Exercises for Lower Back Pain: What Actually Works

Patients ask me almost every week which exercises for lower back pain will help them the most. Most are surprised when I tell them the more important question is not which exercises, but in what order.

In thirty years of treating backs and necks, I have seen the same pattern play out repeatedly. Someone with a stiff, weak spine decides to get fit. They start running, lifting weights, or return to a sport they used to play, and their back gives way. They come to see me only once something has already gone wrong. Ironically, this is almost always the wrong order to do things in.

Why the order of exercises matters more than which ones you choose

The correct sequence is to first restore mobility in the spine and joints, then build stability through targeted static exercise, and only then move on to general, spine-friendly activity such as swimming, cycling or walking. Once the spine is flexible and strong, a person is far better prepared to return to the activities they enjoy, whether that is football, running, tennis or anything else, and can generally expect better performance and fewer injuries as a result.

Most people do this backwards. They load a weak, stiff spine with high-impact or high-intensity activity before it is ready for it, and the injury that follows is often what eventually brings them into the clinic.

Stage one: restoring mobility

The first stage is gentle range of motion work for the spine, done on the floor or bed. This is not stretching to the point of strain. It is short, relaxing movement, generally held for five to fifteen seconds at a time, aimed at easing stiffness before anything else is attempted.

We generally recommend this type of movement at least twice a day as a full routine, with shorter, low back and neck specific movements repeated more frequently through the day where comfortable. The goal at this stage is simply to prepare the spine for what comes next, not to build strength.

Stage two: building stability

Once mobility has improved, the next stage is static core stability work, drawn from the Pilates and yoga range of exercises. These are held positions rather than dynamic movements, and they train the spine to stay properly supported during everyday activity. This is one of the most overlooked exercises for lower back pain, since patients often move straight from mobility work to general activity without building this layer in between.

We typically recommend this daily, ideally morning and evening, for around five to fifteen minutes at a time. An alternative for those who prefer fewer, longer sessions is around half an hour, twice every other day, although this tends to be somewhat less effective than a shorter daily routine. For suggestions on which exercises to do check out our video guide.

Stage three: general, spine-friendly movement

Only once mobility and stability are established does it make sense to move on to general exercise. The best options are comfortable, symmetrical, big-range activities such as swimming, rowing, cycling and walking, along with yoga, pilates and tai chi.

Where possible, exercises with a round, continuous motion are preferable to those with sudden impact, for example cross-training rather than running, or cycling rather than jumping, since this reduces the load placed on the joints. Everyday activity such as gardening or physical work can also count, provided it gets you out of breath, loads both sides of the body evenly, and is paired with range of motion stretches before, during and after. We generally recommend this level of activity at least twice a week, ideally two to three sessions of thirty minutes to an hour.

A caution worth taking seriously

One point I raise often with patients is that exercising while exhausted, sleep-deprived, or without the mobility work that should come before and after activity can work against you rather than for you. Skipping the preparation and recovery stages does not simply reduce the benefit of exercise. It can have the opposite effect on your spinal health.

Where chiropractic care fits in

These recommendations are designed to help whether or not you are receiving chiropractic treatment. What chiropractic adjustment adds is speed. By stimulating the nerves and improving joint mobility directly, treatment can help this process along more quickly than exercise alone.

This is also where the nervous system connection becomes relevant. A spine that is not moving properly does not only create mechanical strain. It can also affect the quality of communication between the spine and the nervous system, which is one of the reasons a structured, assessment-led approach tends to outperform a generic exercise routine picked at random.

Getting the right routine for you

The stages above reflect the general approach we recommend to patients at The Back Pain Centre, but the specific exercises within each stage should be suited to your own condition, mobility and history. This is also where posture and daily habits come into the picture, since the hours spent sitting, standing or lifting each day affect how much benefit you get from any exercise routine.

If you are unsure where you currently sit in this sequence, or which exercises are appropriate for your particular back pain, our chiropractic assessment is the right place to start. We also offer physiotherapy for patients who benefit from a more rehabilitation-focused approach. Call us on 02089 893 338 or complete our contact form to book an appointment.

About the author

Vasily Maslukovs, Doctor of Chiropractic, has been treating backs and necks since 1994, beginning his clinical career in Latvia before qualifying as a UK registered chiropractor. He has been the owner and clinical director of The Back Pain Centre in South Woodford since 2012.

Frequently asked questions

What are the best exercises for lower back pain?

The best approach follows a sequence rather than a single set of exercises: gentle mobility work first, followed by static core stability exercises, and then general activity such as swimming, cycling or walking. Attempting high-impact exercise before the spine is mobile and stable is one of the most common reasons back pain develops or returns.

How often should I do exercises for lower back pain?

Mobility exercises are generally recommended at least twice a day, core stability work daily or near-daily, and general exercise at least twice a week. Consistency across all three stages matters more than doing any single stage intensively.

Can exercising too much make lower back pain worse?

Exercise done while exhausted, sleep-deprived, or without proper mobility work before and after can work against your spinal health rather than support it. This is one reason a structured, staged approach is safer than an intense but unstructured routine.

Do I need chiropractic treatment alongside exercise?

These exercises are designed to help with or without chiropractic treatment. Chiropractic adjustment can speed up progress by stimulating the nerves and improving joint mobility directly, which is why many patients benefit from combining both.