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Exercises to help manage your lower back pain

01 November 2016

According to figures released in the British Medical Journal, four out of five adults will suffer back pain at some time in their life.

The same survey also revealed that almost half the country’s adult population experience lower back pain that last for more than 24 hours at some time each year!

For some, painkillers can solve the problem, for others it may need surgery to end their agony - but, for millions of people, physiotherapy can be the answer!

Physiotherapy can help people regain movement, increase mobility and reduce pain using a variety of techniques.

Conditions treated include back and neck pain, sports injuries, joint, ligament, muscle and tendon problems, posture issues, whiplash, upper and lower limb conditions as well as post-surgery rehabilitation.

Pippa Carter is the Perform Physiotherapy Manager at Spire Cardiff Hospital and has dealt with thousands of back pain problems in her nine in the profession.

She said: “Non-specific lower back pain has, in fact, become a major public health problem. Tension, soreness or stiffness in the lower back region all come under the ‘non-specific’ banner when it is not possible to identify a specific cause of the pain.

“However, appropriate management in the early stages can lead to reduced long term symptoms and their impact on quality of life.”

Pippa explained that the NICE guidelines of May 2009 covering the early treatment and management of persistent or recurrent lower back pain

This guideline covers the early treatment and management of persistent or recurrent low back pain - defined as pain that has lasted more than 6 weeks but less than a year.

“A key focus pain is helping a patient to self-manage their condition. Providing advice and information is an important part of this.

“The aim of is to reduce the pain and its impact on the person's day-to-day life, even if the pain cannot be cured completely,” explained Pippa.

Recommendations for the treatment of non-specific low back pain include:

  • Information and education
  • Physical activity and exercise
  • Manual Therapy
  • Combined physical and psychological treatment programme
  • Further assessment, imaging or consultant referral


Pippa added: “A common misconception about back pain is that moving will increase pain and make symptoms worse. Although it is true that some movements can be uncomfortable, it is well established that returning to movement and work as soon as you are able, is better for both recovery and preventing recurrence than bed rest.

“Therefore it is important to gradually increase your movement and stay on the go. Actually it is generally accepted that exercise is the best way to treat lower back pain.”

Try these simple exercises at least once a day to help manage your symptoms.

(If at any point while completing these exercises your symptoms increase then we advise you to stop and seek expert medical advice.)

Exercise 1: Lying on your front

Lie on your front with a pillow underneath your hips for a period of up to 10 minutes or as long as you feel comfortable.

Exercise 2: Knee rolls

Lying on your back with your knees bent and feet together gently roll your knees from side to side (keeping knees together and to where you feel comfortable) approximately five times to each side.

Exercise 3: Bent leg fall out

Lying on your back with your knees bent and knees and feet hip width apart. Keep one leg completely still with the knee cap pointing up to the celling and gently control the other leg to turn out to the side moving from the hip. Then return to the start position and repeat with the other leg. Repeat approximately five times on each leg.

If you are experiencing lower back pain with any of the symptoms below it is important you seek medical advice before trying any of the exercises above:

  • Unrelenting pain that does not vary or change in a 24 hour periods
  • Night pain where pain is at its most intense at night in a 24 hour period
  • Unexplained weight loss
  • Fevers
  • Bowel and bladder changes with a loss of control, sensation or incontinence
  • Numbness around the genitals or back passage
  • Loss of power in the legs
  • Pins and needles into both legs
  • A history of trauma prior to the onset of back pain

If gently increasing movement and completing these exercises does not help with symptoms it is advised that an assessment by a chartered physiotherapist may be beneficial.

Physiotherapists can use a number of ways to assess symptoms and provide treatment including, among other things, exercise therapy, manual therapy, acupuncture and Pilates.

Since the 1970’s acupuncture has increased in popularity in the west. Western acupuncture is the practice of inserting thin, single use, pre-sterilised needles into the skin at certain points in the body, depending on the area of pain or tension.

The locations of the points used are based on a thorough clinical assessment and a number of needles can be used during each treatment, with typical treatment normally lasting between 20 to 30 minutes. Acupuncture maybe used as a standalone treatment or alongside other physiotherapy techniques.

Pilates is another method of the management and prevention of lower back pain. Originally developed by Joseph Pilates in the 1920’s it is basically a series of exercises which focus on breath control, postural alignment and activation of the deep abdominal muscles.

Pilates has increased in popularity over the past few years with notable celebrities such as Madonna, Andy Murray and Jennifer Aniston saying it had helped them overcome back pain while improving general wellbeing and fitness.

Clinical Pilates is a series of exercises in various different body positions which have been adapted by physiotherapists to make them more suitable for patients with back and neck pain, and those recovering from injury.

As Clinical Pilates classes are led by physiotherapists they can utilize their knowledge of anatomy, physiology and injury management in order to deliver the best program for individuals recovering from or suffering with injury. Class sizes are normally small and allow the instructor to monitor each individual closely and ensure correct exercise technique and progression.

If symptoms persist following exercise therapy or physiotherapy it is recommended further investigation in the form of an MRI scan is beneficial with the prospect of a referral to a specialist consultant in the management of spinal pain.