Low back pain: which exercises help relieve back pain

Low back pain presents as pain in the lower part of the back, sometimes associated with stiffness or difficulty in daily movements. It can appear suddenly after exertion or incorrect movement, or without an apparent cause.

“Low back pain is pain localized in the lumbar region, often accompanied by reduced mobility due to pain. When the pain radiates to the lower limbs, it may indicate nerve compression, as occurs with a herniated disc. ‘Pure’ low back pain, on the other hand, remains localized,” clarifies the specialist.

This distinction is important because the origin of the pain may vary: muscular, structural, or in some cases not directly related to the spine. Dr. Beretta identifies three main categories of causes: muscle-tension, structural, and non-spinal.

Muscle-tension causes

These forms can occur even in the presence of a structurally healthy spine. They are often related to:

• poor posture (e.g., long hours at the computer);
• repetitive movements or physically demanding work;
• sedentary lifestyle and weakening of supporting muscles;
• overweight or metabolic alterations.

Workstation ergonomics and alternating between sitting and movement are key elements in prevention.

Structural causes

These are related to spinal conditions and become more frequent with age. The main causes include:

• degeneration of intervertebral discs;
• disc protrusions and herniations;
• spinal canal stenosis;
• spondylolisthesis (slippage of one vertebra over another);
• vertebral fractures, particularly due to osteoporosis.

“These conditions have an anatomical basis that explains the pain and may sometimes be associated with neurological symptoms such as numbness or weakness in the limbs. With aging, the spine undergoes physiological changes. Intervertebral discs progressively lose hydration and elasticity, reducing their ability to absorb loads, with possible onset of pain,” adds Dr. Beretta.

Osteoarthritis and degeneration of the posterior spinal joints also contribute to increased risk of low back pain in older age groups.

Non-spinal causes

Not all lower back pain originates from the spine. In some cases, it may reflect conditions affecting other organs, such as kidney stones or, more rarely, abdominal diseases.

“Low back pain can be a referred pain from internal organs. For this reason, it is always important to evaluate any associated symptoms,” emphasizes Dr. Beretta.

“Postural exercise is the true ally of the back,” states the physiatrist. Strengthening supporting muscles, improving posture, and maintaining spinal mobility contribute to:

• pain management;
• prevention of recurrences.

Exercises should preferably be performed after medical or physiotherapy evaluation, especially in the presence of persistent pain.

They must always respect pain levels and be adapted to the clinical phase:

• in acute phases, gentle movements are recommended;
• for prevention, strengthening and stabilization exercises are introduced.

Below are 5 exercises for back pain recommended by the physiatrist.

• Cat-cow:i n a quadruped position, alternate controlled arching and rounding of the back. Promotes mobility without overload.
• Knee-to-chest (single leg): lying on your back, bring one leg at a time toward the chest while keeping the lower back in contact with the floor. Helps reduce tension and load.
• Superman: in a quadruped position, lift the opposite arm and leg while keeping the spine neutral. Improves stability and trunk control.
• Dead bug: lying on your back with arms extended upward and legs bent at 90°, slowly extend the opposite arm and leg toward the floor. Strengthens deep core muscles.
• Glute bridge: lift the pelvis with knees bent. Strengthening the glutes helps protect the spine.

Sleeping position also plays an important role. Sleeping on your side, with knees bent and a pillow between the legs, promotes better spinal alignment. The prone position (on the stomach) is generally not recommended.

“As for the mattress, it is essential that it provides adequate support. If it is too soft, it may be counterproductive for those with low back pain. A firmer support often improves comfort and reduces pain,” adds the specialist.

During an episode of back pain, it is advisable to avoid:

• hyperlordosis under load;
• forced trunk rotations;
• high-impact activities;
• lifting heavy loads.

“These are movements that increase stress on the spine, especially during the painful phase,” the specialist emphasizes.

“Acute low back pain often improves within a few days or weeks. If pain persists beyond 6 weeks, it is considered chronic and specialist evaluation is recommended,” says Dr. Beretta.

It is also advisable to consult a doctor if:

• acute pain does not improve after a few days;
• fever, weight loss, or other systemic symptoms appear;
• loss of strength or sensory changes in the limbs occur.

“Incontinence or numbness in the groin area also require urgent evaluation, as they may indicate significant neurological compression,” warns Dr. Beretta.

Preventing low back pain involves adopting proper daily habits:

• maintaining an active lifestyle with regular physical activity;
• controlling body weight;
• paying attention to posture at work and during study;
• targeted strengthening of supporting muscles.

“Taking care of your back means listening to your body, staying active, and maintaining good posture and muscle strength. This is the most effective strategy to prevent recurrences,” concludes the specialist.