Physiotherapy exercises for lower back pain

Are you looking for exercises to relieve your lower back pain?

Our qualified and trusted team has put together this list of six (6) exercises which we often prescribe to our patients with aches and pains in the lumbar spine region of the back.

If you’re experiencing any aches in your lower back region, it’s important to seek personalised advice from a qualified health professional before beginning an exercise program.

6 Exercises for Lower Back Pain Relief

Knee rocking is a great exercise to help relieve pain and stiffness in your lower back. It can be especially effective for those with an acute presentation of lower back pain.

This movement helps to reduce joint stiffness, muscle spasm and improve rotational range of motion in your lower back, thus helping to boost overall function.

How to do Knee Rocking

1. Begin by lying on your back with your knees bent and your feet flat on the floor.
2. Keeping your knees together, gently rock both bent knees from side to side as far as you can go (within a pain free range).
3. Continue this pattern of movement in a slow and controlled manner for 1-2 minutes. Try to time your movements to match each breath.

Cat-Cow is a gentle, yoga-style exercise commonly used to help improve flexion/extension and range of motion, as well as to reduce pain and muscle spasm in your lower back.

It is important to keep this movement slow and controlled, while moving within a pain-free range.

How to do Cat-Cow Pose

1. Begin in a tabletop position, on all fours with a flat back.
2. Arch your back towards the ground as you inhale to look up.
3. Then, on an exhale tuck your chin into your chest and arching your spine toward the ceiling.
4. Continue this pattern of movement for 1 to 2 minutes. Again, keep trying to move with each breath in a slow and controlled fashion.

Knees-to-chest is a gentle exercise commonly given to help reduce pain in an acute lower back injury, especially if bending backwards or extending your back provokes pain for you.

This movement helps to relax your hips, thighs and glutes, while also providing a flexion stretch of you lower back.

How to do Knees-to-Chest Stretch

1. Lie on your back on the floor. Bend your knees and place your feet flat on the floor. 
2. Draw one knee into your chest, while keeping the second knee bent or extend that leg out along the floor.
3. Clasp your hands behind the thigh or at the shinbone on the knee which is drawn into your chest.
4. Take deep breaths to alleviate any tension you may have.
5. Hold this position for 30 seconds to 1 minute.
6. Repeat on the other side.

Pelvic tilt is an exercise designed to help promote mobility and reduce stiffness in your lower back, while also helping to build strength in your core abdominal muscles. 

This exercise aims to improve your core muscle control, hence helping to protect and strengthen your lower back.

How to do Pelvic Tilt Exercise

1. Lie flat on your back. Bend both of your knees and position your feet flat on the floor. 
2. Gently tilt your hips backwards, engaging your abdominal muscles and flatten your back against the floor.
3. Breathe normally while holding this position for 2-3 seconds, before slowly reverting to your starting position.
4. Do 1 to 3 sets of 8 to 10 repetitions.

This yoga-based exercise is used to help reduce stiffness in your lower back and hips, by gently stretching your erector spinae muscles of your back, glutes and thigh muscles.

This exercise can be relieving and help to alleviate pain if extending your back hurts and causes discomfort. 

How To Do Child’s Pose

1. Begin in a kneeling position and place your hands on the ground in front of you. Sink your hips backwards and rest them on your heels. 
2. Fold forward by hinging at the hips, while walking your hands out in front of you.
3. Rest your stomach on your thighs.
4. You can either extend your arms out in front with your palms to the ground, or alongside your body with your palms facing upwards.
5. While holding this position, concentrate on breathing deeply and relaxing any areas of tension or tightness.
6. As you feel comfortable, you can slowly walk your hands further away from your body to increase the stretch.
7. Hold this position for up to 1 minute.

When you have an injury or pain in your lower back, it is very common for the muscles in your hips to spasm/tighten as a form of protection.

This can progress to tightness in your gluteal and piriformis muscles, which can further increase the stiffness in your lower back and hips.

How to do Piriformis Stretch

1. Start by lying flat on your back with both knees bent. Ensure your feet are flat on the floor.
2. Bring your right ankle to the base of your left thigh, so it is positioned on top of your left knee.
3. Hold onto your left thigh with your hands and pull up toward your chest until you feel a stretch.
4. Hold this position for 30 seconds to 1 minute.
5. Perform this stretch on both sides.

Brisbane Physio for Back Pain

If your back pain is impacting your quality of life and you’re ready to see a trusted physio, please contact one of our clinics on Brisbane’s northside.

North West Physiotherapy is your one-stop pain relief and healthy living practice in Brisbane. With six clinics across North Brisbane; Everton Park, Keperra, Eatons Hill, Nundah, Lutchwyche and Newmarket, our aim is to provide holistic healthcare solution to suit your specific lifestyle. 

Our services include Physiotherapy, Sports Physio, Hydrotherapy, Pilates, Podiatry, Dry Needling, Massage, Womens Health, and Seniors Strength and Balance Classes. Please note that services vary across our clinics. 

Contact your local clinic to book an appointment.

Today, exercise is recognized for its importance to healthy lifestyles, longevity, quality of life, mental health, and the management of many chronic diseases, including low back pain. Exercise is the best way to increase functional capacity.

• For the acute back pain patient, early activation towards normality that includes exercise should begin in the primary care setting. Unfortunately, a large percentage of primary care physicians do not recommend exercise to their back pain patients.
• Good evidence supports the use of exercise-directed therapy for patients with chronic back pain. When compared with other therapeutic approaches, exercise demonstrates positive results by itself and in combination with cognitive interventions eg CBT approach to chronic low back pain[1].

Physiotherapy[edit | edit source]

In response to physical inactivity, skeletal muscles go through a process called adaptive reductive remodeling. This results in a loss of muscle mass and changes in muscle composition, leading to a decreased in muscle strength (see sarcopenia). The paraspinal muscles (erector spinae, transversospinalis and abdominal muscles[2]) change in response to physical inactivity ie atrophy and increased in fat content, increasing the risk of low back pain.

Following an assessment of back function we have formulate a treatment plan. This includes prescribing specific and progressive strengthening exercises. With exercise physiotherapists aim to improve the strength of the injured and surrounding areas by increasing the tolerance and capacity of the trunk to take load and control movement.

Below are a selection of back exercises, choose being client specific.

Abdominal bracing[edit | edit source]

• Abdominal bracing with heel slides

• Abdominal bracing with leg lifts

• Abdominal bracing with bridges

• Abdominal bracing with standing row exercise

• Abdominal bracing with walking/standing

Erector Spinae/Multifidus[edit | edit source]

• Quadruped arm lifts and bracing

• Quadruped leg lifts and bracing

• Quadruped alternate arms and legs with bracing

Back Stretches[edit | edit source]

Cat Stretch

Prayer Stretch

Single Knee to Chest stretch

Pilates and Low Back Pain[edit | edit source]

Pilates as a rehabilitation programme is used in treatment of chronic low back pain (CLBP) and its results could be compared to exercise programs results. Pilates consists of isometric contraction of abdominal muscles, pelvic floor muscles, gluteus maximus and multifidus. Exercises consisted of 5 min of warm-up (breathing and mobility exercises), 50 min of Pilates exercises (stretching and strengthening exercises for muscles of the trunk and lower and upper limbs) and 5 min of cool down (relaxation exercises and massage with ball). [3]

Extension Based Exercises[edit | edit source]

Mckenzie Exercise is an exercise regimen used in the treatment of low back pain and sciatica, prescribed according to findings during mechanical examination of the lumbar spine and using a combination of lumbar motions, including flexion, rotation, side gliding, and extension. It is sometimes referred to as McKenzie extension exercises, but this is a misnomer because the regimen involves movements other than extension[4].

Flexion Based Exercises[edit | edit source]

Williams' flexion exercises are a therapeutic exercise regimen used in the treatment of low back pain; it seeks to reduce lumbar lordosis through flexion of the lumbar spine and strengthening of the abdominal musculature.[4]

This 5 minute video is titled Williams Flexion Exercises for Lumbar Spine, and outlines the specifics.

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Lumbar Stabilization Exercise[edit | edit source]

Lumbar stabilization exercise programs are used to improve the strength, endurance and/or motor control of the abdominal and lumbar trunk musculature. The stabilizing exercises focus on the re-education of a precise co-contraction pattern of local muscles of the spine. Stabilizing exercises along with routine exercises help with the reduction of pain intensity while increasing functional ability and muscle endurance and are recommended in the treatment of patients with lumbar segmental instability. The following videos are examples demonstrating progressions of spinal stabilization exercises that can be used for patients requiring this technique[6].

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Proper Lifting Techniques[edit | edit source]

Many lower back injuries come about as a result of poor lifting techniques, something that physiotherapists are uniquely placed to address. Safe lifting techniques given below.

Squat lift

1. Plan The Lift: Know how heavy the object is. Clear a path and know where the object is to be placed.
2. Lift Close to the body: This will make the body stronger and more stable. Ensure there is a firm hold on the object and balance it close to the body.
3. Feet shoulder width apart: This allows for a solid base of support.
4. Bend the knees while keeping the back straight: Avoid any twisting motions.
5. Tighten the stomach muscles: This will hold the back in good alignment and prevent excessive force on the spine. Avoid breath holding.
6. Lift with the legs: The leg muscles are stronger than the back so use them.
7. Avoid straining, get help: Get help if the object is too heavy or it is in an awkward position.
   

Squat - Remember to:

• Keep back straight
• Knees behind toes
• Keep knees parallel

Golfer’s Lift

• The Golfer’s lift is another lifting technique that is useful for picking something off the floor
• This works best when using something like a chair or table for support when bending
• Kick out the unsupported leg - This helps to keep the back straight

Diagonal Standing

• Stand with one foot slightly in front of the other and distribute the weight evenly between both legs
• This is a preferred position over straight standing
• Avoid putting all of the weight onto one leg while standing.

Aerobic Activity[edit | edit source]

Aerobic exercise is an important part of fitness, elevating the heart rate and improving circulation. Aerobic exercise can help relieve back pain by decreasing stiffness and improving blood flow to the spinal structures, which increases the amount of nutrients reaching the spine.

Lack of exercise increases the risk of obesity and other co-morbidities increases which can lead to increased pressure on the spine and decreased flexibility[9].

Low-impact aerobic exercise, can elevate the heart rate without jarring the spine and worsening back pain. Low-impact aerobic exercises include: Walking, cycling, swimming, climbers, steppers, elliptical machines, ski machines, low impact aerobic dance. This type of aerobic exercise may be a preferable option for those with back pain. [10]

References[edit | edit source]