Exercises for lower back pain are not created equal
There is no one exercise or group of exercises that are perfect for lower back pain.
This is because lower back pain can have different causes and different structures can be pain generators. The disc, facet joints, SI joints, nerves, muscles, and ligaments can all be a source of pain. Different exercises affect these structures in different ways.
Don’t make the mistake of fixating on the diagnosis though
In other words, don’t worry so much about the bulging disc or whatever it is that’s the source of pain. Focus more on what types of exercise will be beneficial so the lower back can heal.
Start out with determining if there is a directional preference. This is especially important if sciatica (leg pain caused by a herniated disc) is present. This video covers directional preference in more detail.
If there is a directional preference, use this directional of movement to decrease leg pain. As leg pain decreases, transition to more lumbar stabilization exercises. It is possible to have a directional preference when pain is localized to the lower back. If the directional preference is there, use it to guide exercise selection.
If multiple directions of movement increase lower back pain there is no directional preference. So bending forward, backward, side to side, etc. may all increase lower back pain. This is common. When this is the case the focus needs to be on lumbar stabilization exercises.
These types of exercises improve the ability of the core muscles to stabilize the lower back
The more stable the lower back is the less stress, strain, and compressive forces there are through the discs, joints, muscles, nerves. Less deleterious forces through these tissues means less pain and inflammation and more healing.
Exercise is especially important with lower back pain because it actually prevents future episodes of lower back pain
Medications, injections, and surgery have not been shown to prevent lower back pain. Only exercise has been shown in the medical literature to prevent lower back pain. Preventing pain is a superior approach compared to curing pain once it’s already there.
There are three keys with exercise for lower back pain
- Doing the right exercises
- Doing the right exercises correctly
- Being consistent over time
It generally takes six to eight weeks to realize the full benefit from exercises for lower back pain
Exercise sometimes does not work for people because they are doing the wrong exercises or doing the right exercises wrong. More often though, exercise does not work for people because they are not consistent over time.
Take the time to figure out what exercises you need to focus on. Then make sure you know how to do them correctly. Then do them, every day. Leave your body no option but to respond and adapt. With consistency lower back pain will decrease and function will improve.
