Expert Physiotherapy Guide
Lower back pain affects approximately 9.5 million people in the UK each year, with 60-80% of adults experiencing it during their lifetime. The good news? You can take meaningful action at home. This guide provides step-by-step instructions for 10 exercises proven to help, along with guidance on how often to exercise, when to seek professional help, and warning signs that require immediate attention.
Lower Back Exercises: 10 Evidence-Based Movements That Reduce Pain
Pelvic tilts, glute bridges, bird-dog exercises, cat-cow stretches, and planks are evidence-based lower back exercises that strengthen core muscles and reduce pain. Research from Cochrane shows these exercises can reduce pain by up to 15 points on a 100-point scale. At CK Physiotherapy in West London, our Chartered Physiotherapists recommend these movements as part of a comprehensive approach to managing and preventing lower back pain.
If your back pain persists beyond a few weeks or significantly affects your daily activities, our team at CK Physiotherapy offers physiotherapy for spinal conditions including back pain and sciatica to help you move well and feel well again.
Why Lower Back Pain Affects 9.5 Million UK Adults Each Year
Lower back pain is the leading cause of disability in the UK and globally. The Health and Safety Executive reports that musculoskeletal disorders caused 7.1 million working days lost in 2024/25, with affected individuals taking an average of 14 days off work. The NHS spends an estimated £3.2-4.76 billion annually treating back pain in primary care, whilst the total economic burden reaches £10 billion per year when productivity losses are included.
Sedentary work significantly increases risk. Research shows that a sedentary lifestyle increases lower back pain risk by 24%, whilst prolonged sitting increases risk by 42%. Those who sit for more than five hours daily face substantially higher chances of recurrence. Among people with back pain, 41% identify prolonged sitting as a contributing factor.
The encouraging news is that 70-95% of people with acute back pain recover within six months, with most cases self-limiting within four to six weeks. However, 69% of people who recover experience recurrence within 12 months—which is precisely why prevention through regular exercise matters so much.
Why Exercise Works: The Evidence
NICE Guideline NG59, the authoritative UK guidance for lower back pain, places exercise at the heart of treatment. The guideline explicitly recommends considering a group exercise programme—whether biomechanical, aerobic, mind-body, or a combination—for managing back pain. What matters most is that programmes are tailored to individual needs and that patients remain active.
A 2021 Cochrane review analysing 249 studies found that exercise therapy reduces pain by an average of 15.2 points compared to no treatment, usual care, or placebo. A 2024 meta-analysis published in Sports Medicine demonstrated that strengthening exercises are superior to stretching alone, with a significant effect size of 0.81. In one clinical study of 90 patients, pain scores averaged 2/10 for those doing strengthening exercises, 3/10 for mixed exercises, and 4/10 for stretching alone.
Regular exercise also prevents future episodes. Research shows that exercise reduces lower back pain risk by 33% and cuts recurrence nearly in half—from 41-57 per 100 people to 27-31 per 100.
10 Evidence-Based Exercises for Lower Back Pain Relief
The following exercises are recommended by the NHS, Chartered Society of Physiotherapy, and supported by clinical research. Start gently and stop immediately if pain worsens. At CK Physiotherapy, our team can help you adapt these exercises to your specific needs and ensure you're performing them safely.
1. Pelvic Tilts
Purpose: Activates deep core muscles and teaches motor control—foundational for all other exercises.
How to perform:
- Lie on your back with knees bent and feet flat on the floor, hip-width apart.
- Flatten your lower back against the floor by gently tilting your pelvis upward.
- Hold for 5 seconds, then relax.
- Repeat 10-15 times.
Tip: Breathe normally throughout. Your hips should not lift off the floor.
2. Glute Bridges
Purpose: Strengthens the posterior chain (glutes, hamstrings, lower back)—a validated component of core stabilisation protocols.
How to perform:
- Lie on your back with knees bent, feet flat, and arms by your sides.
- Tighten your abdominal muscles and glutes.
- Raise your hips until your body forms a straight line from shoulders to knees.
- Hold for 5 seconds, then slowly lower.
- Repeat 10-15 times.
Tip: Avoid arching your back at the top—maintain a neutral spine.
3. Bird-Dog
Purpose: Part of the validated "McGill Big 3" protocol. Research shows bird-dog reduces spinal compression by 50% compared to bilateral exercises whilst strengthening the multifidus, erector spinae, and glutes.
How to perform:
- Start on all fours with hands under shoulders and knees under hips.
- Keep your back flat and engage your core.
- Slowly extend your right arm forward and left leg backward.
- Hold for 5 seconds, maintaining a straight line from fingertips to toes.
- Return to start and repeat with the opposite arm and leg.
- Complete 10 repetitions on each side.
Tip: Avoid rotating your hips—imagine balancing a cup of water on your lower back.
4. Cat-Cow Stretch
Purpose: Improves spinal mobility and encourages gentle movement through the vertebrae.
How to perform:
- Start on all fours with hands under shoulders and knees under hips.
- Inhale: Drop your belly toward the floor, lift your head and tailbone (Cow).
- Exhale: Round your spine toward the ceiling, tucking chin and tailbone (Cat).
- Move slowly and smoothly between positions.
- Repeat 10-15 times.
Tip: Let your breath guide the movement—don't rush.
5. Knee-to-Chest Stretch
Purpose: Relieves tension in the lower back and hip, reducing pressure on the spine.
How to perform:
- Lie on your back with knees bent and feet flat.
- Gently pull one knee toward your chest, holding it with both hands.
- Keep your other foot flat on the floor (or extended if comfortable).
- Hold for 20-30 seconds.
- Lower slowly and repeat with the other leg.
- Perform 2-3 times on each side.
Tip: Keep your head on the floor and avoid forcing the stretch.
6. Plank (Modified or Full)
Purpose: Core stabilisation exercise with strong evidence—part of the "McGill Big 3" protocol.
How to perform (modified version):
- Start on all fours, then lower onto your forearms.
- Keep your knees on the floor (modified) or extend your legs (full plank).
- Your body should form a straight line from head to knees/feet.
- Engage your core—don't let your hips sag or pike upward.
- Hold for 10-30 seconds, gradually increasing duration.
Tip: Start with modified planks and progress to full planks as you build strength.
7. Side Plank (Modified)
Purpose: Strengthens the obliques and lateral stabilisers—the third of the "McGill Big 3" exercises.
How to perform:
- Lie on your side with your forearm on the floor, elbow under shoulder.
- Bend your knees to 90 degrees (modified version).
- Lift your hips so your body forms a straight line from head to knees.
- Hold for 10-30 seconds.
- Repeat on the other side.
Tip: As you progress, extend your legs for a more challenging variation.
8. Knee Rolls
Purpose: Gently mobilises the lower spine and stretches the surrounding muscles.
How to perform:
- Lie on your back with knees bent and feet together, flat on the floor.
- Keep your shoulders firmly on the floor and arms out to the sides.
- Slowly roll your knees to one side, keeping them together.
- Hold for 5-10 seconds.
- Return to centre and roll to the other side.
- Repeat 8-10 times each side.
Tip: Only go as far as is comfortable—you should feel a gentle stretch, not pain.
9. Child's Pose
Purpose: A restorative stretch that elongates the lower back and promotes relaxation.
How to perform:
- Start on all fours.
- Sit back onto your heels whilst stretching your arms forward on the floor.
- Rest your forehead on the floor (or a cushion).
- Let your chest sink toward the floor and breathe deeply.
- Hold for 30 seconds to 1 minute.
Tip: If you have knee problems, place a cushion between your calves and thighs.
10. Walking
Purpose: The NHS specifically recommends walking as beneficial for back pain. It promotes blood flow, maintains mobility, and supports overall spine health.
How to perform:
- Start with short, flat walks (10-15 minutes).
- Maintain good posture—head up, shoulders relaxed, core gently engaged.
- Gradually increase duration as comfort allows.
- Aim for 30 minutes of walking on most days.
Tip: Comfortable, supportive footwear makes a significant difference.
How Often and How Long to Exercise
NHS Trust guidelines and recent network meta-analyses suggest optimal exercise dosages for lower back pain:
| Duration per session | 15-30 minutes (most effective range) |
| Frequency | 3-5 times per week |
| Programme length | 8-12 weeks minimum; 16+ weeks for sustained benefits |
| Repetitions | 5-15 repetitions per exercise |
| Stretch holds | 20-30 seconds, repeat up to 3 times |
Pain guidance during exercise: Mild discomfort (up to 5/10 on a pain scale) during exercise is generally acceptable. However, if pain increases significantly during or after exercise, or if you experience sharp or shooting pain, stop and consult a healthcare professional.
The team at CK Physiotherapy can design a personalised exercise programme based on your specific condition, fitness level, and goals. Our comprehensive guide to coping with lower back pain through exercise provides additional evidence-based approaches.
When to See a Physiotherapist
Whilst these exercises help many people, some situations benefit from professional assessment and treatment. Consider booking an appointment with CK Physiotherapy if:
- Your back pain persists for more than six weeks despite self-care
- Pain prevents you from doing daily activities or sleeping
- You experience recurring episodes of back pain
- Pain radiates down your leg (possible sciatica)
- You're unsure whether certain exercises are safe for your specific condition
- You want a tailored rehabilitation programme for optimal recovery
Our Chartered Physiotherapists specialise in physiotherapy methods for sciatica relief and comprehensive back pain management. We use evidence-based manual therapy, personalised exercise programmes, and education to help you recover faster and prevent recurrence.
Warning Signs That Need Urgent Medical Attention
Seek immediate medical attention if you experience back pain with any of the following:
- Numbness, weakness, or tingling in both legs
- Numbness or tingling around your genitals or buttocks (saddle area)
- Difficulty passing urine or loss of bladder control
- Loss of bowel control
- Back pain following a serious accident or trauma
- Unexplained weight loss, fever, or feeling generally unwell
These symptoms may indicate cauda equina syndrome or other serious conditions requiring emergency assessment. Call 999 or go directly to A&E if you experience any of these warning signs.
Frequently Asked Questions
What exercises help lower back pain?
Pelvic tilts, glute bridges, bird-dog exercises, planks, and cat-cow stretches are evidence-based movements that strengthen core muscles and reduce lower back pain. Cochrane research shows these exercises can reduce pain by up to 15 points on a 100-point scale when performed regularly over 8-12 weeks.
Is stretching or strengthening better for back pain?
Strengthening exercises are more effective than stretching alone for lower back pain. A 2024 Sports Medicine meta-analysis found strengthening produced significantly better outcomes (effect size 0.81). Focus on core strengthening exercises like planks and bridges, complemented by gentle stretches.
How often should I exercise for lower back pain?
Exercise 3-5 times per week for 15-30 minutes per session. Research suggests programmes lasting 8-12 weeks minimum, with 16+ weeks showing sustained benefits. Consistency matters more than intensity—regular, moderate exercise outperforms occasional intense workouts.
Is it better to rest or stay active with back pain?
Staying active is better than prolonged rest. NICE guidelines and NHS guidance specifically recommend against staying in bed for long periods. Gentle movement and exercise help recovery, whilst bed rest can prolong symptoms. Activities like walking, swimming, and specific back exercises are beneficial.
How long does lower back pain take to heal?
Most acute lower back pain improves within 4-6 weeks, with 70-95% of people recovering within six months. However, 69% experience recurrence within 12 months, which is why prevention through regular exercise is so important. Chronic pain lasting beyond 12 weeks benefits from professional physiotherapy assessment.
Can desk work cause back pain?
Yes, prolonged sitting significantly increases back pain risk. Research shows sedentary lifestyles increase risk by 24%, whilst prolonged sitting increases risk by 42%. Taking regular breaks, using proper ergonomics, and doing daily back exercises can help prevent and manage work-related back pain.
Does yoga help lower back pain?
Yes, yoga shows moderate-to-strong evidence for lower back pain relief. A 2023 systematic review published in Frontiers in Neurology found yoga produced significant short-term pain reduction (SMD -0.48) with low adverse events. NICE guidelines include mind-body approaches like yoga as a recommended treatment option.
Should I exercise if my back hurts?
Gentle exercise is generally beneficial even when experiencing back pain, as long as you stay within comfortable limits. Mild discomfort (up to 5/10) during exercise is acceptable. Stop if pain worsens significantly, becomes sharp, or shoots down your leg. When in doubt, consult a physiotherapist for personalised guidance.
Lower Back Pain: Key Statistics
| UK adults affected annually | 9.5 million |
| Lifetime prevalence | 60-80% of adults |
| Working days lost (2024/25) | 7.1 million |
| Pain reduction from exercise | 15 points (0-100 scale) |
| Risk reduction with regular exercise | 33% |
| Recovery within 6 weeks (acute) | 70-95% |
| Recurrence within 12 months | 69% |
Ready to Take Control of Your Back Pain?
Our Chartered Physiotherapists in West London are here to help you move well and feel well.
Book Your AppointmentReferences and Further Reading
- NICE (2020). Low back pain and sciatica in over 16s: assessment and management [NG59]. Available at: https://www.nice.org.uk/guidance/ng59
- NHS (2022). Back pain. Available at: https://www.nhs.uk/conditions/back-pain/
- Hayden JA, et al. (2021). Exercise therapy for chronic low back pain. Cochrane Database of Systematic Reviews. Available at: https://www.cochrane.org/evidence/CD009790
- Health and Safety Executive (2025). Working days lost in Great Britain. Available at: https://www.hse.gov.uk/statistics/dayslost.htm
- Chartered Society of Physiotherapy. Back pain. Available at: https://www.csp.org.uk/conditions/back-pain
- Versus Arthritis (2024). The State of Musculoskeletal Health. Available at: https://versusarthritis.org/the-state-of-musculoskeletal-health/
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