What is the best exercise for low back pain?

Low back pain is one of the most common issues experienced in our society. In fact, it is estimated that one out of every four Americans report an episode of low back pain in the previous three months! Core strengthening exercises are often given for the treatment and prevention of low back pain. However, since there are so many different ways to strengthen the core, it is easy to get confused on where to start and which exercises are best.

The problem with finding the answer for the best exercise for low back pain is that “low back pain” is actually more of a symptom than a diagnosis. The term low back pain tells us exactly that, there is pain in the low back. It doesn’t actually tell us what is causing the low back pain. 

For example, let’s say that we are having car problems so we take the car to a mechanic. Instantly, we ask the mechanic to tell us how to fix the car without letting him open up the hood or do any diagnostic tests. The problem could be something serious like a broken hose or something simple like we are out of gas or need an oil change. 

As with low back pain, we need to figure out what is causing the pain. Is it something sinister like cancer? Did we tear a muscle? Or is the nervous system just being cautious about a certain position or movement? Since all of these can cause low back pain, we need to figure out what is going on, similar to the car mechanic. Once we can conclude there isn’t a sinister pathology, we can move on to finding an exercise to help with the low back pain. 

Unfortunately, there does not seem to be a single answer for the best exercise for low back pain. But that’s okay. Since each case of low back pain can have a different set of factors which cause it(biological, psychological, and social factors can all contribute to pain syndromes), we can work with the variety of core exercises to find one that works best for you. 

As a general recommendation, exercises that force you to hold a certain position (called isometric exercises) should be started first because they have been shown to alleviate pain. Examples of isometric exercises for the low back include planks, side planks, and gluteal bridges. These three isometric exercises were picked because they load different tissues (front, side, and backside, respectively). 

If those exercises either cause pain or are not effective in relieving the pain, there are other exercises that load the same tissues but in different positions. For example, if planking causes pain, we can try a dead bug exercise to start loading the low back again. 

In conclusion, there is no single best exercise for low back pain but this is a good thing because it means we have options. When starting off, begin with isometric exercises and slowly build movement into your low back exercise program. If you need help finding a place to start or building an exercise progression, don’t be afraid to reach out for guidance! 

 

References:

  • Deyo, Richard A., Sohail K. Mirza, and Brook I. Martin. "Back Pain Prevalence and Visit Rates." Spine 31.23 (2006): 2724-727.
  • Rio, Ebonie, Dawson Kidgell, Craig Purdam, Jamie Gaida, G. Lorimer Moseley, Alan J. Pearce, and Jill Cook. "Isometric Exercise Induces Analgesia and Reduces Inhibition in Patellar Tendinopathy." British Journal of Sports Medicine Br J Sports Med 49.19 (2015): 1277-283.