What are the best back strengthening exercises?
Any you’ll do at least twice a week. In trials, exercise plus lessons on back pain cut the risk of new low back pain by about 45%. But one popular type does no better.
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What are the best exercises to strengthen your back?
The best one is the one you’ll keep doing. The NHS says adults should work their main muscles, including the back, on at least 2 days a week.
A review pooled 21 trials in over 30,000 people. Exercise plus lessons on back pain cut the risk of a new bout of low back pain by about 45%. Exercise alone may help too, but that evidence is weaker.
| What people tried | Risk of new low back pain (1.0 = no change) | What it means |
|---|---|---|
| Exercise plus lessons on back pain | 0.55 | About 45% lower. Moderate-quality evidence. |
| Exercise alone | 0.65 | May be about 35% lower. Low to very low-quality evidence. |
| Lessons alone | 1.03 | No clear effect. |
| Back belt | 1.01 | No clear effect. |
| Shoe insoles | 1.01 | No clear effect. |
Source: Steffens 2016
A risk of 0.55 means about 55 people get a new bout for every 100 who would without it. It lowers the odds. It can’t promise you’ll never get it.
Pick two days this week and put them in your diary.
Which back exercises can I do at home?
Physios at Addenbrooke’s Hospital in Cambridge give out a sheet of back moves. Here are six you can do on a mat.
Six home moves from NHS physios
- Knee hugs: lie on your back and pull both knees towards your chest with your arms. Hold, then relax.
- Forearm back bend: lie face down on your elbows, press your hips into the floor and lift your upper back.
- Hands back bend: lie face down, hands under your shoulders, and straighten your arms. Keep your hips and legs relaxed.
- Knee rolls: lie on your back, knees bent and together. Roll them slowly side to side, keeping your upper body still.
- Bridge: lie on your back, knees bent, flatten your back, then lift your hips. Hold, then lower slowly.
- Pelvic tilts: lie on your back, knees bent. Flatten your lower back into the floor, then gently arch it away.
The sheet leaves holds and repeats blank for your physio to fill in, so start easy. If a move hurts, ask a physio or GP.
To build strength, add a pull such as a dumbbell row. Our two-day home routine fits it in, and band exercises work if you have no weights.
What are the best lower back exercises in the gym?
The “lower back machine” in most gyms is the back extension bench. Pair it with a row and a pulldown to work your back from top to bottom.
| Move | What it works | How to do it |
|---|---|---|
| Back extension bench | Lower back and hips | Bend and lift from your hips, not by curling your upper back. |
| Seated cable row | Upper back and the muscles down the sides of your chest | Pull the handle to your waist. Don’t lean too far forward at the start. |
| Lat pulldown | The same side muscles and upper back | Pull the bar to the front of your chest, never behind your neck. |
| Dumbbell row | Upper back and the back of the shoulder | Lean forward from the hips with a straight back. Don’t let your shoulder roll forward. |
Sources: Schellenberg 2017; Mayo Clinic: seated row; Mayo Clinic: lat pulldown; Mayo Clinic: dumbbell row
Why the hips? In a 16-person lab study, bending from the hips loaded the hips and lower back more than curling the spine. The authors said it seems the better way to build strength there.
Mayo Clinic trainers say one set of 12 to 15 is enough for most people. A review of 137 reviews by the ACSM, a US sports body, found 2 to 3 sets, at least twice a week, built more strength.
Machines or free weights? The same review found the type of kit made no steady difference. Add reps, then weight, as our progressive overload guide shows.
Do I need core exercises for my lower back?
No. NHS physios at Addenbrooke’s say Pilates or core exercises are no better for people with back pain than any other exercise.
That popular type is core work: drills for the deep tummy and back muscles, such as one called multifidus. Your spine needs only a little trunk muscle effort to stay steady.
You also can’t work your core on its own. The same physios say all types of exercise use about the same amount of it.
Enjoy Pilates? Keep going. If core drills make your pain worse, you can drop them.
Posture matters less than you think. There’s no clear evidence that bad posture causes back pain, and no perfect posture. Change position often instead.
Lifting “correctly” hasn’t been shown to prevent back pain either. In a review of 27 studies, regular exercise protected best.
Skip the back belt. NICE says don’t offer belts or corsets for low back pain.
Can I exercise with back pain?
Usually, yes. The NHS says to stay active and not to stay in bed for long. But stop if your pain gets worse and see a GP.
In long-term low back pain, 249 trials found exercise probably eases pain by about 15 points out of 100, compared with no treatment. Picture a pain of 7 out of 10 easing to about 5.5.
The gain in day-to-day function was small. Side effects were mostly minor, such as sore muscles. To tell normal soreness from a problem, see our muscle soreness guide.
Walking, swimming, yoga and Pilates may also help. For a flare-up, NICE suggests a group exercise class chosen to suit you.
Prefer walking? Try Nordic walking.
When to speak to a GP
Back pain: who to call
- 1
999 or A&E
Pain, tingling, weakness or numbness in both legs, numbness around your genitals or bottom, or bladder or bowel changes.
- 2
Urgent GP or 111
You feel hot, cold, shivery or generally unwell, or severe pain starts suddenly or gets worse fast.
- 3
See a GP
No better after a few weeks at home, or it stops your daily life.
- 4
Keep moving
Otherwise stay active. Stop any exercise that makes the pain worse.
Source: NHS
Also call 999 for chest pain, changes in sexual feeling or function, or pain after a serious accident. Don’t drive yourself to A&E.
Leg, genital, bottom, bladder or bowel signs can mean cauda equina syndrome, when the nerves at the very bottom of your back are squashed. It’s rare, affecting 1 to 3 people in every 100,000, but needs A&E straight away.
See a GP if your back pain:
- doesn’t improve after a few weeks of home care, or you’re struggling to cope
- doesn’t ease with rest, or is worse at night
- is worse when you sneeze, cough or poo
- comes with weight loss you can’t explain, or a lump, swelling or change in your back’s shape
- is between your shoulders rather than in your lower back
In many areas you may be able to refer yourself to NHS physio without seeing a GP first.