What are the best exercises for lower back pain?

Lower back pain is a very common problem that physiotherapists see in clinic. Most of the time this is mechanical lower back pain. Here we’ll discuss common causes and our favourite exercises to help with your lower back pain issues!

It has been estimated that up to 80% of us will have lower back pain at some point in our lives. Each year around one third of the UK adult population will experience a period of lower back pain.

Mechanical lower back pain just means the pain comes from structures such as joints, ligaments, muscle, discs and connective tissues. This is different to inflammatory back pain, which we will cover in a later blog.

Mechanical lower back pain is often referred to as “non-specific lower back pain”. Even after assessment, it is often not possible to identify the precise cause of pain. One of the reasons for this is that sometimes there is more than one cause.

Even results from an MRI scan can be misleading, as lots of people without any pain at all have been found to have degenerative changes or a disc bulge in the spine. These are normal processes in the spine and do not necessarily cause pain.

For this reason, x-rays and MRI scans are not routinely completed for mechanical lower back pain.

National guidelines for lower back pain indicate that it is not necessary to identify the specific source of pain in non-specific lower back pain for effective management. As physio’s, we can assess where you are stiff, tight or weak and work on improving these areas with you.

What causes lower back pain?

Many things can cause mechanical lower back pain. A common cause for lower back pain is stiffness in the joints. This can be caused by excessive sitting, for people who drive a lot and have a desk based job. This can lead to muscle tightness, as the muscles around the lower back are unable to move freely, and can become overworked in one area.

Sometimes lower back pain comes about in the opposite way. A lift or twist can cause a muscle to strain or tighten up. This can then lead to pain, which leads to reduced movement, which causes stiff joints!

Exercises for lower back pain

These are 4 simple but very effective exercises to help reduce lower back pain.

Bear in mind, these exercises are for those with lower back pain only. If you have back pain with referred pain into your buttocks or legs, it may be that you have some nerve irritation. These can be very sensitive and easy to aggravate, so it is best to consult a physiotherapist before commencing any exercises.

Knee rolls

Lying on your back with your knees bent and your arms out to the sides.

Keeping your upper body still and your shoulders on the floor, slowly bring your knees down to the floor.

Then slowly bring your knees back to the middle.

Repeat to the other side.

Complete for 30 - 60 seconds.

Knee hugs

Lie on your back. Bend one knee and bring it up to your chest.

Put your hand around your knee and hug it into your chest.

Then complete the same on the other side.

Hold the stretch for up to 20 seconds, whatever feels right for you.

Repeat 5 times.

Rotational stretch

Lying on your back. Bend one knee up towards your chest.

Use the opposite hand to pull your knee diagonally up and across your body.

Hold this position for up to 20 seconds.

Complete on the other side.

Repeat 3 times on each side.

Back extensions

Level 1: Lying on your tummy. Bring your chest up off the floor and rest up on your forearms.

Hold this position for up to 20 seconds. Then slowly lower.

Repeat 5 times.

Level 2: (be careful with this as it can stress your lower back. Take it slowly and if you have any pain, just work on level 1).

Bring your hands underneath your shoulders. Slowly push through your arms and lift your chest off the floor.

Stop if you have any lower back pain.

Hold this position for up to 20 seconds. Then slowly lower.

Repeat 5 times.

These exercises stretch the spine in different directions, and so will target different joints and muscles and improve your mobility. There may be some discomfort when you first start, so take them very slowly and build up as your body feels able to.

These are also great to complete even when you are not experiencing lower back pain - as keeping the spinal joints mobile and the muscles flexible can prevent an episode from occurring.

This is absolutely not written to substitute medical advice and it is always important to see a qualified health care professional for a formal diagnosis. If any of the exercises cause pain during or after the exercise, discontinue and consult a physiotherapist.

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