonderful doctors and nurses out there.

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Lesley2000 said on 16 May 2014

I totally agree with Jake Burton. I think it is appalling how I have had to spend a small fortune going privately, because of the lack of care from the NHS. I am really annoyed that it states mobilisation or manipulation can be helpful, and suggests that an NHS physio will do this.In 30 years of being asked what helps, and being ignored, the NHS physios are given directives on just giving exercices, instead of feeling each joint and mobilisation before exercise takes place. They even go against NICE guidelines. They ask you what you have found useful, and then take absolutely no notice anyway. They try to fool people into thinking that if they have a longterm problem, the pain is there for no reason and just do everything as you would normally. They then try to blame the patient for 'avoidance' of activities and that 'hurt isn't the same as harm' which is really patronising and implying a person avoids doing something because they are scared of harming themselves, rather than being in too much pain to do things. If Mel received massage from an NHS physio, she is a very lucky person.I was told I would never get this as it was the same as giving me money to go spend on shopping - in other words, therapeutic, but of little benefit apart from that.

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Jake Burton said on 28 July 2013

There's some dangerous suggestions here and I talk from experience. Running gardening etc are terrible for your back. I took drs orders and carried on, my disc in my back ruptured and nearly paralysed me. The NHS does not treat back did orders until your crippled and possibly beyond repair. I'm 30 years old. Can't work, educate myself ( can't sit down) no longer have any meaningful purpose or hope because I listened to my GP. I advise anyone who has had back pain a while especially if you have sciatica... To go seek private care. Do whatever it takes because being dragged along on by the NHS could prove very costly. In the time I saw my GP and finally got help after being constantly fobbed off with stronger and more dangerous painkillers, 14 months had passed before I had my scan and a further 4 no the till I saw a DR. Tragic. Don't make my mistake.

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Mel O said on 03 July 2013

I started getting back pain when I was 14 years old, and every time I went to the doctors, I was told it was period pains, growing pains, overdoing things and even arthritis! For the past 3 years, I've changed everything from my diet, to my exercise regime to even buying a new mattress and pillows in case that was the problem! Nothing worked and I got fed up of being in constant pain. I finally got help 2 months ago, when I turned 17, and even though I still get bad days, being seen regularly by a physiotherapist has changed my life for the better and I can now walk and jog without suffering the next day! My physio Chris is absolutely amazing, and he decided on my last session to experiment and see if his idea worked. He placed three-four pillows on the bed and asked me to position my hips on them and to lay on my front. He then proceeded to massage my spine in 4 specific places and relaxed the muscles. I was then able to bend over and touch my toes much easier then when I arrived at that session. All my exercises are easy, quick and very effective. He has asked me to do 'donkey/camel', to kneel on hands and knees and lift one arm at a time to keep my position straight, to bridge my back from the bed holding onto my stomach muscles to stretch them out and to do simple stretches such as hugging my knees to my chest. All I can say is thank god for physiotherapists, because Chris has helped me do everything I used to before my back problems, including exercising which I used to love!

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Anonymous said on 13 September 2012

I'm only 26years old, I had a serious injury when I was 15, ended up spending 2 weeks in bed unable to move. I did about 12 physio sessions over 3 months and that was it. Over the last 10years I've been going to the gym and trying to keep active.

Recently I've been having a lot of lower back pain, pain I can only assume is sciatica and numbness in my right leg when I sit for any length of time. I went to my doctor, asked to be referred to a physio, he said "take these tablets, there's nothing we can do".

The lower back pain I'm trying to combat with low impact exercise the gym... cross trainer for cardio and working my core muscles, but does anyone have any idea how to use exercise to help with the sciatica? I hope I'm young enough to do something about it so I don't end up completely immobile by the time I'm 35. Which at the moment, if the last 10years is anything to go by, seems very possible. Some mornings I don't want to get out of bed because it's agony and sometimes taking strong painkillers is the only way I can, but I don't want to rely on tablets if there's something I can do.

I'll take the yoga suggestion on board and hopefully it'll help!

Any other suggestions would be greatly appreciated.
Thanks.

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dirk gently said on 01 September 2012

I had a discectomy in 2005, at the time I was fit and healthy and cycled maybe 100 miles per week. The operation cured the sciatica, which was good. But the ache that I have in my lower back has persisted and I have yet to find an exercise that can strengthen associated muscles. I cycle now about 30-60 miles per week with no improvements to my back. I think its making it worse. Due to other accidents dislocated collar bone and wrist problems I cant swim. I think everyone should exercise, I just would not hold your breath for a miracle cure for the pain. sorry if this sounds negative, maybe you can find something to help.

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Joffman said on 31 March 2012

I have suffered with chronic back pain for 3 years now. three months after my first combination of pain relief left me in hospital recovering from a cardiac arrest.

It took a total of 9 months to be able to regain the flexibility to put my own socks on.

because of my extreme lack of mobility I gained over 6 stones of weight. 2 years 2 months on from my cardiac arrest I am now barely able to function as a human being. I am loosing weight now but have 9 stones to loose to be at a safer more manageable weight.

I have tried most types of low impact excersise but the only one that does not leave me struggeling in pain is walking. However I am finding as I cannot walk at pace my walking does very little to build stamina or burn many calories.

I am now 32 years old and desparate to get back to running and cycling but now fear with this Chronic pain, limited movement and lack of pace it may be one dream too far.

Any help on finding other low impact excersise that may assist in my weight loss would be greatly apreciated.

I forgot to mention I do swim occasionally when i can afford to, and my balance is gone so riding a bike is dangerous to say the least.

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back pain review said on 02 January 2012

Although Dr Hettinga has been fairly vague here he still makes a good point. Over the years people with back pain have been told to rest their backs as opposed to exercising. This in turn causes the back muscles to weaken and stiffen up, which makes movement even more difficult.
Yoga is a great way to exercise and strengthen the back muscles.

www.backpainreview.info

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ellen56 said on 12 December 2011

Back extension exercises.
Lie on your front, hands by your sides, and lift your legs and torso at the same time. Do this 10 times to start, and work up to 25 at a session.
Source : http://www.sciaticnervepainblog.com

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ThriveHealthTV said on 02 October 2011

The trainers comments and suggestions for exercise are extremely basic, limited, and in many cases could make the problems worse.
In reality there are many different causes of back pain and it is therefore of paramount importance to consult with a specialist practitioner such as a CHEK Practitioner who can assess the posture, structure, movement and muscular function of each patient. From there, he/she will provide a specific and structured programme of strengthening and stretching exercise that one can do at home.
brkpj: You are correct about the opinions of the quoted PT instructor but I wouldn't advise taking painkillers for so long. The key is in getting to the underlying cause of the pain.
Feel free to comment if you would like me to elaborate further.

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brkpj said on 10 August 2010

Dries Hettinga sounds like a typical PT instructor who has never suffered back pain, telling us it is all in our imagination.

Whatever is the BEST treatment should be available IMMEDIATELY on the NHS. Initial assessment by a physiotherapist should be a part of that treatment.

My (private) physio told me that acupuncture was available on the NHS, but my doctor told me that the contract for such things had just been taken over by a different company and they didn't believe in acupuncture!

The ACTUAL treatment for back pain remains as it was 20 years ago: try some painkillers for 2 months, and if it has not gone away book a hospital appointment with a physio for 3 months hence!!!

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User72301 said on 08 December 2008

crushed vertibrea should have healed in 12 wks now 25 wks & no improvment any comments would help regards liberty

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