What's The Best Exercise For Back Pain?

Physical activity is now accepted as beneficial for reducing chronic pain, but what's the best exercise for back pain?

Doctors and physiotherapists often recommend Pilates, Yoga or core strengthening exercises, so surely these are going to be the most effective.

You may be surprised that research studies say NO, there isn't any 1 exercise that's superior!!

Despite all the evidence saying otherwise, people still perceive specific exercises for the core as more beneficial for back pain than general strength exercises, such as Deadlifts and Squats.

They tended to base their beliefs on what they've been told by healthcare professionals (doctors, physiotherapists, personal trainers etc), as well as what they've seen on social media and the internet.

A 2024 study aimed to explore people's beliefs about what they believed to be the best exercises for back pain, and where they based their opinions from.....

113 people who had experienced low back pain for more than 3 months completed an online survey. They were asked to comment on their healthcare, exercise status, pain intensity, level of disability and their fear-avoidance beliefs around physical activity.

Then they were shown photos of 5 specific exercises and 5 general exercises:

1) Specific Exercises

• Curl up
• Dead bug
• Bird dog (4 point kneeling)
• Side Plank
• Plank

2) General Exercises

• Romanian Deadlift
• Zercher Squat
• Jefferson Curl
• Good Morning
• Bulgarian Split Squat

This study revealed some common recurring themes in the participants responses which are fascinating and paint a picture of why finding a solution to lower back pain can be a frustrating experience for both the patient and their healthcare practitioner.

Recurring Themes About Back Pain

1) The Role of the Core

Of the 113 participants, 44 people thought strengthening was important and 48 believed the core was important. These people attributed their back pain to having a weak core, and that if they made their core stronger they could decrease their pain and prevent flare ups.

Strengthening the back, gluteal and abdominal muscles was seen as particularly beneficial for back pain. The exercises that looked like they targeted these muscles were perceived more positively by the study participants. 

But if more core strength was really the answer I'd just give you a 12 week programme of abs, hovers and planks....and you'd be cured of your back pain for life. 

Hands up, if this approach has actually worked for you and your back pain has gone away forever?

From my personal experience, I've been able to hold a hover for 17.5 minutes. At this time of my life, I still had back pain every day. How much stronger did my core have to get to get rid of my back pain?!?

2) Load and Spinal Flexion

Many of the study participants had negative comments about using load and rounding the spine.

Even though most thought strengthening was beneficial, using a heavy load was believed to be damaging.

The main criticism of the general exercises was that they showed an external load being used, and this could increase the chance of feeling pain. Some participants believed that a heavy load was the cause of their disc herniations.

Spinal flexion was seen as "poor technique". Bad technique was highly associated with flare ups of pain by the participants. 

For example, 1 person commented "Poor form, rounded back".

HOWEVER, some people also mentioned that spinal flexion was helpful at times. Another commented that "Arching my back helps with pain management".

Hmmm....so spinal flexion can both hurt your back but also reduce pain!!

Would it surprise you that research studies DON'T support the theory that rounding your back when lifting a load will damage your spine. The current body of evidence is actually pretty inconclusive.

3) Beliefs About Back Pain

This study revealed some fascinating insights into people's beliefs about their back pain.

Most of their opinions were based on their interactions with their healthcare providers. If an exercise was prescribed by a physiotherapist, for example, the person would often automatically assume that it's going to be beneficial.

Considering how wildly variable the experience, beliefs and skillset doctors, physiotherapists and other health professionals possess, this is concerning. 

Personal attitude to exercise and pain is also hugely influential. One study participant commented "If I were to try any of those exercise in my current state, you can drive me straight to the hospital.” This person viewed all 10 exercises as dangerous and likely to cause pain without clarifying why they think this.

You can imagine how frightening any physical activity might be if you thought exercise could put you in hospital. How would your body feel if you were this scared about moving?

You'd probably be so stiff and rigid that any movement would feel awkward and painful, confirming your worst fears. 

Caveats

• As the survey was completed online, the researchers had to assume that the participants answered the questions honestly.
• Only still photos of the exercises were shown to the participants. If they'd seen videos, would they have viewed the exercises differently?

Takeaways

Despite these limitations, the study provides an interesting insight into how people perceive exercise and back pain.

Personal beliefs about whether an exercise is beneficial or unhelpful for back pain matters.

Perhaps, rather than promoting 1 type of exercise over others, we're better off considering a person's attitude to their body, movement and pain.

My approach is to use neural repatterning to rebuild safety and confidence into the body and nervous system. This shifts muscle behaviour and movement patterns away from tension and stiffness towards relaxation and ease.

WAYS TO WORK WITH ME TO FIND FREEDOM FROM PAIN

If you're ready to find lasting relief from your pain, I have a variety of options available:

1) Unlock Your Body breakthrough session

This is a single powerful 1:1 session designed to help you find the root drivers behind your persistent pain. You'll leave with a deeper understanding of what's triggering pain in your body, and a clear action plan to get lasting relief. 

I have 4x Unlock Your Body breakthrough slots open for October, as well as very limited availability for 3 or 6 month 1:1 coaching.

Apply HERE  and I'll be in touch to arrange an initial complementary consultation to discuss which option will be a good fit for you.

2) Restorative Movement for Lower Back and Sciatic Pain Relief Workshop

Next date: Sunday 20th October, 1.15pm to 2.45pm (last 2x spaces left). **Bookings open now**

Angmering Village Hall  (The Kings Suite)

A friendly and inclusive small group workshop where you'll discover the common causes of lower back and sciatic pain, why you're not getting the results you desire even if you've tried the usual treatments, and how to find lasting relief.

The session will be a blend of informal group discussion and a restorative movement session, where you'll practice gentle exercises that retrain the nervous system to release tense muscles, reduce stiffness and find new ways of moving without pain. 

After the workshop, you'll have lifetime access to a simple home programme to relieve lower back and sciatic pain in just 10 minutes a day. 

Click HERE to read all the details and how to book your place.

Other ways you can find help with managing pain or an injury are:

• Book into a Stretch or Pilates class with me - these are a good introduction to the foundational principles of The Befriend Your Body (BYB) Method for pain relief and relaxation. This is my signature framework that I use to help my clients get out of pain and back to the activities they love.
• Get your copy of my free E-guide "How to Get Relief From Back Pain and Muscle Tension in just 10 mins a Day". This introduces the 3x universal stress responses that can keep you stuck in pain, and explains the 4x pillars of The BYB Method. There's also 2x 10 mins video tutorials showing you how to release muscle tension from the front and back of your body in the comfort of your without expensive equipment. Download for instant access HERE
• Subscribe HERE to receive "The Movement Chronicle", a weekly e-newsletter delivering movement and pain relief truth bombs directly into your inbox every Monday morning,

You can connect with me through any of these channels:

• Email at norma@unicornhealthandfitness.com
• Follow me on Facebook and DM me on Messenger https://www.facebook.com/norma.pearsonfitness
• WhatsApp message to 07801 867361.