Exercises For Lower Back Pain – Acute and Chronic

The world of lower back pain (LBP) is a big one. There are many different causes of LBP (eg. Osteoarthritis, disc issues, facet joint sprain, muscular injuries, poor mechanics – just to name a few), and many different symptoms and presentations. Sometimes there is just a lower back ache, sometimes it can be a more intense pain. When it involves the nerves it can also include lower limb symptoms, such as pins and needles or numbness. However, despite the cause, LBP can be frustrating, debilitating, and costly.

So to help you start to lower back pain treatment, I thought it would be good to compile a list of safe and easy exercises and stretches to help you get some relief, whether you have current lower back pain, or to prevent a recurrence if you have a history of lower back pain.

These exercises have been separated into those for Acute back pain vs Chronic back pain (pain lasting longer than 3 months). The aim for chronic pain is mainly to promote and improve mobility and flexibility – the majority of the initial inflammatory part is completed and it is now time to restore normality to the lower back (within comfort levels of course!).

With Acute pain, or fresh pain, it is important to note that movement is necessary to create a good base for healing. Many studies have shown the detrimental effects of long periods of bed rest with LBP. However, you want to make sure that you move in the right way, so that you don’t trigger increased inflammation and pain. There is often a particular direction that is aggravating for acute LBP – usually it’s either bending forwards, or arching backwards. Aggravating activities tend to fit this pattern also; If you main trouble is bending, then sitting, driving, bending forwards will tend to be aggravating, whereas if your main trouble is extending, then walking and standing may be worse. With this in mind, I have separated the acute exercises into 2 categories: (1) Extension Exercises (acute), and (2) Flexion Exercises (acute).

As I mentioned earlier, with acute pain we want to get the area moving, but in a pain-free way. This is usually in the OPPOSITE DIRECTION to that which causes pain. Therefore, the extension exercises will suit someone whose main pain is aggravated by flexion activities. The Flexion exercises will suit someone whose main pain is aggravated by extension activities. In other words, we are aiming to promote the movement that is not painful.

So, without further ado, let’s get into some exercises! (Please follow the instructions carefully, and STOP any exercise if it causes pain. Please note that some exercises will cross over, and you may see the same exercise in different categories).

Exercises for Chronic LBP (Mobility based):

Angry Cat/Happy Dog

Start on all 4’s, then slowly curl the spine as far as possible

Tuck the chin in towards the chest and the ‘tail under’

Breathe out as you move into position

Move from the Angry Cat position into full spine extension

Look up, and stick the ‘tail out’

Breathe in as you move into position

Alternate between the Angry Cat and Happy Dog positions, moving as you breathe. Aim for 1-2 minutes, or as comfortable.

Lion Exercise

Start on all 4’s, arms slightly forward of the shoulders, then sit down towards the feet

This should stretch anywhere from the shoulders, to mid and lower back

For added stretch, try keeping the feet together and knees apart as you sit back

Aim for 5 repetitions, holding each for 5 seconds (or longer if you like!)

Bridging

Start on your back with knees bent (no pillow is best)

Slowly roll pelvis/hips off floor, followed by one vertebrae at a time

Aim to lower down, one vertebrae at a time

Try 10 repetitions

Hamstring Stretch

Sit on side of bed/lounge chair, with one leg out straight

Aim to get the chest towards the knee (no need to reach with the hands)

Move until you feel a comfortable stretch down the back of the leg

Hold 20 seconds, repeat 3 times each leg

Gluteal Stretch

Sit on edge of chair, cross one foot over the other knee, SIT UP TALL, and lean forwards

There should be a comfortable stretch in the buttocks, or even down the side/back of the leg

Hold 20 seconds, repeat 3 times each leg

 

Extension Exercises (Acute):

(Note, these exercises are for someone whose pain if Flexion-based, eg. Sitting, driving, bending)

Extension at wall

Start with feet a little bit away from the wall, and forearms on the wall

Aim to slowly bring your hips forwards, slightly arching your back as you move

Slowly move in and out from this position, aim for 10 repetitions

 

Prone push up

Start on tummy, with elbows resting underneath shoulders

Slowly push yourself up onto your elbows (keep shoulder relaxed)

You should be able to feel a gentle stretch in the lower back (not pain)

Hold 5 seconds, repeat 10 times

Gluteal stretch

Sit on edge of chair, cross one foot over the other knee, SIT UP TALL, and lean forwards

There should be a comfortable stretch in the buttocks, or even down the side/back of the leg

Hold 20 seconds, repeat 3 times each leg

 

Flexion Exercises (Acute):

(Note, these exercises are for someone whose pain is Extension-based, eg. Walking, standing)

Knees to chest (Single and Double legs)

Lying on your back, slowly bring one, or both, knee(s) towards your chest as far as comfortable

You should feel a gentle, comfortable stretch in your lower back, or buttocks

Hold for 10 seconds, repeat 5 times

Seated Lumbar flexion

Sit on edge of chair, push arms against the inside of the legs (for support)

Slowly lower down towards the floor, as far as comfortable

Breathe out on the way down, then in on the way up

Repeat 10 times (don’t hold the position initially)

Lion Exercise

Start on all 4’s, arms slightly forward of the shoulders, then sit down towards the feet

This should stretch anywhere from the shoulders, to mid and lower back – but just move to where you’re comfortable

Aim for 5 repetitions, holding each for 5 seconds

To Conclude

Please take care with these exercises. It is also important to note that not all of these exercises and stretches will be suitable for everyone (as everyone’s pain is different). If you experience any discomfort with these exercises, please STOP immediately and discuss them with your physiotherapist. Alternately, please know that all the above exercises will have a counterpart on the Pilates equipment – so if you find any that you particularly enjoy, please let us know and we can show you on the machines!

If you would like further information, to discuss these or other exercises in more detail, or to make an appointment please contact us on 8221 5011, or email us at info@therapia.com.au. We have physiotherapists working at our Adelaide CBD clinic and at Southern Fleurieu Family Practice in Yankalilla.

In the meantime, happy exercising!

(We would also like to say a big THANK YOU to Angela for agreeing to be in our blog photos!)

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