By Michelle Crouch, January 2025, AARP
The pelvic tilt exercise is a safe, effective way to relieve tightness and pain in your lower back and strengthen your core.Low back pain can make simple tasks, like bending over or getting out of bed, feel terribly difficult, especially as we get older. Yet back pain is surprisingly common, with as many as eight out of 10 people experiencing at least one episode during their lifetimes. Back pain can be caused by a long list of things — muscle or tendon strains, arthritis, structural problems or disc injuries. The number of hours most Americans spend sitting also contributes to the problem.
In older adults, pain is often caused by degenerative changes to the discs in the spine.
“We start to wear, tear and degenerate,” says Ken Hansraj, M.D., a spinal and orthopedic surgeon in New York and author of Watch Your Back: Nine Proven Strategies to Reduce Neck and Back Pain without Surgery.
If you experience severe back pain that persists for more than a few days or if it’s accompanied by symptoms like numbness, weakness or tingling, difficulty urinating, fever or unintended weight loss, federal health guidelines recommend seeing a spine specialist who can pinpoint the problem.
Persistent back pain lasting longer than six weeks is also a reason to consult a specialist.
For back pain, focus on your belly
Research reveals that the key to relieving back pain isn’t doing “back” exercises but focusing on activities that strengthen your core.
Indeed, a 2022 review of 118 trials published in the Journal of Orthopaedic & Sports Physical Therapy found that core-based exercises are among the most effective interventions at easing low back pain and disability.
When your abdominal muscles are not strong, your postural alignment is thrown off and your spine must work harder to keep your body in balance, Hansraj says.
Strengthening the core muscles provides extra stability and support for your spine, creating “a sort of an internal brace around those painful areas,” explains Rojeh Melikian, M.D., an orthopedic spine surgeon at DISC Sports & Spine Center in Newport Beach, California.
Hansraj and Melikian recommend starting with isometric core exercises that minimize bending or twisting, because too much movement can aggravate problem areas and worsen pain.
One of the easiest, safest and most effective moves to try is a simple pelvic tilt, Hansraj says.
A pelvic tilt can help relieve pain and tightness in your lower back by bringing motion back to your spine and firing up your hip flexors and hamstrings, which often are tight in people who sit all day, Hansraj says.
It’s also a safe way to strengthen your lower abdominals.
“Here is this one keystone stretch that stretches the pelvis, stretches the lumbar spine, stretches the hip flexors and stretches the hamstrings — ever so gently,” Hansraj says. “With one maneuver, you are not only moving your pelvis, but you’re giving a range of motion to your lumbar spine.”
Best exercise for back pain: Pelvic tilt
Here’s how to do a pelvic tilt step-by-step. Remember to talk to your doctor before beginning any new exercise routine. And if you feel pain with movement, stop and consult with a health care provider or physical therapist.
1. Lie on your back with both knees bent and feet flat on the floor. Your arms can be resting by your sides, on your stomach, or behind your head, whatever is more comfortable.
2. Keeping your shoulders pressed to the floor, tighten your abdominal muscles and press the small of your back to the floor.
3. Hold the contraction for 10 seconds, then release and take a few deep breaths to relax.
4. Repeat 10 times.
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