Most low back pain is not caused by damage that needs protecting. It is caused by tissue that has become sensitive and deconditioned, usually after a period of pain, fear, and reduced movement. That is why rest tends to make chronic back pain worse over weeks, even though it feels better over hours.
The exercises below are the ones we start most patients on. They are deliberately gentle. The goal in the first few weeks is not to strengthen your back — it is to convince your nervous system that movement is safe again, which is what allows strength work to be tolerated later.
Before you start
Some back pain does need urgent assessment rather than exercise. Stop and see a doctor or physiotherapist promptly if you have any of the following:
- Numbness around the groin, buttocks or inner thighs, or difficulty controlling your bladder or bowels
- Progressive weakness in a leg — a foot that catches on steps, or a knee that gives way
- Back pain following a significant fall or accident
- Unexplained weight loss, fever, or night pain that wakes you and does not settle with position change
- A history of cancer, osteoporosis, or long-term steroid use with new back pain
1. Pelvic tilts
Lie on your back with your knees bent and feet flat. Gently flatten your lower back into the floor by tightening your lower abdominals, then release so a small arch returns. That is one repetition — the movement is small, roughly a centimetre.
Do 10 slow repetitions, twice a day. This is usually the first movement people can do without provoking pain, and it restores the sense that the lower back can move under control.
2. Knee rolls
In the same position, keep your knees together and let them roll slowly to one side, only as far as is comfortable, then to the other. Keep both shoulders on the floor.
Do 10 to each side. This restores rotation, which is usually the first direction people stop using and the one that makes getting out of bed or turning in a car painful.
3. Glute bridges
Knees bent, feet flat, arms by your side. Push through your heels and lift your hips until your body is in a straight line from knees to shoulders. Hold for three seconds, then lower slowly.
Start with 8 repetitions and build to 15. The hips and glutes take load off the lower back when they work well, and they are almost always underused in people with long-standing back pain.
4. Cat–camel
On hands and knees, slowly arch your back up towards the ceiling, then let it sag down, moving smoothly between the two. This is a mobility exercise, not a stretch — do not push into the end of the range.
Do 10 slow cycles. It is one of the few exercises that moves the whole spine through its range with almost no load on it.
5. Walking
Walking is the most underrated back exercise there is. It loads the spine rhythmically and at low intensity, which is exactly what sensitised tissue tolerates best.
Start with whatever you can do without a flare-up the next day — for some people that is five minutes — and add roughly ten percent a week. Consistency matters far more than distance.
What to expect
Some discomfort during and shortly after these exercises is normal and is not a sign of harm. The rule we give patients is that pain should settle back to your usual baseline within about half an hour, and should not be worse the following morning. If it is, reduce the repetitions rather than stopping altogether.
Most people notice a change in three to four weeks of near-daily practice. If you have been doing these consistently for six weeks with no improvement, or if the pain is spreading down a leg, that is the point to get assessed rather than to push harder — a programme built around your specific presentation will do more than any general list can.
Want this assessed properly?
Book an appointment with Dr. Saleem Shazad and get a plan built around your own presentation.
Book an Appointment