6 exercises to try if you have back pain

Having back pain doesn’t mean you have to spend your free hours on the couch. In fact, sitting for long stretches of time may actually worsen back pain.

If you’ve injured your back or if you have chronic low-back pain, consult with a healthcare provider (HCP) on the best ways to rehab. Then discuss a plan to get moving again. There are plenty of exercises you can do to strengthen your muscles (especially those in your core) to help strengthen your back and prevent reinjury.

Allen Kaisler-Meza, MD, a physical medicine and rehabilitation specialist and Chief Medical Officer at RehabOne Medical Group in San Jose, California, offers tips on which exercises to avoid if you have back pain and which to do instead.

Classic sit-ups and crunches—moves that involve arching your back—can put pressure on spinal discs.

Try this instead: Modified sit-ups. Start by lying on your back. With both feet planted on the ground, bring your knees up to a bent position. Cross your arms over your chest, tuck your chin in and raise yourself up until your shoulder blades come off the ground. “Elevate your upper

shoulder and reach up toward the ceiling with your head. This way you don’t come up beyond shoulder level, you don't flex the neck, and you don't arch forward to your bent knees,” says Dr. Kaisler-Meza. Hold this position for three to five seconds, then return to the flat position on your back.

The plank is another back-friendly alternative to crunches and sit-ups that can help strengthen your core because it activates practically all of your core muscles at the same time without causing your back to arch or bend excessively.

Here’s how to do it correctly: Lie facedown with your forearms on the floor, your legs extended behind you and your feet together. Push up onto your forearms and raise your body to form a straight line from your head to your feet, without sagging your hips. Look downward while contracting your abdominal muscles. Don’t hold your breath. Instead, take steady, even breaths while holding this position.

This exercise looks simple but doing it right can feel like you’re really spending quality time with your core. Start slow—holding anywhere from 10 to 30 seconds at a time—and build up to one minute or longer. Try working toward two to three sets of a minute or more each. You can do planks every day; they don’t take much time and you don’t need extra equipment to do them.

“High impact exercises such as contact sports or high-impact aerobics can put pressure on a spinal disc and cause more injury,” explains Kaisler-Meza. It’s also important to avoid movements that cause twisting, such as golf or racquet sports, which can increase pressure on the back, and in turn, back pain.

Try this instead: Water aerobics or yoga. Because of the buoyancy of the water, swimming can give you a workout without motions that can be jarring to a tender back. Yoga’s great, as well, because it focuses on relaxation, posture, core strength, and flexibility. Kaisler-Meza recommends working with a yoga instructor who’s knowledgeable about back injuries, as some yoga postures may need to be modified to suit your needs.

A runner’s high may be a great feeling, but the repetitive pounding of your feet on the pavement or treadmill can wreak havoc on your back by putting stress on an injured disc or strained muscle.

Try this instead: Walking. Walking can help tone and strengthen your lower back and leg muscles and can be gentle on your back as you recover from an injury. “You will not cause any physical damage to your spine by walking,” says Kaisler-Meza. “If you’re recovering from a back flare-up or you have back pain, start out with ten minutes a day, walking outside or on a track.” If that hurts, start in the water if you have access to a swimming pool.

You may be safe biking outdoors if you stick to a smooth surface. The bouncing you may experience when you’re biking on a trail, on the other hand, combined with the arched-forward position of mountain biking, can exacerbate back pain.

Try this instead: Use a stationary bike. Some people with back pain may prefer using a recumbent exercise bike, which has a backrest that keeps your back straight and erect and can help support your lower back. These types of bikes can help you maintain proper posture and stay “spine neutral,” where you’re putting an equal amount of pressure on your spine.

“This way, you’re getting the aerobic exercise of the biking, as well as the toning and strengthening in the legs, which can, conversely, be excellent for people with back pain,” says Kaisler-Meza. Other people may prefer an upright stationary bike, which has a forward-leaning position, allows for greater range of motion, and activates more muscle groups.

Aside from adding pressure to your back, lifting free weights, like dumbbells, can also cause you to hold your breath, which increases pressure in your abdomen and may lead to more back pain.

Try this instead: Light machine weights. Machine weights may be safer for vulnerable backs because you have more control over the weights. Kaisler-Meza recommends using light weights and doing lots of reps. “If you lifted weights and you had a back injury, you should never go back to the weights you were doing initially,” he says. “I always tell people, cut your weights by at least a quarter. If you used to lift 100 pounds, do 75 and focus on the reps.”

If you find yourself tempted to “cheat” and lift without engaging your core while using machine weights, try lifting very light free weights or doing body-weight moves like squats. Adding resistance bands to body weight moves like squats or pushups is also a way to ease back into a strength-building routine. These types of exercises force you to activate your core muscles, which is key to back health.

It’s important to listen to your body when exercising. If you feel any unusual pain, stop what you’re doing. “What you want to do is emphasize good form, repetition, and things that may cause some muscle fatigue and soreness—but you don't want to do any exercises that actually imitate or replicate your pain,” says Kaisler-Meza. Also, remember to warm up for at least 5 to 10 minutes before working out with some light walking, jogging, or calisthenics and to cool down post-workout with gentle stretching.