Exercising with Low Back Pain

Exercising with Low Back Pain

When you have lower back pain, the last thing you feel like doing is working out. Morning workouts are especially challenging when you wake up with stiff, tight back – but don’t be too quick to skip your workout when your back aches. Research shows inactivity often worsens lower back pain. On one hand, you don’t want to overdo it and end up sorer than when you started, but physical activity may actually help you get back on track. Ask more orthopedists these days and they’ll tell you they usually recommend moderate exercise for people with back pain.

If you have severe back pain, you may need a few days of rest before tackling a workout. As a general rule, if you can walk around and bend over to pick up a pair of weights, you’re probably able to do a modified workout, but it’s a good idea to check with your doctor first.

Should You Work Out When Your Lower Back Hurts?

Before grabbing a set of weights, make sure you know why your lower back hurts first.  If you have pain that radiates below your knee or have numbness or tingling, you may have a slipped disc – time to get evaluated by a physician. If you have weakness in the legs or bowel or bladder problems, get medical attention right away. You may have impingement of the nerves in your spinal cord and a delay in seeking help could lead to permanent nerve damage. Also, if you have back pain that isn’t better after 10 days or if you have back pain after an injury, you should see a doctor.

If your back pain is the garden variety type where you have lower back pain and tightness that comes and goes, exercise can help speed your recovery. This type of back pain is usually due to a strained muscle or ligament in your back and will go away on its own. Moderate physical activity helps you work out some of the spasms so you feel less stiff and tight.

Strength Training for Lower Back Pain

If you don’t have any of the red flag signs above, continuing to strength train may help you recover from lower back pain more quickly and reduce the chance of future problems. Some exercises to approach with caution or avoid entirely when you have lower back pain: good mornings, deadlifts, barbell rows, sit-ups, and back extensions a.k.a “supermans”. Repetitive bending at the waist can also aggravate lower back pain.

Now’s the time to decrease the resistance you use on other exercises that work your lower back muscles and do higher reps until the back pain lessens. Use pain as an indicator that you’re pushing yourself too hard or need to lighten up. Needless to say, this is a time to use impeccable form – no swinging the weights around or arching your back. Let pain be your guide. If something hurts or feels uncomfortable, don’t do that exercise.

Yoga and Stretching

If you’re prone towards lower back pain, consider adding a few weekly yoga sessions to your routine. A study published in the Annals of Internal Medicine showed yoga AND stretching exercises are effective for relieving lower back pain.

The strength of this study is it included a large number of participants – 228 adults. One group of adults took a 75-minute yoga class once a week for 12 weeks. A second group followed a similar exercise schedule but did stretches instead. The stretches consisted of a hip flexor, rotator, and hamstring stretches that they held for a minute at a time.  A third group read a self-help book on back pain. Participants in the first two groups were asked to practice the moves they learned in class at home for 20 minutes a day.

The results? Both the yoga and stretching group experienced improvement in their lower back symptoms while the third group who did no exercise didn’t. According to this study, yoga and stretching exercises both benefit lower back pain.

Yoga has the benefit of both stretching out tight lower back muscles while strengthening back and core muscles at the same time. One common cause of lower back pain is tight hip flexors due to too much sitting. Certain yoga poses, like boat pose, bridge pose, and pigeon pose, are ideal for lengthening tight hip flexors after a long day at the office.

Here’s an effective stretch for lengthening tight hip flexors. Lie face down on an exercise mat. Lift your head, chest, and tummy up off the mat while supporting yourself with your arms. Arch your back as you extend your body up towards the ceiling and hold the stretch. Try this stretch when you first wake up in the morning and several times throughout the day. Then turn on a warm shower and let the water massage your lower back.

Strengthen Your Glutes

With so many back problems related to sitting and tight hip flexors, hip flexor stretches, like the one above, are helpful. At the same time, you need to strengthen the opposing muscles, hip extensors like your glutes and hamstrings that don’t get enough stimulation when you sit. The best exercises are those that specifically target the glutes and hamstrings without activating a muscle towards the front of your hip called the tensor fascia lata. Further strengthening this muscle can worsen lower back pain. Two of the best exercises for strengthening the hip extensors without activating the tensor fascia lata are single-leg bridges and hip extension exercises.

To do hip extensions, get down on your hands and knees with your head facing the floor. Extend one leg up into the air, hold for a second or two and bring it back down. Do a full set and repeat on the opposite side. You can do this exercise with your leg straight or bent. Doing it with your leg straight is more challenging. These exercises really target weak gluteal muscles. You can also do hip extensions standing by extending your thighs behind you using an exercise band for resistance.

Don’t forget about strengthening your core, but while your back is sore and stiff, avoid doing crunches, sit-ups, leg lifts, and bicycles you do. Stick with exercises like planks that you can comfortably do without worsening the pain. Also, avoid high-impact exercise until your lower back pain has resolved.

The good news? Strength training is one of the best ways to prevent future episodes of back pain, but make sure you’re using good form to avoid injury.



WebMD. “Yoga Stretching May Ease Lower Back Pain”

Arch Intern Med. 2011 Dec 12;171(22):2019-26. doi: 10.1001/archinternmed.2011.524. Epub 2011 Oct 24.

WebMD. “Relieve Back Pain with Core Strength Training”


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