16 Physiotherapy Exercises for Low Back Pain

Low back pain (LBP) is a common condition that can affect people of all ages, often interfering with daily activities and reducing quality of life. It can result from muscle imbalances, a sedentary lifestyle, or strain on the lower back.

Among various management strategies, exercise has emerged as a highly effective, evidence-based approach for alleviating pain and improving spinal health. By focusing on strengthening core muscles and enhancing flexibility, individuals can experience long-term relief and improved mobility. Let’s explore some of the best exercises for LBP.

EXERCISES FOR LBP

1) Breathing exercise

Purpose: Breathing exercise promotes relaxation, and restores normal breathing pattern

How to perform:

Step 1: Be in a relaxed position (sitting, lying down)

Step 2:  Inhale through your nose and fill your stomach letting it rise up

Step 3: Exhale slowly through the mouth like blowing a candle and empty the stomach

Note- inhale: exhale ratio should be 1: 2 

2) Core Breathing

Purpose: Strengthen the diaphragm 

How to Perform:

Step 1: Lie down by facing the ceiling and keep lightweight on your abdomen.

Step 2: Inhale through your nose and let your stomach up against the resistance

Step 3: Exhale slowly through the mouth like blowing a candle and empty your stomach

Step 4: Note- inhale: exhale ratio should be 1: 2 

MOBILITY EXERCISES

3) Cobra to Child’s Pose

Purpose: Improves spinal mobility, stretches the back and abdominal muscles, and promotes relaxation and flexibility.

How to Perform:

Step 1: Start in a prone position, with your hands under your shoulders and legs extended straight.

Step 2: Press into your palms to lift your chest into a cobra pose, keeping your hips grounded and engaging your back muscles

Step 3: Hold the position for 2–3 seconds, then lower your body back down.

Step 4: Shift your hips backward toward your heels, moving into a child’s pose while stretching your arms forward.

Step 5: Hold the child’s pose for 2–3 seconds, then return to the starting position.

4) Posterior pelvic tilt

Purpose: Activates the deep core muscles, enhances pelvic control, and promotes spinal stability, helping to reduce lower back discomfort.

How to Perform:

Step 1: Lie on your back with knees bent, feet flat on the floor, and arms resting by your sides.

Step 2: Engage your core and glutes to flatten your lower back against the floor, tilting the pelvis backward.

Step 3: Hold the position for a second.

Step 4: Slowly release and return to the starting position.

 5) Supine Scorpions

Purpose: Stretches the hips, lower back, and chest while improving spinal mobility and flexibility.

How to Perform:

Step 1: Lie on your back with arms extended out to the sides and legs straight.

Step 2: Lift one leg at the hip, then slowly lower it across your body toward the opposite side, aiming to touch the floor with your toes.

Step 3: Keep your shoulders grounded as you reach the leg across, and hold briefly.

Step 4: Return to the starting position and repeat on the other side.

6) Prone Scorpions

Purpose: Increases flexibility in the lower back and hips while improving spinal rotation and mobility.

How to Perform:

Step 1: Lie face down with arms extended out to the sides and legs straight.

Step 2: Lift one leg at the hip and rotate it across your body toward the opposite side, aiming to touch the floor with your foot.

Step 3: Keep your chest and shoulders grounded as you rotate your leg.

Step 4: Return to the starting position and repeat on the other side.

7) World’s Greatest Stretch

Purpose: It is a full-body stretch, mainly working the glutes, hamstrings, hips, chest and back muscles. It also helps with mobility in your thoracic spine and stretches the oblique muscles in your core

How to Perform:

Step 1: Get into a crawling position.

Step 2: Place one leg forward on the side of your hands and lift your back knee off the floor.

Step 3: Rotate your body, reaching your top arm toward the ceiling, opening up your chest, and taking a deep breath in.

Step 4: Hold for 2-3 seconds, then bring your arm down, touching your elbow to the floor, and breathe out.

Step 5: Return to the starting position and repeat on the other side.

8) Upward to Downward Facing Dog

Purpose: Stretches the anterior kinetic chain muscles while in the upward-facing dog and stretches the posterior kinetic chain muscles while in the downward-facing dog

How to Perform:

Step 1: Start in a high plank position with your hands under your shoulders and feet hip-width apart.

Step 2: Move into Upward Facing Dog by lowering your hips slightly and lifting your chest and thighs off the ground, extending your arms, and arching your back.

Step 3: Transition into Downward Facing Dog by lifting your hips towards the ceiling, straightening your legs, and pressing your heels toward the floor while keeping your head between your arms.

Step 4: Hold each position for 2-3 seconds, then smoothly transition between the two.

STRENGTHENING EXERCISES

9) Curl-ups

Purpose: Strengthens the rectus abdominis and improves core stability, focusing on controlled abdominal engagement.

How to Perform:

Step 1: Lie on your back with your knees bent and feet flat on the floor. Place your hands flat on the ground beside your hips.

Step 2: Engage your core, tilt your pelvis back, and then slowly lift your shoulders off the floor, curling your upper body slightly forward.

Step 3: Keep your lower back in contact with the ground and avoid pulling with your neck.

Step 4: Hold the top position for 1–2 seconds, then slowly lower back down.

10)    Bird Dog

Purpose: This exercise strengthens the core, lower back, and glutes while improving balance, coordination, and spinal stability.

How to Perform:

Step 1: Get into a crawling position, with wrists under shoulders and knees under hips.

Step 2: Slowly extend your right arm forward and your left leg backward, keeping your back flat and core engaged.

Step 3: Hold this position for 3–5 seconds, maintaining balance and avoiding any arching or twisting of the spine.

Step 4: Return to the starting position in a controlled manner.

Step 5: Repeat on the opposite side, extending your left arm and right leg.

11)  Beast hold

Purpose: Engages the deep core muscles, improves diaphragmatic breathing, and enhances shoulder, hip, and core stability in a functional position.

How to Perform:

Step 1: Begin in a crawling position with your hands under your shoulders and knees under your hips.

Step 2: Lift your knees slightly off the floor, while engaging your core and maintaining a neutral spine.

Step 3: Inhale deeply through your nose, allowing your diaphragm to expand without losing core engagement.

Step 4: Exhale forcefully through the teeth gap producing a hissing sound.

Step 5: Focus on controlled, steady exhalation for 8–10 times per breath.

12)  Dead bug

Purpose: This exercise strengthens the deep core muscles, including the transverse abdominis and rectus abdominis, while improving spinal stability and coordination.

How to Perform:

Step 1: Start by lying on your back with your arms extended toward the ceiling and your knees bent at a 90-degree angle.

Step 2: Slowly lower your right arm and left leg toward the floor and touch your left hand to your right knee while keeping your lower back pressed into the ground.

Step 3: Pause briefly when your arm and leg are just above the floor, then return to the starting position.

Step 4: Repeat the movement with your left arm and right leg and touch your right hand to the left knee

13)  Side Plank

Purpose: Strengthens the obliques, glutes, shoulders, and core while improving spinal stability, balance, and hip control.

How to Perform:

Step 1: Start by lying on your side with your legs extended with one another.

Step 2: Lift your body, ensuring your elbow is directly under your shoulder.

Step 3: Engage your core and squeeze your glutes as you lift your hips off the ground, creating a straight line from head to heels.

Step 4: Hold the position for 20-30 seconds, focusing on keeping your hips lifted and core engaged.

Step 5: Lower your hips back to the ground and repeat on the other side.

Note:

• If you feel the side plank is difficult, you can perform the regressed version

Regression (Modified Side Plank):

1. Start by lying on your side with your knees bent and legs one above another.
2. Prop yourself up on your forearm, but keep your knees bent to 90° on the ground.
3. Then Follow the same as above

• If you feel the side plank is easy, you can perform the progressed version.

Progression (Side Plank with Leg Lift):

1. Start in a regular side plank position.
2. While keeping your body stable, lift and hold the top leg towards the ceiling and follow the same as above.

14) Banded Core Rotation

Purpose: This exercise strengthens the obliques and transverse abdominis while enhancing rotational stability and control. It also improves functional core strength for sports and daily movements.

How to Perform:

Step 1: Anchor a resistance band at chest height and hold the handle with both hands. Stand with your feet shoulder-width apart, perpendicular to the anchor point.

Step 2: Step away from the anchor to create tension in the band, and position your arms straight out in front of your chest.

Step 3: Engage your core and rotate your body away from the anchor point, keeping your arms extended and moving as a single unit. Avoid twisting your hips or lower body.

Step 4: Slowly return to the starting position with controlled movement.

Step 5: Turn towards the other side and repeat the same.

15) Glute Bridges

Refer to Physiotherapy Exercises for Hip Pain

16)  Clamshells

Refer to Physiotherapy Exercises for Hip Pain

WHAT RESEARCH EVIDENCE SAYS ABOUT PHYSIOTHERAPY MANAGEMENT OF LBP (George, S. Z., 2021)

EXERCISE FOR ACUTE LBP

• May include:

Muscle strengthening and endurance exercises, Specific trunk activation

• Can include:

general exercise training

EXERCISE FOR CHRONIC LBP

• Should include:

1. General exercise training, muscle strengthening and endurance, specific trunk activation, aerobic, aquatic, multi-model exercises
2. With movement control impairment – Specific trunk activation, Movement control
3. For older adults- general exercise training

• May include:

1. Movement control, trunk mobility
2. With leg pain- specific trunk activation, movement control

• Can include:

1. General exercise training (post-operative)

Tips for Safe and Effective Exercises for Low Back Pain:

1. Warm-Up First: Start with 5-10 minutes of light aerobic activity to prepare your muscles and joints.
2. Maintain Proper Form: Perform all exercises with controlled movements to avoid straining your lower back.
3. Start Gentle: Begin with basic exercises like pelvic tilts or bridges and increase intensity gradually.
4. Avoid Overexertion: If an exercise feels uncomfortable or causes sharp pain, stop and adjust your movements to a more comfortable range.
5. Recover: give your body time to recover between sessions. Optimal recovery includes Sleep, Nutrition, Hydration, Training Load management, and stress management.

DISCLAIMER

The exercises mentioned above are designed to alleviate low back pain and improve strength and mobility. However, it is essential to consult a qualified physiotherapist before beginning any new exercise routine. A professional assessment will help determine the root cause of your pain and ensure that the exercises are appropriate and tailored to your specific needs, reducing the risk of further injury or complications.

At Exercise Prescriptor Health and performance physio rehab clinic, our experienced physiotherapists are dedicated to guiding you toward effective pain management and improved quality of life. Schedule a consultation today to take the first step toward a healthier, pain-free back.