Exercising with Back Pain

Published on September 13, 2013 by Kimberly Bergeron, PA-C, MPAS

Studies show that 60-80% of the population will experience back pain at some time, with 5-10% developing chronic back pain. Because this is such a prevalent concern for so many people, many worry about exercising.

At The Spine Center we receive questions daily about exercise:

Will I cause more damage to my back?
Are there exercises I can do to strengthen my back?
Are there tips to exercising with back issues?

While there is no panacea to cure back pain, and results vary dependent on tolerance and acuteness of pain, exercise should become a part of a patient’s daily regimenIt will provide a measure of relief that should improve quality of life. 

The first misconception of exercising and back pain is that you will be forced into a sedentary lifestyle and will never be able to exercise again. Removing all exercise from your daily life can be damaging to your health, because a healthy life style should include some form of exercise. The least stressful exercise for any patient is walking. Walking can improve a patient’s cardiovascular health and strengthen leg muscles, which can both contribute to a better outcomes with back pain. In particular, when compared with no exercise, trunk strengthening is effective for reducing pain and improving function. Alternatives to walking outdoors or on a treadmill include walking in a pool and swimming.  Both will provide the same aerobic benefits as walking without the added strain to your joints.

The first step is to start an aerobic exercise schedule which will establish a baseline for your overall health and tolerance for exercise. Once you have determined your baseline, you should introduce stretches and exercises that will strengthen both your back and your core. With any exercise regimen, you should integrate exercises slowly and with a low number of repetitions to ascertain your physical ability and pain tolerance.  In addition, you should not attempt exercises that will negatively impact your back. For example, leg lifts, traditional, bent and flat leg sit-ups, lifting weights above the waist, and toe touches all place strain on your lower back that may exacerbate your back pain.

For an easier and safer way to exercise, try performing exercises that you can do either on your back (so that you are not placing strain on the lower back) or sitting in a chair (which will help minimize the impact on your back). Additionally, exercises should be performed in gentle and smooth motions so that you do not accidentally place strain on you back with violent and unexpected motions. Simple exercises that will accomplish these goals are knee to chest stretches, which can be performed either seated or lying down, and rotational stretching, which is accomplished when lying on your back you rotate your legs, with knees bent, to either side of your body.

No matter which approach you take, exercising on your own or enlisting the services of a personal trainer, the most sensible approach will be the most beneficial for exercising with back pain. Many websites, including WedMD and the Mayo Clinic, offer visual guides on exercising with back pains; however, you have to know your own limit. If something does not feel right, you should not attempt to push through the discomfort, as you could be causing more harm than good.


Lillios, S., & Young, J. (2012). The Effects of Core and Lower Extremity Strengthening on Pregnancy-Related Low Back and Pelvic Girdle Pain: A Systematic Review. Journal Of Women’s Health Physical

Shnayderman, I., & Katz-Leurer, M. (2013). An aerobic walking programme versus muscle strengthening programme for chronic low back pain: a randomized controlled trial. Clinical Rehabilitation, 27(3), 207-214.

Slade, S., & Keating, J. (2006). Trunk-strengthening exercises for chronic low back pain: a systematic review. Journal Of Manipulative & Physiological Therapeutics, 29(2), 163-173.

Avoid back pain and improve balance by strengthening core muscles. (2013). Harvard Health Letter, 38(7), 1-7.




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