June 17, 2020

It can be a Catch-22: Back pain prevents you from working out, yet a workout could ease your discomfort. Learn the correct back pain exercises to break the cycle.


Many of us will experience back pain at some point in our lives. The pain may be the result of a sudden tweak or an ache that develops over time. When we have back pain, we have a natural inclination to freeze up, out of fear of making things worse. But giving up an active lifestyle or avoiding movement typically increases stiffness and limits mobility. Back exercises are important for patients to continue.

“Motion is lotion,” said Aaron Yang, M.D., of Vanderbilt’s Spine Center. “We used to tell people to get bed rest and limit all activities until they got better. And what we’ve found is that people actually got worse.”

Exercise is one of the most beneficial things you can do for chronic pain. But knowing what to do when discomfort strikes, or how to get started with activity after a period of immobility, proves challenging. We asked Dr. Yang to provide basic exercise guidelines for people with back pain.

Chronic back pain exercise

For patients who have chronic back pain, Yang focuses on active rather than passive treatments. Passive treatments are when something is done to a patient, such as getting a massage or using a heat pack. Active treatments are when the patient is doing most of the work, such as exercising. “We do know that with people who do active treatments,” Yang said, “that it has been shown to reduce physical therapy visits. They have greater improvement at one year in terms of their pain, and they’re less likely to have medications or injections or surgery.”

Yang recommends that people with chronic back pain ease into an exercise routine and build on it. “I’m not telling you to just go run miles,” he said. “I’m saying you should slowly progress through this.” He often recommends the recumbent bicycle, the elliptical machine or getting in a pool to move around and stretch. Yang said he sees too many people jump into activities full force, develop stiffness or soreness and then get discouraged and quit exercising altogether.

Aerobic activity, the kind that gets your heart pumping, is important to do about three to four times per week. But Yang also likes to see patients working on strength and flexibility. A short course of physical therapy can be helpful to address specific muscle tightness or imbalances as well as provide recommendations when returning to exercise.

“There is a strong correlation between consistent exercise and preventing worsening episodes of back pain,” Yang said. “That is often the hardest thing to tell people because that’s not a silver bullet. It takes time and effort.”

Acute back pain exercise

If your back pain came on suddenly, the recommendation for movement is different than if you’ve had back pain for a long time. “I really try to focus on just maintaining activity levels,” Yang said. “The natural inclination is to immediately shut everything down and just lay in bed.”

Yang typically recommends keeping up with gentle activities and, for a short period, avoiding any heavy lifting or strenuous exercise. Walking, even if just around the home, is a good example. Until your pain subsides, skipping a boot camp class or longer runs is usually a good idea. But don’t stop moving altogether.

Aim for a good night’s sleep, too. “Over-the-counter medications may be helpful to achieve this,” Yang said, “as less sleep can increase pain perception, further worsening the situation.’

Stay positive as well. “We know that most people with an acute episode of low back pain will get better, whether they had any treatment or not,” Yang said. “So that’s good news.” If your pain doesn’t improve in five to seven days, Yang said that’s a good time to see a spine professional.


The Vanderbilt Spine Center treats patients from across the Southeast for back pain, sciatica, whiplash and other conditions of the spine, offering a full range of treatments including non-surgical options. If surgery is necessary, the Vanderbilt Spine Center team provides an extraordinary level of experience and expertise for each patient’s needs. For more information, click here or call 615-875-5100.

Aaron Yang, M.D., is assistant professor of physical medicine and rehabilitation at Vanderbilt University Medical Center and his practice focuses on non-surgical approaches for neck and low back pain. He is currently a co-investigator of a wearable device to prevent back injury and provides clinical expertise and input on how this device translates to patient clinical care.