Lower back pain affects a large proportion of the adult population at one time or another — and the numbers are only growing. Therefore, lower back pain is one of the most common conditions for doctors to treat. Some treatment options for lower back pain include medication, surgery, and exercise therapy.

Exercise therapy has relatively few adverse side effects, in comparison to other treatment options. Doctors may recommend exercise therapy as one of the initial treatment options for lower back pain. 

This guide from HealthTap explains exactly what makes exercise therapy effective and provides exercises patients can follow at home to relieve lower back pain. 

Do strengthening exercises help the back?

Weak muscles can cause or worsen low back pain. 

To prevent low back pain, strengthening exercises should target not only the lower back muscles but also those that support the lumbar spine — the hips, the buttocks, and the abdominals. 

Strong abs can help maintain an upright posture, keeping joints in alignment. This can prevent the joints from being worn down prematurely while reducing stress on the ligaments that hold the joints together. 

Strengthening the hips and buttocks can also help with low back pain. These muscles support the back while walking, standing, and sitting. If these muscles are weak, they can make the lower back compress, leading to increased pain. 

As a bonus, strengthening exercises don’t have the same side effects as powerful pain medications.

Simple exercises may be better than over-the-counter painkillers, such as nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs, such as Advil and ibuprofen, are fine if used in the short term. But if taken over a long period of time, they can lead to indigestion, stomach ulcers, or other side effects.. 

Exercise therapy may be just as effective as painkillers, without the side effects. 

12 exercises to strengthen the lower back

Before attempting a new exercise program, it’s important to remember that some people may experience lower back pain or have other conditions which prevent them from performing certain exercises. It’s best to consult a doctor before starting any new exercise program, or if any exercise causes pain. 

It’s fine to start with more gentle exercises and build up from there, with approval from a doctor. 

Here are 12 exercises which may strengthen the lower back and other essential muscles. 

1. Pelvic tilt

The pelvic tilt is a gentle exercise done lying down. A thick mat can provide cushioning for those with low back pain. 

Here’s how to do it:

1. Lie on your back with your knees bent and the soles of your feet touching the floor.

2. Gently contract the abdominal muscles.

3. Gently rock your hips towards your head. (You should feel your lower back pushing against the floor.)

4. Hold this pose for five seconds before releasing. 

5. Do this exercise for 10 reps. 

2. Glute bridge

The glute bridge is an excellent way to strengthen the lower back, abs, glutes, and hamstrings — all at the same time.

Here’s how to do it:

1. Lie on your back with your knees bent and feet on the ground at a hip-width distance apart.

2. Gently contract the abdominal muscles while squeezing the glutes together.

3. Lift the hips off the mat as far as possible — without causing back pain.

4. Hold for five seconds and gently release to starting position.

5. Repeat this exercise 10 times. 

6. For those wanting an extra challenge, you may increase the number of repetitions in each set.

When performing this exercise, send your belly button to your spine to engage your ab muscles and protect your lower back from over-extending.

3. Isometric hip flexor hold

Isometric exercises strengthen the muscles without making them contract. The isometric hip flexor hold is an excellent way to strengthen the hips, glutes, and lower back.

Here’s how to do this exercise: 

1. Lie on your back with your knees bent and your feet on the ground.

2. Lift your left knee, so it’s facing up towards the ceiling.

3. Press one hand into the left knee without letting it move. (You should feel a contraction in your hips.)

4. Hold this pose for five seconds. 

5. Slowly release to starting position.

6. Repeat on each side for 10 reps. 

4. Simplified piriformis stretch

While stretches technically don’t build muscle, they’re an important part of a strength-training routine. They can increase muscle flexibility while lengthening the muscles, making it easier to strengthen them.

The piriformis muscle is in the buttocks. Stretching the piriformis can increase muscle strength in the buttocks and the hips, hamstrings, and lower back. 

Here’s how to do it: 

1. Lie on your back with knees bent and feet flat on the mat.

2. Cross the left leg over the right (your left foot should rest on your right knee).

3. Press against the left knee until you feel a stretch in the glute.

4. Hold this stretch for up to 15 seconds. 

5. Repeat this stretch five times on each side. 

5. Piriformis stretch

This stretch is a variation of the simple piriformis stretch, which goes deeper into the glute muscle.

Here’s how to do it: 

1. Lie on your back with bent knees and feet against the floor. 

2. Cross your left leg over the (bent) right leg.

3. Place both hands behind your right knee.

4. Pull your right knee towards your face until you feel a stretch in the glutes. 

5. Hold this stretch for up to 15 minutes — or, if well-tolerated, longer.

6. Slowly bring the right foot down to the ground. 

7. Repeat this exercise five times on each side. 

6. Dead bug

The core muscles help to stabilize the spine, preventing it from moving in ways it shouldn’t. As such, a strong core can protect the lower back from injury. 

The dead bug is an excellent exercise for strengthening the core. 

Here’s how to do it: 

1. Lie on your back with your arms extended up towards the ceiling.

2. Bend the knees at 90 degrees with your feet lifted off the ground.

3. Engage your abs, maintaining contact between the lower back and the floor.

4. Move your right arm back while extending the right leg forward. (Your left arm and left leg should not move.)

5. Return to starting position.

6. Now, do the same with the left side.

7. Repeat on each side for 10 reps. 

7. Bird dog

This exercise promotes core stability while giving virtually all of your major muscle groups a strengthening boost.

Here’s how to do it:

1. Get on an all-fours position on a mat.

2. Make sure your spine is neutral — in other words, neither arched nor rounded. (It might help to do this exercise in front of a mirror first.)

3. Slowly raise your right leg back while lifting your left arm off the mat.

4. Use the remaining arm and leg to stabilize your body. 

5. Hold this position for five seconds.

6. Return to starting position.

7. Repeat with the other side. 

8. Perform this up to 10 times on each side. 

8. Fire hydrant

The fire hydrant takes its name after dogs who urinate on a fire hydrant. While it may seem silly initially, it’s an excellent exercise for building muscle. 

The fire hydrant works out all muscles in the glutes, making it an effective way to develop this area. It can also target the lower back.

Here’s how to perform it:

1. Get onto your hands and knees on a mat.

2. Make sure your spine is in a neutral position — squeezing your core may help. 

3. While keeping your right knee bent, lift it sideways off the mat. 

4. You should feel a contraction in your glutes and hips. 

5. Hold this position for three seconds.

6. Slowly return to starting position.

7. Repeat this exercise on each side for at least 10 reps. 

9. Single-leg bridge

Although challenging, the single-leg bridge is an excellent way to strengthen the glutes, hamstrings, hip, and lower back. 

If you’re feeling up for a challenge, here’s how you can do this exercise:

1. Lie on your back with your knees bent and feet planted on the ground. 

2. Extend one of the legs fully. This is the starting position.

3. Squeeze your abs and glutes, and lift your hips off the mat.

4. Make sure to keep both hips at the same level during the exercise.

5. Hold for five seconds.

6. Slowly returning to starting position. 

7. Repeat on each side for 10 reps. 

10. Plank

This is one of the most well-known exercises for strengthening the core. It also is an excellent way to target the glutes, hamstrings, lower back, shoulders, and arms. 

Here’s how to do it the proper way:

1. Get into plank position with your body extended and your hands and toes on the floor.

2. Make sure that your wrists are directly under your shoulders. 

3. Keep your spine neutral. 

4. Last, make sure your torso is straight. If you’re beginning to sag towards the floor, take note of it and straighten it back up.

5. Once you’re in plank position, hold for as long as possible. Over time, you can work your way up to a longer holding time. 

6. You can repeat this exercise three times per day.

11. Floor back extension 

This exercise targets the back muscles, helping to strengthen the lower back while providing a slight chest stretch.

Here’s how to do it:

1. Lie on a mat facing down.

2. Place your arms at about a 90-degree angle to your sides.

3. Keeping your neck in a neutral position, look down towards your mat.

4. Lift your upper body a few inches off the ground by contracting your lower back.

5. After lifting your upper body, pause for about five seconds — or more. 

6. Slowly lower your body to the ground.

7. Repeat this exercise about 10 times.

12. The superman

This is a variation of the floor back extension with an added challenge.

Here’s how to do it: 

1. Lie on a mat facing down with your arms extended overhead.

2. Engage your abs and glutes.

3. Lift your upper back and lower body off the floor by contracting your lower back. 

4. Pause for about five seconds and return to starting position. 

5. Repeat this exercise about 10 times. 

If any of the above exercises lead to increased pain, it’s important to consult a doctor right away.

It’s best to avoid high-impact exercises for low back pain 

While strengthening the lower back and surrounding muscles can help prevent pain, other exercises may worsen it.

High-impact cardiovascular exercise (also known as “cardio”) includes running, jogging, and jumping. These exercises put increasing pressure on the joints in the back, which may lead to inflammation and pain. 

Of course, cardio is still an important part of treating and preventing chronic low back pain (meaning back pain which lasts longer than 3 months). It increases circulation, bringing oxygen to injured tissues and speeding up healing. Plus, it releases endorphins, which can act like natural painkillers.

Low-impact cardio may be an alternative. Some low-impact cardio options include walking, swimming, and elliptical training. It’s best to consult a doctor when starting a new exercise plan, and they can advise on which types of exercise work well for those who experience low back pain. Most doctors recommend doing cardio at least three times per week (preferably more) for best results.

Takeaways 

Some exercises can strengthen the lower back and its surrounding muscles, which may help prevent low back pain. 

HealthTap’s primary care providers can evaluate low back pain and create an individualized treatment plan. HealthTap doctors may recommend being seen in-person for testing or an exam to diagnose lower back pain. 

Our virtual platform here at HealthTap can connect you with a low-cost virtual doctor visit as soon as today. Schedule your virtual visit here.