Lower back pain exercises A physical therapist’s starter program, step by step

Exercise is a core part of lower back pain treatment, but it is hard to know where to start, and many people stop because a move felt wrong. This post is a practical starter program with step-by-step instructions, the same kind of moves a physical therapist teaches in the first weeks. For other drug-free options, such as hands-on care, traction and daily habits, see our guide to back pain relief without medication.

Before you start

• Use a mat or carpet, wear comfortable clothes and move slowly
• A mild stretch or effort is fine; keep pain at about 3 out of 10 or less
• Pain should settle within an hour or so and not be worse the next morning
• Stop and get checked if pain spreads below the knee, or you feel numbness, tingling or weakness

8 lower back pain exercises to start with

1. Pelvic tilt: lie on your back with knees bent. Gently flatten the lower back into the floor by tightening the stomach, hold 5 seconds and relax. 10 times.
2. Knee-to-chest stretch: on your back, hug one knee toward the chest until you feel a gentle stretch in the lower back. Hold 20 to 30 seconds, then switch. 3 each side.
3. Cat-cow: on hands and knees, slowly round the back up, then let it sag gently, moving within a comfortable range. 10 slow repetitions.
4. Bridge: on your back with knees bent, squeeze the buttocks and lift the hips until the body forms a straight line from shoulders to knees. Hold 3 seconds. 10 times.
5. Bird dog: on hands and knees, reach one arm forward and the opposite leg back, keeping the back level. Hold 3 seconds, then switch. 8 each side.
6. Clamshell: lie on your side with knees bent, keep the feet together and lift the top knee without rolling back. 12 to 15 each side.
7. Supported hamstring stretch: lie on your back and raise one straight leg, holding behind the thigh or using a towel around the foot, until you feel a stretch behind the thigh. Hold 20 to 30 seconds. 3 each side.
8. Walking: short, comfortable walks, two or three times a day, adding a few minutes each week.

When these feel easy, a physical therapist may add a resting stretch over an exercise ball, wall squats, side planks or band work for the upper back. Our lower back pain page covers the conditions these exercises help.

How often and how hard

Start with one set of each exercise once or twice a day. After a week or two, if your back feels the same or better the next morning, add a few repetitions or a second set. Progress one thing at a time. Most people notice easier movement within two to four weeks; lasting change in strength takes six to twelve weeks of regular work. If the back is very sensitive, do fewer repetitions more often rather than skipping days.

What to avoid during a flare

• Bouncing toe-touches and forcing a stretch into pain
• Full sit-ups and heavy twisting with a load
• Heavy lifting from the floor until the flare settles
• Long periods of bed rest, which make the back stiffer

How a physical therapist builds on these exercises

Once these feel easy, the next step is a progression of core exercises for back pain. In the first video, after an animation of the lower spine and the nerves running into the legs, a physical therapist stretches a patient’s leg on the table and the patient practices a side-lying movement. In the second, hands-on work on the lower back leads into exercise over a large ball. A therapist checks how you move, chooses which exercises fit your back, and adds manual therapy when stiffness or spasm is holding you back (more in physical therapy for back pain). Physical therapy is offered at our Brooklyn and Staten Island offices; see what to expect at physical therapy before your first visit. If an X-ray report mentions wear and arthritis, see lumbar spondylosis.

When to get checked first

See a physician before starting, or stop and get checked, if pain travels below the knee, you have numbness, tingling or weakness in a leg, the pain started after a fall or accident, or it keeps getting worse despite exercise. If pain has lasted months, our guide to chronic back pain treatment explains other options. Go to an emergency room or call 911 for back pain with loss of bladder or bowel control, numbness in the groin or sudden leg weakness.

Related care at Precision Care Medical & Sports Performance

A physical therapist near you for back pain

Searching for a physical therapist near me to guide your back exercises? For physical therapy and back pain treatment in Brooklyn, physical therapists Zoya Reznik, DPT, OCS and Maggie (Yi) Zhang, DPT, with physical therapist assistants Dennis Furman, PTA and Leila Nahmoud, PTA see patients at our Brooklyn physical therapy office on Shell Rd, a short trip from Sheepshead Bay, Gravesend, Coney Island and Midwood. For physical therapy on Staten Island, physical therapists Victoria Lynn Kain, DPT and Nicholas “Nick” Ursini, DPT work at our Staten Island physical therapy office on Richmond Rd, convenient to New Dorp, Great Kills and Eltingville.

Would you rather see a back pain doctor first? Ashley Marcus, MD sees patients at our Brooklyn office, and Jake Stephen, DO is the back pain doctor on Staten Island at our Staten Island office. For a back pain doctor in Midtown East, Yuri Gordin, MD sees patients at the Precision Care Spine & Pain Center in Midtown Manhattan, convenient for Washington Heights and Spanish Harlem; physical therapy is not offered at the Manhattan office. Request an appointment or call the Brooklyn or Staten Island office.

Questions patients ask

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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