What are the best exercises for lower back pain… and which should I skip?

For most people with non-specific lower back pain, the “best” exercise is the one you’ll do consistently. Walking, gentle mobility, core control, hip/glute strengthening, and mind–body options (yoga, Pilates, tai chi) all help. 

Avoid prolonged bed rest, and temporarily modify anything that spikes your symptoms. If you have (or are at risk of) osteoporosis, be cautious with repetitive, loaded spinal flexion (e.g., fast, rounded-back sit-ups). 

First things first: check the red flags

Get urgent medical help if any of these appear with back/leg pain: new bladder or bowel changes, numbness in the saddle area (i.e. areas that would touch a bike or horse saddle), progressive leg weakness, or severe, unrelenting pain after significant trauma. These can indicate cauda equina syndrome or other serious issues and need same-day assessment. 

What the evidence says 

• Keep moving. Staying active beats bed rest for faster recovery and better function. 
  
• Exercise works. Across many studies, exercise (aerobic, motor-control/core, strength, yoga/Pilates, mixed programmes) improves pain and function in chronic low back pain. There’s no single “magic” exercise - choose what fits your preferences and symptoms, take it slowly, and stay within a safe range of motion. Make sure you work with a qualified instructor.
  

Programmes that combine different elements (movement + education, sometimes manual therapy) are often used; acupuncture, TENS, ultrasound and traction aren’t recommended in UK guidance.

Best exercise categories

Walking / light aerobic

• Why: boosts blood flow, reduces sensitivity, supports mood/sleep.
  
• Start: 10-15 min at an easy pace, most days. Build gradually. Use short, frequent walks if sitting aggravates symptoms. 

Gentle mobility

• Why: eases stiffness, builds confidence in movement.
  
• Try: pelvic tilts, knee-rolls, cat-cow, knee hugs. Aim for smooth, pain-tolerable motion ((0–3 fine; 4–5 acceptable; 6–10 too much). 
  

Core control (“motor control”)

• Why: improves coordination of deep trunk/hip muscles that share the load with your spine.
  
• Try: modified dead bug (keep one foot on the floor);  bird-dog (hands & knees, small ranges), side-plank on knees; 5–8 slow reps each. 
  

Build glute & hip strength

• Why: stronger glutes and hips reduce over-reliance on the low back.
  
• Try: sit-to-stand from a chair, bridges, squats; 2–3 sets of 6–10 reps, slow tempo. 
  

Directional preference (extension bias)

• Why: if standing/walking feels better than sitting/flexing, gentle extension can calm symptoms for some.
  
• Try: lying on tummy, arms in a cactus position, pelvis flat → if tolerated, ‘slide’ breastbone forward and gently lift off the mat, keeping bottom rib on the mat hips flat, 3-5 gentle reps. (If it worsens pain down the leg, stop.) 
  

Mind–body options (Meditation, Breathwork, Yoga, Pilates, Tai Chi)

• Why: combine mobility, strength, breath, and relaxation which help calm the nervous system, reduce tension and are helpful for reducing pain and improving function. 
• How: choose beginner or back-friendly classes/instructors; avoid end-range positions that provoke symptoms. 

What to skip (for now) or modify

• Prolonged bed rest or long spells of inactivity. It slows recovery. Keep daily activities going, pacing as needed. 
  
• Movements that spike pain >5/10 during or after (and linger >24 hours). Use the “acceptable pain” rule (0–3 fine; 4–5 acceptable; 6–10 too much). Adjust range, load, or exercise choice. 
  
• Repetitive, loaded spinal flexion (rounded-back sit-ups, fast toe-touches with load), especially if you have osteoporosis or high fracture risk. Choose neutral-spine variations and back-extensor strengthening. 
  
• High-impact or heavy, end-range lifts during an acute flare. Reintroduce progressively when symptoms settle and technique is solid. (General principle alongside guideline advice to keep active and tailor to tolerance.) 
  

How much, how often? (simple dosing)

• Frequency: little-and-often wins - most days for walking/mobility; 2–3 x /week for strength. 
  
• Progression: add 1–2 reps or a minute every few sessions, not every session.
  
• Pain guide: work in the 0–5/10 zone; pain should settle within 24 hours. If not, scale back.  

A 15-minute starter routine (no equipment)

Do daily for 2 weeks, then progress.

1. Breath & pelvic tilts x 60–90 seconds (slow nasal breath).
   
2. Knee-rolls x 8 each side (small, smooth range).
   
3. Sit-to-stand x 8–10 (slow down, controlled up).
   
4. Bridge x 8–10 (pause at the top, don’t over-arch).
   
5. Bird-dog (short reach) x 6 each side (hips level).
   
6. Walk 8–10 minutes (easy pace).

Modify any exercise that pushes pain above 5/10 or sends symptoms further down the leg (reduce range, slow down, or swap to another in the same category). 

FAQs 

Do I need a scan before I exercise?

Usually no. Imaging isn’t routinely recommended unless it would change management (or red flags are present). 

Is one exercise “the best”?

Not really. Multiple types work, and your preference + consistency matter most. Programmes can be biomechanical, aerobic, or mind–body - pick the one you’ll stick with. 

What if I have osteoporosis?

Exercise is safe and valuable. Emphasise strength, balance, posture, and spine-care. Be cautious with repetitive, forced end-range spinal flexion; prioritise neutral-spine strategies and back-extensor work. 

When should I see someone?

If pain isn’t improving after a few weeks, is severe, or you have leg pain/numbness/weakness, speak to a clinician for tailored guidance. Seek urgent help for the red flags at the top. 

Sources

NICE guideline NG59: assessment and management of low back pain and sciatica (exercise, stay active; what not to offer).

Cochrane Review & updates: exercise therapy improves pain and function in chronic low back pain.

NHS (UK): back pain advice and exercises; avoid prolonged bed rest.

ACP guideline: non-pharmacologic care first; exercise and mind–body options endorsed.

Osteoporosis context (ROS/NOGG): exercise is safe; avoid repetitive, loaded spinal flexion; focus on strong, steady, straight.