What is the ultimate exercise for lower back pain?

A common question I get asked is “what is the best exercise to help my back?” That’s a reasonable question, considering that almost all of us will end up with lower back pain at some point in our life. Despite how common it is, no two back problems are exactly the same. On top of that, different exercise approaches have had their time in the sun at different times. We can all be guilty (me included) of jumping on the latest trends as they make appearances on our social media feeds or are spruiked by popular gurus. Let’s put that to one side to see where the best evidence lies. 

Let’s start with core exercise. Around the nineties we all became obsessed with strengthening our abs to protect our back. This was reinforced by research that showed that people with long term back pain did not turn on their tummy muscles in the same way people without back pain did1. People started being conscious of bracing their tummy muscles when lifting weights or bending over. Approaches like Pilates really took hold and are still popular today. We did find that we were helping people with core muscle exercises. 

Was there something special about core exercises that helped people’s back pain or was it the fact that we just got people moving? Researchers got onto answering that question. People with back pain were given general exercises that included cardiovascular conditioning and strengthening. Evidence emerged that showed that general exercise helped people with back pain too. There was no significant difference between doing core exercises and doing general exercises. 

So where does this leave us? Basically, it’s horses for courses. You need to consider many things like the type of back pain you have and your goals. Like I said, two backs are never exactly the same. Some backs like to stand and arch, some like to sit and bend and there is everything in between. Your goals will also drive your exercise selection. If your goal is to be able to stand and walk further without your back hurting, there is no point doing exercises that solely involve sitting and lying down. Exercises need to be specific to your problem and your goal. Finally, your preferences need to be considered. Some people do well with structured exercise classes on set days of the week, others do well with a program of exercises designed for them that they can complete in their own time at home. The key is to find someone who will work with you to find what works best for you to achieve your goals. 

If you have new or persistent back pain and want to get on with life, odds are that exercise will help. Physiotherapists are highly trained at assessing your back and your needs and can work with you to design an appropriate rehabilitation program. At Goulburn Valley Physiotherapy Centre we have well trained and experienced physiotherapists who are ready and willing to help you out.