Back pain? Try exercise!

The Bottom Line

  • Low back pain is a very common problem and can severely affect mobility and quality of life.
  • Common treatments do not always help relieve pain and disability.
  • Certain exercises have been shown to help reduce low back pain.
  • Try strength and resistance training, and exercises that improve balance and coordination

When your back hurts it can put a damper on your whole world. It’s hard to relax and you don’t want to move any more than necessary for fear of making the back pain worse. As for exercise – this is one time you feel completely justified in skipping your workout. But before you retire to the couch with your hot water bottle, you should know that exercise may actually help get you relief from persistent back pain.


Low back pain is such a common health problem, it’s a load most of us will bear in adulthood.  In fact, it is estimated that as many as 70% of adults suffer from this chronic condition (1;2). We know there are many contributing factors: age, physical fitness and general health, occupational requirements (e.g. heavy lifting and/or repetitive movements), stress and anxiety levels (2), but there is much we don’t understand about who will be affected, or when, or by what degree. When back pain strikes, treatment options are limited and often aren’t very effective in providing adequate relief (3).


Exercise therapy for relief of low back pain isn’t a new concept; it’s consistently recommended based on studies that show it helps improve physical function (strength, flexibility and range of motion) and reduces pain, at least to a small degree (4-8). But what works best? Are some exercises more effective than others when it comes to relief of low back pain?


A systematic review of 45 randomized controlled trials provides some answers (8). The studies involved 4,462 adults between the ages of 30 and 62 who had low back pain. They participated in one of four different categories of exercise programs:

  • coordination/stabilization – focusing on balance and agility

  • strength/resistance – targeting major muscle groups

  • cardio-respiratory – aerobic and continuous motion

  • combined exercises (with more than one component – eg. strengthening, stretching and aerobic training)

The exercise programs lasted from one and a half to 18 weeks, after which participants’ pain scores were compared with those in control group who carried on with their usual activities or received other types of therapy for their back pain.


What the research tells us

Evidence from the review confirms that exercise is good for people with bad backs, however not all exercises are equal when it comes to reducing pain. Strength and resistance training appear to be the most effective with participants reporting “medium” improvement, followed by coordination/stabilization exercises that reduced pain by a small amount. Cardio exercises and combined exercises had little significant impact on pain levels (8).


While exercise may not completely relieve your back problems, it is a non-surgical, drug free and low cost therapy that may help ease your pain and discomfort and improve your range of motion. 


Looking for exercises to prevent or relieve a bad back?

Strengthen your muscles with elastic resistance bands

Yoga relieves the pain and disability associated with low back pain

5 Strengthening exercises for lower back pain


Talk to your doctor or physiotherapist about the best exercises for your abilities.


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References

  1. Duthey B. Priority medicines for Europe and the World – 2013 update: Background paper 6.24 – Low back pain. WHO Collaborating Centre for Pharmaceutical Policy and Regulation (Ultrecht University, Netherlands), WHO Collaborating Centre in Pharmaceutical Policy (Boston, USA), WHO headquarters in Geneva, 2013: 1-29.
  2. Hall H, McIntosh G. Low back pain (chronic). BMJ Clin Evid. 2008; 10:1116.
  3. Bogduk N. Management of chronic low back pain. Med J Aust. 2004; 180:79-83.
  4. Koes BW, Tulder M, Lin CC, et al. An updated overview of clinical guidelines for the management of non-specific low back pain in primary care. Eur Spine J. 2010; 19:2075-2094.
  5. Rainville J, Hartigan C, Martinez E, et al. Exercise as a treatment for chronic low back pain. Spine J. 2004; 4:106-115.
  6. Chou R, Deyo R, Friedly J, et al. Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med. 2017; 166(7):493-505. doi: 10.7326/M16-2459. 
  7. Wieland LS, Skoetz N, Pilkington K, et al. Yoga treatment for chronic non-specific low back pain. Cochrane Database Syst Rev. 2017; 1:CD010671. doi: 10.1002/14651858.CD010671.pub2. 
  8. Searle A, Spink M, Ho A, et al. Exercise interventions for the treatment of chronic low back pain: A systematic review and meta-analysis of randomized controlled trials. Clin Rehabil. 2015; 29(12):1155-1167.

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of new and old blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with changing public health recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.