By Stacey Colino & Aaron Kassraie, AARP, September 2024
Strengthen your lower back and prevent pain, injury with these exercises. Whether it’s chronic, acute or episodic, lower back pain is a common problem among adults, causing more disability around the world than any other condition. Fortunately, there are a variety of stretches and exercises that can be done at home to relieve lower back pain and improve mobility.
How common is lower back pain?
At least one-fourth of U.S. adults report having low back pain in the past three months, national survey data shows. Research suggests that up to 80 percent of adults will experience low back pain in their lives, meaning that even if you haven’t had it yet and you don’t have it now, there’s a good chance you will — especially since back pain becomes more frequent with age.
That’s because as we age, our bodies undergo natural changes — declining muscle mass and bone density, for example — that can contribute to back pain. It doesn’t have to be inevitable, though. With weight-bearing exercises, it’s possible to slow down the progression of these changes, even reverse them, and improve bone density and muscle strength, says Christopher Bise, an assistant professor at the University of Pittsburgh School of Health and Rehabilitation Sciences.
Deconditioning and “poor body mechanics” can also lead to lower back pain, says Robert Gillanders, a physical therapist in the Charlottesville, Virginia, area. And a history of back pain likely means there’s more to come. “If you’ve had an injury in the past, you’re probably going to get it again,” he says.
Causes of lower back pain
Common causes of lower back pain include:
Overuse injuries (from doing the same form of exercise over and over)
Muscle or ligament strains or sprains
Trauma (from falling down, for example)
Degenerative discs, joints and ligaments
Spinal stenosis
Repetitive movements, especially those that strain the body
A physical therapist can work with you individually to tailor exercises suitable for your body type that can address any pain-causing activities in your daily life, says Ryan DeGeeter, a physical therapy assistant professor at the Washington University School of Medicine in St. Louis.
Here are additional factors to consider:
1. Sedentary lifestyle:
Lack of regular exercise can lead to weakened and inflexible back muscles.
2. Excess weight:
Maintaining a healthy weight reduces strain on the back and decreases the likelihood of experiencing pain.
Ensure your diet includes adequate amounts of calcium, phosphorus and vitamin D, as deficiencies in these nutrients can affect bone health and contribute to back pain.
4. Poor ergonomics:
Improperly designed furniture and equipment at home and work can strain the back muscles and lead to discomfort.
5. Prolonged sitting:
Sitting for extended periods without breaks or changes in position can result in muscle tension and back pain. Regularly moving and stretching can help alleviate this.
6. Footwear choice:
Wearing uncomfortable or high-heeled shoes can disrupt posture and alignment, increasing the risk of back pain.
7. Sleeping posture:
Sleeping on a firm surface and adopting a side-lying fetal position can help alleviate pressure on the spine and reduce the likelihood of waking up with back pain.
8. Improper lifting techniques:
Lifting heavy objects incorrectly, especially without engaging the leg muscles, can strain the back and lead to injury.
9. Core strength:
Weak abdominal muscles can contribute to back pain. Strengthening these muscles can provide better support for the spine and reduce the risk of injury.
10. Smoking:
Smoking reduces blood flow to the lower spine, contributing to spinal disc degeneration and impairing the body’s ability to heal. Quitting smoking can improve blood flow and promote better spinal health.
How do you relieve back pain?
Walking
When lower back pain strikes, you don’t need to take it lying down. On the contrary, you should keep moving by walking regularly. “Walking is one of the most therapeutic things you can do for your back,” Gillanders says. “Yet it’s low hanging fruit that’s not used that often.” Studies have found that walking improves pain levels, disability and quality of life among people with chronic low back pain.
Ice or heat
To relieve low back pain fast — whether short-term or chronic — you can apply an ice pack or heat (whichever you’d prefer) and use a foam roller to release tension, Gillanders recommends.
Breathing
It can help to engage in diaphragmatic breathing, says Alex Garreau, a physical therapist at Northwestern Memorial Hospital in Chicago. As you inhale slowly, let your belly expand with air, then exhale slowly, allowing your belly to deflate. “This slows down your breathing, which can slow down pain signals and have a calming effect,” Garreau explains.
Braces and other tools
If you have sudden, sharp pains, a soft corset brace may help during activity by acting as a crutch for muscles that aren’t ready for certain tasks. Just know that if you wear it too frequently, it can cause these muscles to “take a vacation” and contribute to further pain and weakness, DeGeeter says. Save it for short-term use. “If a patient needs to get through a certain season of life — say for holiday prep, a wedding or work in the yard during the spring,” a brace can be helpful, DeGeeter says.
Other tools to relieve lower back pain include pillows, towel rolls and 2-inch stools. Placing pillows on your lap while sitting can help take weight off the spine and improve its alignment. Feet don’t reach the floor when you sit? Dangling legs can pull on your spine and cause pain, but a small footstool (or even old phone books) can remedy that, DeGeeter says.
Lumbar rolls are popular. A 2019 study in the journal Applied Ergonomics found an association between static sitting behavior and chronic low back pain among people who worked at a call center. If you have a job or medical condition that involves sitting for long periods, consider using a lumbar roll, a soft cylindrical device you put between your back and the chair. It helps support your lower back by promoting a semi-extended position that can alleviate discomfort and improve pain.
Warning signs you shouldn’t ignore
Some red flags with lower back pain: If the pain radiates down one of your legs; if you have numbness, weakness or tingling in one (or both) of your legs; or if you experience changes in your bowel or bladder function, call your doctor right away, advises Stacey Cladis, a physical therapist at Northwestern Medicine in Chicago.
These symptoms could be caused by spinal cord compression or nerve compression. If the pain persists for more than a week or prevents you from doing daily activities, it’s a good idea to see a doctor.
Tips for starting physical activity
Bise recommends adding a walking routine to complement the stretches listed below. Though step count is all well and good, it’s not the only thing that matters. Your walking speed and the length of your strides bring health benefits, too, Bise says. Gradually increasing your walking speed and distance can enhance stamina and overall endurance.
As you test out exercises and stretches, pay attention to any pain that arises, knowing that some muscle soreness is to be expected. Make sure not to overdo it — start slow, and gradually increase your activity.
Questions? Reach out to a physical therapist. Many offer initial visits to get started on an at-home program. A study published in JAMA found that people who received tailored instruction from a physical therapist experienced greater and longer-lasting benefits compared with those who participated in a more generalized strength and flexibility exercise program.
“One-on-one treatment with a well-trained physical therapist will help you determine which exercises are best for your body type, as well as help you to troubleshoot the specific activities in your life that are causing you pain,” DeGeeter says.
Above all, stick to the program that works best for you. Once pain starts to improve, don’t stop or it will likely come back. Consider these exercises as a long-term lifestyle change, rather than a temporary solution.
8 exercises to help with back pain
A word of warning: As you do these exercises, be sure to listen to your body and heed its messages. “If something is hurting, don’t do it,” Cladis says. “You can aggravate your symptoms if you’re trying to push through the pain.”
If doing these exercises and stretches on the floor is too difficult, you can try completing them on a bed.
1. Standing lumbar extension
In a standing position with your feet apart, place your hands on your lower back with your fingers pointing down. Bend your body backward at the waist, supporting your trunk with your hands, and keep your knees straight.
Modification: Perform the stretch with your back against a countertop for support.
2. Supine bridge
Lie on your back with your arms on the floor at your sides, your legs bent at the knees and your feet flat on the floor. Tighten your abdomen and glutes, and slowly lift your hips off the floor while keeping your back straight. Then, slowly lower your butt and hips back down to the floor.
Do 10 repetitions.
Modifications: Put a bolster or pillow in the crevice behind your knees. Instead of pushing up with your feet, push up from the back of your knees. This reduces the range of motion and makes the exercise a bit less strenuous, Garreau says.
3. Bird dog
Get down on all fours, with your hands on the floor directly under both shoulders and your knees directly under your hips. Keep your head in line with your spine and lift your right arm forward and your left leg straight behind you until they are both parallel to the floor. Pause, then return to the starting position. Repeat with the left arm and the right leg. Be sure to keep your abdominal muscles tight, your back flat and your hips level throughout the exercise. Do 10 repetitions on each side.
Modifications: Lean forward over a bed with your feet on the ground and hands on the bed instead of having both on the floor.
4. Cat-camel
Start on all fours, with your hands on the floor directly under your shoulders and your knees directly under your hips. Tuck your chin toward your chest and slowly round your back up toward the ceiling; pause for a couple of seconds, then slowly draw your shoulders away from your ears, relax your back and arch it slightly while gazing ahead of you. Return to the starting position. Do 10 repetitions.
Modifications: Plant your feet on the ground, and lean forward over a bed or couch-height surface to complete the exercise.
5. Double knee-to-chest stretch
Lie on your back with both legs bent and your feet flat on the floor. Lift your feet, pull both knees toward your chest and hug them with your arms. Hold this position for 20 to 30 seconds while keeping your back relaxed against the floor. Release. Repeat this stretch a few times.
Modifications: For a less strenuous stretch that will work the same muscles, pull in one knee at a time. If you have trouble bringing your knee all the way up, hook a towel or small strap behind the knee to pull it toward you.
6. Supine twist
Lie on your back with your knees bent and your feet flat on the floor. Keep your shoulders flat on the floor and your knees together as you let them slowly roll to the right side of your body. Pause for five seconds, then slowly return your knees to the starting position. Then, slowly let your knees roll to the left side of your body; pause for five seconds, then return to the starting position. Repeat this several times on each side.
Modifications: Instead of dropping your knees all the way to the ground, try lowering them about half of the way to the floor.
7. Child’s pose
While you’re on your hands and knees, push your butt back onto your heels, with your knees apart. Lower your upper body between your knees, stretch your arms along the floor above your head and place your forehead on or near the floor. Hold this position for 20 to 30 seconds.
Modifications: Get into a half-kneeling position with your hands on the bed or a couch-height surface.
8. Cobra stretch
This is also known as the cobra pose, or Bhujangasana in yoga. Begin by lying on your stomach. Keep your legs close together, and place your palms below your shoulders with your elbows alongside your body. As you breathe in, gently lift your upper body and abdomen while pressing your lower abdomen and toes into the floor.
Modification: To avoid overstretching, keep your forearms and palms flat on the floor. Alternatively, you can perform the stretch on a bed instead of the floor, or stand with your body facing a wall.
Note: Bise’s single best stretch combines two positions. Begin in the child’s pose, then transition your body forward and upward into the cobra position. This movement, called the hand-heel rock, not only flexes the spine but also provides a transitionches to strengthen the area.
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