The Best Exercises for Lower Back Pain: Building Strength and Confidence
The Best Exercises for Lower Back Pain: Building Strength and Confidence
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If you're living with lower back pain, you’re not alone—and exercise is one of the best tools for recovery. Movement helps reduce pain, improve function, and build long-term resilience. But not all exercises are created equal. This guide explains which exercises are most helpful, why they’re chosen, and how a physiotherapist can guide you through safe progression.
Why Exercise?
Why Exercise?
Strong evidence supports exercise as a first-line treatment for both acute and chronic lower back pain. According to current clinical guidelines, “exercise therapy is beneficial for reducing pain and improving function in non-specific low back pain” [1]. Importantly, no single type of exercise has been shown to be better than all others—what matters most is that it is consistent, progressive, and individualised [2].
Introducing the McGill Big 3
Introducing the McGill Big 3
The McGill Big 3 are a set of core stability exercises developed by spine researcher Professor Stuart McGill. These exercises are designed to improve spinal stability while minimising spinal load. They’re particularly helpful early in rehab when you want to start rebuilding strength without aggravating symptoms [3].
1. Curl-Up
1. Curl-Up
Lie on your back, one knee bent.
Keep your hands under the lower back to maintain a neutral spine.
Gently lift the head and shoulders, avoiding full flexion.
Hold for 10 seconds and repeat.
Purpose: Activates the anterior core without stressing the lumbar discs.
2. Side Plank
2. Side Plank
Lie on your side with knees bent or straight.
Prop up on your elbow and lift hips off the floor.
Hold for up to 10 seconds. Repeat both sides.
Purpose: Targets the obliques and quadratus lumborum to build lateral stability.
3. Bird Dog
3. Bird Dog
On hands and knees, extend opposite arm and leg.
Keep your spine stable and hips level.
Hold for 6–10 seconds. Repeat both sides.
Purpose: Builds coordination and control in the back extensors and glutes.
“These exercises are designed to increase endurance of core stabilisers while sparing the spine from excessive load” [3].
Other Helpful Exercises
Other Helpful Exercises
Beyond the McGill Big 3, your physiotherapist may guide you through:
Glute Bridges
Glute Bridges
Strengthen the glutes and support lumbar-pelvic control.
Helps offload the lumbar spine during movement.
Knee Hugs or Windshield Wipers (gentle mobility)
Knee Hugs or Windshield Wipers (gentle mobility)
Improve flexibility and movement confidence without provoking pain.
Especially useful in the early stages if stiffness is dominant.
Cat-Cow or Pelvic Tilts
Cat-Cow or Pelvic Tilts
Mobilise the lumbar spine and pelvis.
Promote gentle movement to reduce guarding.
Wall Sits or Box Squats
Wall Sits or Box Squats
Once pain is better managed, lower body strengthening becomes essential.
Teaches safe spinal control during functional tasks.
How Do You Know Which to Do?
How Do You Know Which to Do?
Not all back pain is the same. A physiotherapist will consider:
Pain irritability: Are your symptoms easily flared?
Dominant presentation: Is the pain related to stiffness, weakness, poor endurance, or fear of movement?
Stage of healing: Early phase may focus on breathing, bracing, and mobility. Later phases focus on load tolerance, strength, and function.
What About Pain During Exercise?
What About Pain During Exercise?
It’s okay to feel a mild discomfort as you build confidence and strength. We don’t aim for pain, but “hurt doesn’t always mean harm” [5]. Your physio will help you interpret the signals your body gives and adjust the plan as needed.
Summary
Summary
The best exercises for back pain are:
Safe and spine-sparing in early stages.
Progressive and strength-building in later stages.
Tailored to the individual with proper clinical reasoning.
If you’re unsure where to start or feel stuck, speak to your physiotherapist. The right exercises can help you move, work, and live with less pain and more confidence.
References
References
Oliveira CB, et al. Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. Eur Spine J. 2023;32(1):181–197.
Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017;389(10070):736–747.
McGill SM. Low back disorders: evidence-based prevention and rehabilitation. 3rd ed. Champaign: Human Kinetics; 2016.
Hodges PW, et al. Biopsychosocial approach to pain and disability: understanding and managing low back pain. Nat Rev Rheumatol. 2019;15(6):391–405.
Foster NE, et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet. 2018;391(10137):2368–2383.
Disclaimer:
Disclaimer:
This content is for general informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you may have about your health or a medical condition. Never disregard professional advice or delay seeking it because of something you have read or seen here. The creators of this content accept no responsibility for any injury, loss, or damage arising from reliance on the information provided.
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