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Core exercises for back pain What your core really is, and a step-by-step plan to strengthen it
Core exercises for back pain train the deep muscles that support the spine: the deep abdominals, the small back muscles, the glutes and the diaphragm. Instead of crunches, the focus is on holding the spine steady while the arms and legs move, with moves like bracing, dead bugs, bird dogs, bridges and side planks. Start easy, keep pain mild, and progress over several weeks. Core work is one part of back pain treatment, so if pain spreads down a leg or comes with numbness or weakness, get checked first.
“Strengthen your core” is one of the most common pieces of advice for back pain, but many people are not sure what that means or which exercises to do. The core is not just the six-pack muscle. It is a group of muscles that work together to keep the spine steady while you lift, twist and walk. The videos show Dennis Furman, PTA combining hands-on care with exercise, which is how core training usually starts in physical therapy for back pain.
What your core really is
- Deep abdominals (transversus abdominis): a natural “corset” that tightens around the waist
- Multifidus: small muscles along the spine that steady each segment
- Diaphragm and pelvic floor: the top and bottom of the “canister”
- Obliques and glutes: control twisting and link the trunk to the legs
Research reviews show that core-focused exercise can reduce chronic low back pain about as well as other kinds of structured exercise. The best program is the one you will do regularly and that progresses with you.
How to brace, the first core skill
Lie on your back with knees bent. Breathe in, then as you breathe out, gently tighten your stomach as if someone were about to poke it, without sucking it in or holding your breath. Keep breathing normally while holding about 20 to 30 percent effort for 10 seconds. Repeat 10 times. Every core exercise below starts with this brace.
Core exercises for back pain: a four-stage plan
- Stage 1, control (weeks 1 to 2): bracing, pelvic tilts and bridges; see the starter moves in lower back pain exercises
- Stage 2, move the limbs (weeks 2 to 4): dead bug (on your back, lower the opposite arm and leg slowly while the back stays still) and bird dog (on hands and knees, reach the opposite arm and leg), 2 sets of 8 each side
- Stage 3, hold against gravity (weeks 4 to 6): side plank from the knees, front plank from the knees or forearms, 10 to 20 seconds, building to 30 to 45 seconds
- Stage 4, real life (week 6 on): band anti-rotation press (Pallof press), farmer’s carries with a light weight, hip hinges and squats with a braced trunk
Do core work three to four days a week. Move on to the next stage when the current one feels easy and pain stays mild (no more than about 3 out of 10) and settled by the next morning.
Common mistakes
- Doing endless crunches or sit-ups, which load the spine without training it to stay steady
- Holding your breath during planks
- Letting the lower back sag or arch as the arms and legs move
- Jumping straight to hard planks during a flare
- Doing core work only, without walking and leg and hip strength
When to get checked first
Back pain can have many causes, including a muscle or ligament strain, a disc problem, arthritic facet joints or a pinched nerve. If pain spreads below the knee, or you have numbness, tingling or weakness, see a physician before starting. They examine you and order imaging or nerve tests only when needed. A physical therapist then adjusts core exercises to what was found; manual therapy and traction and spinal decompression are other parts of treatment. See our lower back pain treatment page.
More videos: lower back therapy
More clips from our YouTube channel @precisioncaremedical showing the hands-on treatment that often comes before core training.
Related care at Precision Care Medical & Sports Performance
Core strengthening with a physical therapist near you
Looking for a physical therapist near me for back pain? Precision Care Medical & Sports Performance offers physical therapy for back pain at two offices. Our Brooklyn physical therapy office on Shell Rd is close to Marine Park, Midwood, Gravesend and Sheepshead Bay, with physical therapists Zoya Reznik, DPT, OCS and Maggie (Yi) Zhang, DPT, with physical therapist assistants Dennis Furman, PTA and Leila Nahmoud, PTA.
Our Staten Island physical therapy office on Richmond Rd serves Castleton Corners, Sunnyside, Todt Hill and Dongan Hills, with physical therapists Victoria Lynn Kain, DPT and Nicholas “Nick” Ursini, DPT. Traction and spinal decompression are offered at both the Brooklyn and Staten Island offices. For a doctor’s exam first, see our back pain doctor page. Request an appointment or call the office closest to you.
Questions patients ask
What are the best core exercises for back pain?
Bracing, bridges, dead bugs, bird dogs and side planks are common choices, progressed over several weeks. The best ones are those you can do with good form and only mild pain.
Are sit-ups and crunches good for back pain?
They are usually not the best choice. They bend the spine repeatedly without training it to stay steady; exercises that hold the spine still while the arms and legs move are generally better tolerated.
How often should I do core exercises for back pain?
Three to four days a week is a good target. Short sessions of 10 to 15 minutes are enough when they are done regularly.
How long until core exercises help back pain?
Many people notice less pain and better control within four to eight weeks. Keep going after the pain settles to help prevent it from coming back.
Can core exercises make back pain worse?
They can if you progress too fast or hold your breath and strain. Keep pain mild and settled by the next morning, and stop and get checked if pain spreads down a leg.
Where can I get physical therapy for back pain near me?
Precision Care Medical & Sports Performance offers physical therapy for back pain at two offices:
- Brooklyn2781 Shell Rd, Suite 101, Brooklyn, NY 11223(718) 648-1234 · Get directions
- Staten Island1630 Richmond Rd, Suite 101, Staten Island, NY 10304(718) 339-7100 · Get directions
Physical therapy is offered at the Brooklyn and Staten Island offices only.
Educational only, not medical advice. These videos and this article explain common problems and treatments in general terms. They are not a diagnosis or a treatment plan for you. Results vary from person to person. See a qualified clinician about your own symptoms, and call 911 or go to an emergency room for an emergency.
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