Scan through the top articles on low back pain, and you’ll find stretches like knee to chest, spine rotations, and child’s pose.
If your back is hurting, do not do these stretches!
In this article, we’ll cover why these stretches can make you feel better for a moment but don’t address anything long term. Then, we’ll cover five safe exercises you can do at home that will get you pain-free as quickly as possible.
You can head over to our YouTube Channel for a follow-along video with the low back pain exercises we explain here.
No matter how healthy you are, low back pain can happen. As Dr. B shares:
“After my pregnancies, I really struggled with my back. I had two kids in pretty quick succession. Particularly when they got heavier, I was struggling with low back pain.”
Coach E says:
“Mine was related to surgery I had when I was 14. Looking back on it now, I realize that it left me with a lot of imbalances and restrictions, especially on my right side. As a kid playing sports, I had no idea what was going on. I didn’t know how to fix it or about things like physio. I just went back to playing sports, and when random tweaks happened, I just had to deal with it. It was not until I went to the University of Waterloo to study Kinesiology, and thankfully I learned from Dr. Stu McGill, who’s one of the foremost experts on the low back. I learned from him and his theory of neutral spine core stability.
That really helped to decrease the pain and decrease the frequency of my low back pain episodes. But I’m still dealing with stuff, and it was not until I continued learning after university, studying, experimenting, trying things out – that I discovered new key elements that were really critical to being pain-free. I can’t really remember the last time I had a low back pain episode.”
The key elements you’re going to learn today will help you have fewer episodes, decrease the intensity of the episodes, decrease the duration of the episodes, and hopefully eliminate them altogether.
Red Flags for Low Back Pain
These red flags are extremely rare. But if you are experiencing these symptoms, get to your doctor ASAP.
- Back pain lasting more than a few days PLUS fever, unexplained weight loss, poor appetite, or a history of cancer.
- Difficulty controlling bowel or bladder, decreased sensation around the perineum.
It may be nothing serious that’s causing this, but it’s better to get a checkup and make sure everything is okay rather than ignore a potentially serious health problem. Your doctor will check to see whether it’s muscular or disc-related.
Particularly if you’re suffering from the second set of symptoms, get into the emergency room. Those are some of the first signs of cauda equina syndrome, which is often related to a central disc herniation, and your spinal cord is being compressed. It’s a surgical emergency.
In short, go to the doctor if you have these red flags.
If not, use your good judgment, and let’s start addressing your low back pain with these exercises.
What About My X-Rays?
As Dr. B says, “We [doctors] don’t treat x-rays. We treat people.”
Showing your doctor friend your x-ray doesn’t help fix the problem. (You’d be surprised how many people email us asking to send us their x-rays.) Your doctor will want your medical history, and they’ll want your story. They’ll ask questions like:
- Where is the pain?
- What makes it better?
- What makes it worse?
- Does it radiate?
On the other hand, Dr. B talks about getting patients into her office who have no pain and show her an x-ray that means they should be in a horrifying amount of pain. Then there are the patients in excruciating pain with a perfectly normal MRI.
An x-ray is a tool. It can show your doctor a problem, but there might also be pain without a visible problem.
“In establishing a diagnosis, we have to correlate the history and physical exam with the radiographic findings.” – Dr. B
Particularly if you’re going in for surgery, your surgeon needs to know where the pain is in addition to what the imaging shows. It’s difficult, even then, to know where the pain is coming from. Is it the disc, muscle, fascia, or something else?
It boils down to if you have back pain, you’re overloading some tissue or some structure in your back. Fixing it boils down to unloading that part of your back, changing the structure, by changing how you move.
The x-ray just tells you that there is a problem. Don’t stop moving. Just change how.
When do you need surgery for low back pain?
The indicators that you might want to consider surgery (except the red flags above!) are relatively rare. Dr. B typically only recommends someone with low back pain for surgery if:
- One, they have a progressive physical deformity, like curvature of the spine, scoliosis, or kyphosis. That also means it might interfere with someone’s health, like their heart or lung function, or their digestive system. And pain, obviously.
- Second, if there is neurological impairment. Pressure on the spinal cord or on a nerve root that is progressive and interfering with your function.
But start with exercise first. Remember that surgery doesn’t fix the root cause of a deformed spine or nerve root compression associated with wear and tear degeneration. Instead, changing how you’re loading your spine (in most instances) treats the root cause. That will have a big, lasting effect on your back pain.
In the event you need to have surgery, doing exercises will strengthen the areas above and below the affected area of your spine and prevent the damage from spreading to a different area.
Dr. B also strongly recommends preparing your body for surgery. Activating the muscles around your spine allows you to recover faster from an operation. She always recommends exercises for everyone, both pre and post-surgery.
Problems with Other Common Low Back Pain Remedies
There’s a lot of information we all learned, perhaps even as far back as grade school, about managing pain. Everyone had at least one gym teacher that told them to “walk it off.”
Some of the common go-to methods for managing pain, especially back pain, don’t hold up under today’s medical scrutiny.
What about painkillers?
You go to the doctor, and they either tell you to take something over the counter or give you a prescription for something a little stronger.
Long-term, the goal is not to be on painkillers. They can help in the initial stages of an episode. Dr. B emphatically recommends avoiding opioids for back pain because they create so many problems.
Instead of anti-inflammatory drugs, Dr. B recommends modalities – hot/cold treatments to manage the pain.
Coach E says if he has an ache somewhere, he’ll hop in the shower, turn it as cold as it gets, and chill the affected area. It’s easy to do, free, and definitely not addictive.
Does bed rest help?
12 – 24 hours can help. Don’t stay in bed any longer. You’ll get better faster if you get up and get going.
How about static stretching?
Static stretching might buy you an hour of pain relief, maybe the better part of a day if you’re lucky. But after that, the pain just comes back.
Static stretching doesn’t address the way you’re loading your back. It’s temporary relief, like a painkiller.
There’s even danger in it. You run the risk of further damaging the already injured tissues that are sending pain signals in the first place. That increases the severity of the pain and prolongs the duration.
But, because stretching offers at least a few minutes of relief, people continue to stretch when the pain increases, and it becomes a cycle of continuous damage.
Instead, spend the time you’d stretch on the exercises below.
5 Exercises You Can Do Right Now for Low Back Pain Relief
These exercises don’t require any equipment. You can do them right now. In fact, we encourage it.
They will activate deep muscles in your back, instead of the superficial ones that stretching tends to tug. They’ll also give you the same pain-killer effect that stretching offers – except it lasts longer and you’re repairing your tissues.
If you another follow-along YouTube video, try our spine damage control. It has many of these same exercises, and the comments are some of the most inspiring these we’ve ever seen.
Key Technical Pointers Before You Begin
First, maintain a neutral spine. That means keeping your natural curves, with a little lumbar extension and a little thoracic flexion. There should also be a slight cervical extension while you’re keeping your chin tucked.
Second, breathe. You will be holding positions for 5 to 10 seconds at a time. It’s normal to forget and hold your breath until you get used to an exercise. If a movement is difficult (but not painful), focusing on your breath and breathing into the tiring area will help you maintain your hold.
Third, begin with the pelvic floor muscles activated. Those are the muscles you clamp down on when you want to stop your pee mid-stream. (Gross, but a universal explanation.) You don’t have to flex hard, just 30-50% activation, and keep them activated throughout all of the exercises. Rest between reps.
Follow the coaching cues, and perform each exercise exactly as we teach to get the best possible results. Having someone spot you or exercising in front of a mirror can help too.
Performing the exercises while focusing on form gives you the strongest foundation possible to build up your muscles into pain-free movement.
1. Hip Bridge
You’ve probably done this before. But we’ll assume you haven’t to ensure that you’re covering everything correctly.
- Lay on your back with your feet flat on the floor and knees at a rough 90-degree ankle.
- Activate your pelvic floor muscles and then your glutes
- Lift your hips up and hold for 5 seconds
- Breathe naturally, relax the shoulder and the neck
- Lower your hips slowly and under control
- Release all the activated muscles between reps
Perform 1 set of 5 reps. Each rep has a 5-second hold.
Don’t hyperextend your spine. Keep it neutral. If you can’t go to neutral spine, that’s fine too. Do as much as you can.
2. Side Bridge
We’re going to cover two types of side bridges here—first, the easier version that bridges from your knees. Then we’ll cover the second version holding from your feet.
- On your side, place your elbow directly under your shoulder.
- Your hip and knees should be on the ground with your legs back at a 90-degree angle, activate your pelvic floor
- Raise your hips until you reach neutral spine and hold for 5-10 seconds
- Keep your chin tucked back and shoulder blades together
- Lower your hips down and back a little bit, under control
Perform 1 set of 5 reps, and hold each rep for 5 to 10 seconds.
You can keep your other hand on your hip to get it out of the way and have it ready if you need to steady yourself.
Driving your elbow toward your knee while holding the bridge will activate your lats and give you a little more stability. Your brain will note the stability and down-regulate your pain.
This version requires a little more strength. If you’re up to it, use this version. But don’t push yourself so hard that you risk further damage to your body.
- On your side, place your elbow directly under your shoulders
- Put your top foot forward with the heel touching the toes on your lower leg
- Bridge up to neutral spine, hold for 5 – 10 seconds
- Keep your chin tucked back and your shoulder blades together
- Lower your hips slowly and under control
- Completely relax between reps
Perform 1 set of 5 reps, and hold each rep for 5 to 10 seconds.
This technique requires extra attention on your form. Avoid shifting your hips left or right as you go through the movements.
You can have a partner help check for a neutral spine here. On your hands and knees, have them hold a dowel, broom handle, or any long rigid object laying around the house. There should be three points of contact when they lay the dowel across your spine: hips, thoracic spine, and back of your head. There should be curves away from the dowel at the back of the neck and lumbar spine. Your partner should be able to fit their hand between the dowel and your lumbar spine if you’re in the correct position.
- Get on your hands and knees with a neutral spine, activate the pelvic floor
- Raise one hand, palm forward & thumb up, at a 45-degree angle away from your head
- Slowly lift the opposite leg, hold for 5 – 10 seconds
- Slowly lower both limbs under control
Repeat, alternating sides for 1 set with 3 reps per side.
As you slowly lower your limbs back to the starting position, you will feel if your hips shifted at all. If they did, focus on holding them steady on the next rep by evenly distributing your weight between your grounded hand and knee.
If you’re still having trouble, try performing the exercise in a door frame. If you’re hitting the door frame with your hip, use it as a guide to correct until you find the right balance. Once you know what your balance should feel like, you can emulate that on later reps.
Another common form mistake is your stomach will drop, creating too much of an arch in your lumbar spine. Lightly flex your abs to prevent overextension.
4. Wall March
The wall march will activate your obliques and your psoas muscle groups. It focuses on building stability in your lumbar spine, which will keep it healthy long-term.
For this exercise, face a wall, extend your palms to the wall, and lean on it. The farther your feet are from the wall, the more difficult it will be.
As always, don’t forget to activate the pelvic floor muscles, and for this exercise you will also want a slight anterior pelvic tilt – stick your butt out just a little bit.
- Face a wall and place both palms against it
- Lean into the wall maintaining a neutral spine with your feet flat on the floor
- Activate your pelvic floor
- Slowly lift one knee, try to get your thigh horizontal
- Lower the arm opposite your raised leg to your side
- Hold for 5 seconds
- Slowly lower your leg, keeping your hip flexors activated, and place your hand back on the wall
Repeat for 1 set of 5 reps per side.
Remember to breathe naturally and keep the pelvic floor flexed, relaxing between reps.
5. Reverse Lunge
Unlike lunges you might do at the gym, you goals are neither max range of motion nor max weight. Instead, your goal will be to lengthen your hip flexors. People with low back pain tend to find themselves doubled over as the hip flexors seize up. Those muscles sometimes remain tight, leading to more back pain if left unaddressed.
You can do this exercise without any tools, although using something for stability can help. Dr. B likes to use a baseball bat, but you can use a chair or table just as easily. The stabilizer works best on the side doing the step back.
- Stand tall, neutral spine posture, activate the pelvic floor
- Step back, maintaining posture
- Lower your back knee as far as it will go without pain
- Slowly rise back up
- Reset, and switch sides
Repeat for 1 set of 5 reps per side.
Push back up through the foot, specifically the metatarsals. You don’t need to try and get your knee all the way to the floor.
Remember, focus on lengthening the muscle in the front of your hip. That doesn’t happen through stretching. Teach your brain the movement is safe by maintaining stability while you lengthen the muscle.
Perform this set of exercises 1 to 3 times a day for as long as you have pain. It should give you some immediate relief, and build your strength to minimize duration and frequency of lumbar pain episodes.
If you want more specific guidance, we developed a low back pain assessment tool. It will help you determine the root cause of your back pain so you can take targeted action for long-term healing.
If these exercises helped you, you’ll benefit from our complete spine control program. It targets all the root causes of back pain over several weeks, offering long-term pain relief and helping you to move pain-free longer.
You’re off to a great start just by looking into long-term solutions. The next step is taking action. Give this set of exercises a try, almost everyone reports an immediate decrease in pain.
This article was reviewed and updated on May 30, 2022 by our Chief Medical Officer, Dr. Erin Boynton, MD, FRCS to include new research and information on latest surgical developments. Read more about Dr. B here.