How to Exercise With Lower Back Pain Without Making It Worse
Lower back pain can make exercise feel like a bit of a dilemma. You know being active is generally good for you, but when simply standing up from the sofa makes your back complain, the last thing you necessarily feel like doing is a workout.
There’s also the worry that moving might make whatever is happening in your back worse.
That fear is completely understandable, particularly if you don’t know why your back hurts in the first place. Back pain can come from all sorts of things, from a simple muscle strain to conditions affecting nerves, discs or joints, and sometimes there isn’t one obvious cause at all.
For many common episodes of lower back pain, though, the advice isn’t to lie still until it disappears. Current NHS and NICE guidance generally encourages people to stay active and continue normal day-to-day activities as much as they comfortably can.
That doesn’t mean ignoring pain or launching into the hardest workout you can find. It means finding an amount and type of movement that your back tolerates and gradually building from there.
Should you exercise when you have lower back pain?
Often, yes, but what you do matters.
If your back pain is mild and you’re otherwise well, keeping gently active can be useful. Walking, swimming, yoga and Pilates are among the activities the NHS suggests may help some people with back pain.
The key word there is some.
There isn’t one perfect exercise for every bad back, because lower back pain isn’t one single condition. An exercise that feels brilliant for one person might irritate somebody else’s symptoms.
That’s why I’d be very wary of articles promising that a particular stretch will “fix” back pain. A much better approach is to start gently, pay attention to how your symptoms respond and stop or adapt anything that clearly makes things worse.
Guy’s and St Thomas’ NHS physiotherapy guidance makes a useful point here (linked below): people with low back pain can sometimes notice more pain when they return to activity or do too much at once, so pacing and gradually building activity can be helpful.
Staying still isn’t always the answer
When something hurts, wanting to protect it makes sense.
If you hurt your back getting out of bed, your instinct might be to spend the rest of the day avoiding movement completely.
But prolonged bed rest isn’t generally recommended for ordinary back pain. The NHS specifically advises trying to stay active and not remaining in bed for long periods.
That doesn’t mean carrying on exactly as normal if every movement is agony. There’s a difference between staying gently active and ignoring what your body is telling you.
You might need to move more slowly, do shorter bouts of activity, take breaks or temporarily avoid something that clearly aggravates your symptoms.
The goal is usually to avoid becoming completely inactive while your back settles.
Walking can be a good place to start
Walking is often one of the easiest forms of movement to experiment with because you can adjust it so easily.
You don’t need to go for an hour-long power walk.
If your back is sore, perhaps start with five or ten minutes on a flat route and see how you feel. If that goes well, you can gradually walk for longer.
Shorter walks spread across the day may feel better than trying to do everything in one go.
This is something I think applies to exercise generally. We can become so focused on what counts as a “proper workout” that we overlook the usefulness of simply moving a little more than we were yesterday.
If ten minutes feels manageable, ten minutes is a perfectly sensible starting point.
What are some gentle lower back exercises?
Guy’s and St Thomas’ lists exercises such as gentle knee rolls, bringing a knee towards the chest, back extensions, moving from all fours towards the heels, and squats among movements that may be used to help people with low back pain get moving.
You might see exercises like these recommended by physiotherapists, but that doesn’t mean you need to do all of them or push through pain. If you try one and it clearly aggravates your symptoms, leave it out and get advice if you’re unsure.
Knee rolls
Lie on your back with your knees bent and your feet supported.
Keeping the movement gentle, allow your knees to move a little to one side and then back towards the middle before changing sides.
This should feel controlled rather than like you’re trying to force the biggest stretch possible.
For some people it can feel pleasantly mobile through the lower back. For others it may not suit their particular symptoms.
That’s completely fine.
Bringing one knee towards you
Another common gentle movement involves lying on your back and slowly bringing one knee towards your chest, supporting behind the thigh or knee as appropriate.
Again, the aim isn’t to drag your leg as far as physically possible.
A comfortable range is enough.
If this creates sharp pain, pain travelling down the leg or anything else that concerns you, stop rather than deciding more stretching must be better.
Gentle back extensions
Some people are advised to try gentle extension movements, such as lying on the front and gradually supporting the upper body on the forearms.
This is another movement included in NHS physiotherapy guidance.
I would be particularly careful with this one if you have symptoms travelling into your legs or have already been told certain movements aren’t suitable for you.
This is where individual physiotherapy advice can be really helpful, because a professional can see how your symptoms respond to movement rather than handing you a generic list.
Squats and sit-to-stands
It might sound strange to include a leg exercise in an article about back pain, but movements involving the hips and legs can form part of building strength and confidence in everyday movement.
If ordinary squats feel too difficult or uncomfortable, sitting down onto a sturdy chair and standing back up may be a more manageable version.
You don’t need to squat incredibly deeply.
And if bending that way clearly makes your back worse, this isn’t the exercise for you right now.
The point is never to complete every exercise on a list.
Is stretching always good for lower back pain?
No.
This is something I think gets oversimplified.
People often assume pain means something is “tight” and therefore needs stretching. Sometimes stretching feels lovely. Sometimes it doesn’t help, and sometimes a particular stretch can aggravate symptoms.
You don’t need to force yourself into uncomfortable positions because stretching is supposed to be good for backs.
Gentle movement can be useful, but the right movement depends on the person and what is causing the pain.
If you’re repeatedly trying stretches and your symptoms are getting worse, that’s a sign to stop experimenting and get proper advice.
Can you exercise with sciatica?
Sciatica can cause pain, tingling, numbness or weakness along the path of the sciatic nerve, often travelling from the lower back or buttock into the leg.
Many people with sciatica are still encouraged to stay active, but the exact exercises that are appropriate can depend on their symptoms.
I would definitely avoid treating “sciatica exercises” as a one-size-fits-all routine.
If you have new weakness, severe symptoms, numbness around the genital or anal area, or changes in bladder or bowel control, that needs urgent medical assessment rather than another stretch from the internet. The NHS lists bilateral leg symptoms, loss of feeling around the genitals or anus, and bladder or bowel changes among red flags requiring immediate assessment.
What about yoga and Pilates?
The NHS mentions yoga and Pilates among activities that may help some people with back pain. I think the important thing is choosing something appropriate to your current symptoms and ability.
A gentle beginner Pilates session is very different from a demanding class full of deep bends and complicated positions.
If you’re attending a class, tell the instructor you’re dealing with lower back pain so they can suggest modifications where appropriate.
And if an exercise repeatedly makes you worse, don’t assume you simply need to become more flexible.
Swimming can be another option
Some people find swimming or moving in water comfortable because the water supports part of their body weight. That can make movement feel easier than exercising on land.
Again, the stroke you choose can matter. Different swimming positions place the spine and neck differently, so pay attention to what feels comfortable.
You don’t have to swim lengths either. Walking or moving in a pool can still give you some gentle activity.
Strengthening your whole body matters too
There’s a tendency to think a bad back means you should focus entirely on the back itself. But everyday movement involves your legs, hips, abdomen and upper body working together.
As your pain settles and activity becomes easier, gradually building general strength can be useful.
That might eventually include movements such as sit-to-stands, squats, resistance-band exercises or other strengthening activities suited to you.
If you’re new to exercise generally, I’d start with something simple rather than jumping straight into heavy resistance training.
Easy Exercise Routine for Beginners
What if you’re overweight and have back pain?
Living in a larger body can affect how certain exercises feel, and back pain can make an already uncomfortable movement even less appealing.
Getting down onto the floor, for example, may be awkward. Deep squats may not fit your range of movement, and some exercises can put pressure through areas that are already sore.
That doesn’t mean you shouldn’t exercise. It means adaptations matter.
You might prefer walking, seated movement, supported exercises or shorter activity sessions while your symptoms settle.
I’ve written a separate guide to exercise for overweight and obese beginners, which focuses much more on starting points, mobility and adapting movement to your body.
Don’t assume pain means you’ve damaged something
Pain is complicated. It’s understandable to worry that if a movement hurts, you must be causing further injury. But pain doesn’t always map neatly onto tissue damage, particularly with persistent back pain.
Guy’s and St Thomas’ physiotherapy guidance specifically discusses the idea that pain during activity does not necessarily mean harm is being caused, while still recommending pacing if pain becomes difficult to tolerate.
I think this is a really useful distinction because fear of movement can sometimes lead people to become progressively less active. But equally, I wouldn’t turn that into “ignore pain and keep going”.
If something suddenly becomes much more painful, your symptoms are changing or you’re worried, get advice.
How much pain is acceptable when exercising?
There isn’t one number I can safely give you.
Some people with persistent back pain are advised to continue moving despite some manageable discomfort. Somebody with a new injury or another condition may need different advice.
A reasonable rule for a general article like this is to avoid sharp, severe or rapidly worsening pain, and pay attention to how you feel both during and after activity.
If an exercise leaves you clearly worse and the increase doesn’t settle, reduce it, change it or stop doing it.
If you’re unsure what is appropriate, physiotherapy is often much more useful than guessing.
Physiotherapy can be really useful
If your back pain keeps returning, lasts for weeks or is affecting what you can do, a physiotherapist may be able to help.
They can assess your movement, symptoms and goals and recommend exercises suited to you rather than simply handing you a generic programme.
In many areas of England, you may be able to self-refer to NHS musculoskeletal or physiotherapy services without needing to see your GP first. The NHS back pain page points people towards local MSK self-referral where available.
That can be particularly useful if fear of making things worse is stopping you from moving.
When should you see your GP about back pain?
Most uncomplicated back pain improves within a few weeks, but there are situations where it’s worth getting advice.
The NHS advises seeing a GP if back pain hasn’t improved after a few weeks of home treatment, is interfering with your day-to-day life, worries you, is worse at night, comes with unexplained weight loss or changes to the shape of your back, or is worse with coughing, sneezing or pooing.
You should seek urgent help if you feel generally unwell with back pain, have a feverish or shivery feeling, or the pain is severe and starts suddenly or gets worse quickly.
And there are some symptoms that require immediate assessment, including loss of feeling around the genitals or anus, bladder or bowel changes, significant symptoms in both legs, chest pain or back pain after a serious accident.
That isn’t the time to keep trying home exercises.
Should you exercise during a flare-up?
A flare-up doesn’t necessarily mean you need to stop moving completely. You may simply need to temporarily scale things back.
Perhaps your usual 30-minute walk becomes ten minutes. Maybe you choose gentle movement instead of strength training for a couple of days.
Pacing can be useful here. Rather than doing as much as possible on a good day and then nothing for several days because you’ve aggravated your symptoms, try finding an amount you can manage more consistently and gradually building from there.
I think this is good advice for exercise generally, but it becomes particularly important when pain is involved.
Back pain doesn’t mean exercise has to stop completely
I understand why lower back pain can make you nervous about movement. When something hurts, the instinct is to protect it, and the idea of deliberately exercising can feel counterintuitive.
But for many common types of back pain, gentle activity and gradually returning to normal movement are part of recovery rather than something you need to avoid. NICE recommends supporting people to continue normal activities where possible and considering exercise that reflects the individual’s needs and capabilities.
That might mean walking today and doing a little more next week. It might mean working with a physiotherapist. It might simply mean moving around the house rather than spending the whole day in bed because you’re frightened of making things worse.
What I wouldn’t do is pick a random “five exercises that cure lower back pain” routine and assume it applies to everybody.
Your back pain is yours. The best exercise is the one that suits your symptoms, your ability and your stage of recovery.
Sources and further reading
- NHS – Back pain — symptoms, self-care, staying active and when to seek medical help.
- NICE – Low back pain and sciatica in over 16s — current recommendations on self-management, exercise and treatment.
- Guy’s and St Thomas’ NHS Foundation Trust – Low back pain physiotherapy and exercises — guidance on pacing, keeping active and examples of exercises used in physiotherapy.
- NHS Better Health – Get active — general advice on gradually increasing physical activity.
Medical note: This article provides general information and isn’t a diagnosis or individual exercise programme. Back pain has many possible causes, so speak to a GP, physiotherapist or other appropriate healthcare professional if your symptoms are persistent, severe, worsening or you’re unsure what exercise is suitable.
