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Patient Resources

Exercise for ongoing low back pain

Patient Resources
        1. Exercise for ongoing low back pain

First published: 28 May 2020

The RACGP gratefully acknowledge the following contributor:

  • Zoe Michaleff, Institute for Evidence-Based Healthcare, Bond University

Related GP HANDI entry Exercise for ongoing low back pain


Your doctor has recommended exercise as a treatment for your ongoing low back pain.

Key points

  • Exercise is one of the best treatments for low back pain.
  • Choose an exercise that you enjoy and, importantly, can do regularly.
  • Exercise is safe for your back. It is important that you start slowly, change activities if needed and learn how to progress the amount of exercise you do over time.

Exercise is one of the best treatments for ongoing low back pain

  • All types of exercise help reduce low back pain and improve your ability to do everyday tasks.
    • Exercises that are mainly strengthening include core exercises (strengthen muscles that support the spine), Pilates and resistance training (e.g. light weights and resistance bands)
    • Exercises that are mainly about flexibility and stretching include yoga and tai chi
    • Exercises that are mainly about general fitness (aerobic) include water-based exercises (e.g. swimming and hydrotherapy) and land-based exercises (e.g. walking, running and riding a bike/exercise bike)
  • No type of exercise has been shown to be much better for back pain than another type. Choose an exercise that you enjoy and can do regularly.
  • Exercise benefits not just your back but also your overall health and wellbeing. Exercise can help build muscle strength, maintain flexibility and movement, and improve overall fitness.

Tips to start exercising

  • Set a goal. It might be playing with your children or grandchildren, going for a bush walk or running a marathon. Your goal needs to be important enough to get you exercising even when you don’t feel like it.
  • Plan. Break your goal down into smaller achievable goals. Plan how often and when you will include exercise in your weekly routine. Make your plan realistic so you can achieve it.
  • Pacing and graded activity. Slowly build up the amount of exercise to avoid pain flare-ups. Start by doing less activity than you know you are able to do. For example, if your goal is to walk for 30 minutes and you can comfortably walk for 20 minutes, start by walking only 15 minutes and do this 3 to 5 times in the first week. It is important to complete this level of activity no matter how good you feel. Every week or so, increase the amount of exercise by 10% until you achieve your goal.

Example: If you walk for 10 minutes, increasing by 10% would mean adding a minute so you would walk for 11 minutes. If you walk for 20 minutes, increasing by 10% would mean adding 2 minutes, so you would walk for 22 minutes.

Over time aim to exercise at least 30 minutes most days. You can break it down into shorter blocks, e.g. a 10-minute walk in the morning, afternoon and evening.

  • Fun: Find an exercise that you enjoy or invite friends or family to exercise with you. If you enjoy the exercise, you will more likely do it regularly.
  • The little things count too. Try to increase the amount of activity every day, e.g. walk the stairs, walk to the shops or park further away from the entrance.
  • See a physiotherapist or exercise physiologist. They can help:
    • get you started and create an exercise plan
    • teach you when and how to progress your exercise for health benefits
    • motivate you
    • give tips on exercise techniques and not ‘overdoing it’

What to look out for

  • Exercise is safe for your back. However, some people have more pain, stiffness or general muscle soreness after starting a new exercise program or increasing the amount of exercise too quickly. This is a normal response to exercise even in people without back pain. It does not mean you have hurt your back.
  • If your back becomes more sore or stiff after certain activities, you may need to change these activities to make them more comfortable until your pain improves. You can change:
    • How long you do it for or adding in breaks e.g. if you want to swim for 30 minutes you can break this down into 5-minute lots with a rest in between.
    • How vigorously you do it e.g. if you usually like to run, you might choose to walk or jog.
    • The type of activity you do e.g. if you usually go swimming, you can continue going to the pool but choose to walk or do other water exercises.
    • How often you do it e.g. swimming fewer laps.
    • How you do the activity e.g. activities like Pilates and tai chi can be made easier to do or even done seated.
  • Ask about costs of attending exercise classes or consulting a physiotherapist or an exercise physiologist.

Learn more about back pain and how to manage it at MyBackPain
Learn simple ways to manage your pain with Musculoskeletal Australia’s free online book: Managing your pain: An A-Z guide
NHS Choices: Lower back pain exercises
Read about pacing on the Australian Pain Management Association’s website

Find a physiotherapist through the Australian Physiotherapy Association or an accredited exercise physiologist through Exercise and Sports Science Australia
Find a yoga Australia teacher a Pilates teacher: pilates.org.au; a tai chi teacher: taichiaustralia.com an Alexander technique teacher
Speak with a nurse on Musculoskeletal Australia’s free help line 1800 263 265 (weekdays 9 am – 5 pm).

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