Lower Back Pain Exercises: A Personal Trainer’s Manual for Safe Relief and Stronger Movement

This guide is designed for personal trainers and fitness professionals working with clients experiencing non-specific lower back pain.

Lower back pain exercises are one of the most practical tools a personal trainer can use to support clients who feel stiff, sore, or nervous about movement. In gym environments, “back pain” often presents as poor tolerance to bending, lifting, standing for long periods, or sitting at a desk all day.

This guide is written like a course manual: clear progressions, simple screening, coaching cues, and programming. It also answers the question clients ask most: what exercise is good for lower back pain? (Spoiler: it depends on the presentation, but we can use a reliable framework.)

Scope note: Personal trainers can coach exercise and general movement advice. You don’t diagnose disc issues, spinal stenosis, or sciatica – but you can use safe resistance training, core stability, and mobility drills to improve function and confidence.

What Exercise Is Good for Lower Back Pain?

If a client asks “what exercise is good for lower back pain”, you should think in categories rather than one magic move:

• Core stability (anti-extension/anti-rotation)
• Hip and glute strength (reduce lumbar overload)
• Mobility (hips + thoracic spine, not excessive lumbar stretching)
• Low-load movement practice (hinge, squat pattern, carries)

Most “lower back pain exercises” programmes work best when they build tolerance, improve body composition over time, and restore daily function – not when they chase a stretch-only routine.

Exercise Selection Framework for Lower Back Pain (PT Use)

When selecting lower back pain exercises, personal trainers should prioritise presentation, tolerance, and confidence, not just the diagnosis or pain label. The framework below helps guide safe, progressive exercise selection based on symptom stage.

Exercise Selection by Pain Presentation

How Personal Trainers Should Use This Framework

This framework helps answer the client question “what exercise is good for lower back pain?” without relying on a single exercise or rigid rule set.

Instead of chasing pain relief alone, personal trainers should:

• Match exercise type to the client’s current tolerance

• Progress from stability → strength → load

• Reinforce confidence and movement control at every stage

• Adjust volume and resistance levels based on pain response, not fear

Lower back pain exercises are most effective when they build tolerance gradually, improve muscle mass and lean mass over time, and restore trust in movement rather than avoiding load entirely.

Quick PT Screening: What Are We Dealing With?

Before you select lower back pain exercises, ask:

• Does pain travel down the leg (possible sciatica symptoms)?
• Any numbness/tingling, weakness, or foot drop?
• Any pain at night, fever, unexplained weight loss, or recent trauma?
• Pain worsened by spinal flexion (bending forward) or extension (arching)?
• What movements trigger discomfort: sitting, standing, walking, lifting?

If red flags appear, you refer out (see referral section below). If it’s typical mechanical back pain, you can proceed with conservative exercise programming.

Most non-specific lower back pain improves with movement and time, which aligns with NHS guidance that encourages staying active rather than complete rest when managing back pain.

Understanding the Anatomy Behind Lower Back Pain Exercises

Effective lower back pain exercises must consider more than just muscles. The lumbar spine protects the spinal cord, supports the intervertebral discs, and transfers force between the upper and lower body. When degenerative changes, a slipped disc, or lumbar stenosis are present, inappropriate loading can increase pain levels rather than reduce them.

Lower back pain is often linked to dysfunction in the supporting musculature, including the core muscles, gluteus maximus, hip abductor muscles, and deep stabilisers such as the transverse abdominis. Poor coordination between these structures increases spinal strain and contributes to back stiffness and hip stiffness. Research has shown that impaired coordination of deep trunk muscles, including the transverse abdominis, is associated with recurrent lower back pain and reduced spinal control.

Personal trainers should understand that lower back pain may also coexist with neck pain, back and neck problems, or thoracic outlet–related postural restrictions, reinforcing the need for whole-body assessment rather than isolated exercise prescription.

The Big 3 Exercises for Lower Back Pain

1. Modified curl-up (core brace, minimal spine motion)
2. Side plank (lateral core, hip stability)
3. Bird dog (posterior chain + spinal control)

These aren’t the only lower back pain exercises that work – but they’re a strong baseline when paired with glute work and appropriate mobility.

Core Stability: Lower Back Pain Exercises That Build Control

Lower back pain often improves when clients learn core stability (bracing + breathing + control) rather than aggressively stretching the lumbar spine.

Use these lower back pain exercises:

• Dead bug (core stability + rib control)
• Bird dog (spinal control + glute activation)
• Side plank (hip stability + trunk endurance)
• Pallof press (anti-rotation, great for gym-floor confidence)

Coaching cues:

• “Ribs down, breathe behind the brace.”
• “Slow reps, no wobble.”
• “Stop 1–2 reps before form breaks.”

Hip and Glute Strength: Reduce Compensation Through the Lumbar Spine

A huge chunk of “back pain” in recreational trainees is a hip-control problem, not a spine problem. If glutes don’t contribute, the lumbar spine often overworks. Reduced hip strength and poor load sharing between the hips and lumbar spine have been associated with increased spinal stress and persistent lower back pain.

Use these lower back pain exercises:

• Glute bridge / hip bridge (glutes + pelvic control)
• Hip hinge patterning (dowel hinge, kettlebell deadlift regression)
• Split squat (hip stability, bodyweight exercises first)
• Step-ups (functional leg strength)

These also support fat loss, healthier body composition, and improved metabolic health – which can reduce overall pain sensitivity in many clients.

Mobility That Helps Without Over-Stretching the Low Back

Mobility work should focus on areas that commonly restrict movement:

• Hip flexor stretch (anterior hip tightness from sitting)
• Thoracic spine rotations (reduce lumbar twisting)
• Hamstring stretch (careful if it provokes nerve symptoms)
• Cat-camel (gentle spinal motion, not aggressive end-range)

Avoid coaching lumbar stretching as the only solution. Mobility is a tool – stability + strength is what makes mobility useful.

What Exercises Should Be Avoided If You Have Lower Back Pain?

When clients are symptomatic, certain exercises can increase spinal load, reduce movement control, or aggravate existing tissue sensitivity – especially when core stability, muscle strength, or body composition has not yet been rebuilt.

In early stages of lower back pain, avoid or regress:

• Heavy barbell deadlifts or maximal strength testing, particularly when lean body mass and core stability are compromised
• High-volume sit-ups, crunches, or Russian twists that involve repeated spinal flexion and rotation under fatigue
• Fast kettlebell swings or ballistic hip hinge movements before proper resistance training technique and hinge control are established
• Deep spinal flexion under fatigue, especially during long sets or metabolic conditioning
• High-impact plyometrics or jumping exercises when pain is active, as these increase compressive forces on the lumbar spine
• Aggressive endurance exercise that prioritises speed or volume over control and movement quality

For many clients, pain is not caused by weakness alone but by poor load management. Psychological factors such as fear-avoidance and reduced confidence in movement can amplify pain perception and reduce tolerance to physical activity.

Effective lower back pain exercises should reduce unnecessary spinal stress while gradually rebuilding muscle mass, lean mass, and movement confidence. Evidence suggests that appropriately dosed resistance training can reduce pain, improve physical function, and increase load tolerance without worsening symptoms in people with chronic lower back pain.

These can return later – but only when the client can demonstrate controlled hinge mechanics, adequate core stability, and tolerance to loading.

What to Expect in a Simple PT Programme

A PT-friendly template (2–4 weeks) for lower back pain exercises:

Warm-up (5–8 min):

• Cat-camel x 6–8
• Hip flexor stretch 30–45s/side
• Thoracic rotations x 6–8/side

Core stability (8–12 min):

• Dead bug 2–3 sets
• Side plank 2–3 sets
• Bird dog 2–3 sets

Strength (15–25 min):

• Glute bridge 3 sets
• Split squat or step-up 3 sets
• Cable row or supported row (posture support) 3 sets

Finish:

• Light cardio for cardiovascular health (walk, bike, elliptical machine) 5–10 min if tolerated

This structure supports muscle mass, lean mass, and long-term success without flaring symptoms.

How Often Should I Do Lower Back Pain Exercises?

General guideline for most clients:

• Core stability + mobility: 3–5x/week (short sessions work well)
• Strength training: 2–3x/week (progressive, not maximal)
• Walking / low-intensity cardio: most days if tolerated

Consistency beats intensity early. You’re building tolerance, not “testing” the back. Systematic reviews indicate that regular, moderate exercise exposure is more effective than sporadic high-intensity training for improving pain and function.

How Can I Modify Lower Back Pain Exercises if I Feel Discomfort?

A key personal training principle is this:

Discomfort does not automatically mean stop – but sharp, radiating, escalating pain always does.

When clients feel discomfort during lower back pain exercises, personal trainers should prioritise intelligent regression rather than complete avoidance of movement. Modifications allow continued training while protecting skeletal muscle, physical function, and confidence.

Common modification strategies include:

• Reducing range of motion to limit spinal stress while maintaining muscle activation
• Switching from loaded movements to bodyweight exercises to control resistance levels
• Changing stance or positioning, such as shortening a split squat stride or elevating hands during pressing patterns
• Replacing free weights with resistance bands to reduce peak load while maintaining tension
• Slowing tempo, lowering total repetitions, and increasing rest periods to manage fatigue
• Substituting spinal movement exercises with core stability drills, such as replacing sit-ups with Pallof presses or dead bugs

These adjustments support continued strength training and resistance training without aggravating symptoms. If discomfort increases session to session, regress further and reassess exercise selection, volume, and recovery.

Well-coached lower back pain exercises should improve tolerance to load over time – not reduce confidence in movement.

When Should Someone Stop and See a Doctor?

For safety, professionalism, and scope of practice, this section should always be clear in educational content.

Most non-specific lower back pain improves with movement and time, with exercise-based approaches shown to improve function and reduce pain when compared to rest or passive treatment alone.

Clients should stop training and be referred to a GP or physiotherapist if they experience:

• Pain that radiates down the leg with numbness or tingling, which may indicate sciatica or nerve involvement
• Progressive weakness, loss of muscle strength, or declining physical function
• Changes in bowel or bladder control
• Severe night pain, unexplained fever, or recent trauma
• Rapidly worsening pain despite appropriate regression and load management

Personal trainers must never diagnose conditions. Your role is to recognise red flags, pause training when needed, and support the client through referral while maintaining trust and professionalism.

These red flags are consistent with NICE guideline NG59 for low back pain and sciatica, which outlines when exercise should pause and further clinical assessment is required.

Appropriate referral protects both the client’s health and the integrity of your coaching practice.

PT Education: Go Deeper With Level 4 Lower Back Pain

If you want a proper framework for lower back pain exercises – including screening, programming, and case-based progressions – point learners to your Level 4 course:

• Level 4 course: https://www.thefitnessgrp.co.uk/courses/level-4-lower-back-pain/
• Course book: https://www.thefitnessgrp.co.uk/product/lower-back-pain-course-book/

FAQs:

What Is the Best Exercise for Lower Back Pain?

The “best” lower back pain exercises are usually the ones the client can do consistently without flare-ups. For many beginners, a combination of:

• Bird dog
• Side plank
• Glute bridge
• Hip hinge patterning
  …is a strong starting point.

If the client’s symptoms suggest sciatica or nerve involvement, you stop guessing and refer appropriately.

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Are lower back pain exercises safe to do every day?

Yes, many lower back pain exercises can be performed daily when they focus on mobility, core stability, and low-intensity bodyweight exercises. Strength training movements that load the spine should usually be performed two to three times per week to allow adequate recovery. Personal trainers should adjust volume and resistance levels based on symptoms and tolerance.

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Can strength training help lower back pain?

When programmed correctly, strength training is one of the most effective ways to reduce lower back pain long term. Strengthening the hips, glutes, and trunk reduces excessive stress on the lumbar spine. Lower back pain exercises that include resistance training help preserve muscle mass, improve lean mass, and support better body composition.

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What are the best bodyweight exercises for lower back pain?

Effective bodyweight exercises for lower back pain include glute bridges, bird dogs, side planks, step-backs, and controlled split squats. These exercises improve muscular endurance, coordination, and stability without excessive spinal loading. They are especially useful in early-stage rehabilitation or for clients returning to training after a flare-up.

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Should people with sciatica do lower back pain exercises?

People with sciatica should be cautious. Some lower back pain exercises may help, but others can worsen nerve irritation. Exercises that cause sharp pain, tingling, or symptoms travelling down the leg should be stopped. In these cases, personal trainers should prioritise gentle movement, avoid end-range spinal flexion, and refer clients to a physiotherapist or medical professional when needed.

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How often should lower back pain exercises be done for results?

Most clients see the best results when lower back pain exercises are performed three to five times per week for mobility and core stability, with two to three strength training sessions per week. Consistency matters more than intensity. Small, repeated exposures to movement help rebuild tolerance and confidence.

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Can lower back pain exercises improve posture and daily movement?

Yes. Lower back pain exercises that target core stability, hip strength, and movement control often improve posture, walking mechanics, and lifting technique. As strength and coordination improve, clients typically experience better physical function during daily activities such as sitting, standing, and bending.

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What exercises should be avoided if someone has lower back pain?

During active pain phases, clients should usually avoid heavy deadlifts, high-volume sit-ups, fast rotational movements, and high-impact exercises. These can increase spinal loading and aggravate symptoms. As pain improves, these exercises may be reintroduced gradually under proper coaching.

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Do lower back pain exercises help with muscle loss and ageing?

Yes. Regular lower back pain exercises that include resistance training help maintain muscle mass, muscle strength, and bone density, which are essential for long-term health and independence. This is particularly important for older adults or those returning to exercise after long periods of inactivity.

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Is stretching enough to fix lower back pain?

Stretching alone is rarely enough. While mobility work can help, most long-term improvements come from combining stretching with strength training, core stability, and movement education. Lower back pain exercises should focus on teaching the body to tolerate load safely rather than avoiding movement altogether.

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When should a personal trainer stop exercise and refer a client?

Personal trainers should refer clients if lower back pain is accompanied by numbness, weakness, progressive worsening symptoms, or pain that does not improve with conservative exercise. Trainers should stay within scope and avoid diagnosing conditions such as disc herniation or nerve compression.

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How do lower back pain exercises fit into a long-term training program?

Lower back pain exercises are not just for rehabilitation. They form the foundation of long-term training programs by improving core stability, movement efficiency, and resilience. When integrated properly, they support fat loss, strength development, and overall training performance.

Resources

Bergmark, A. (1989). Stability of the lumbar spine: A study in mechanical engineering. Acta Orthopaedica Scandinavica, 60(Suppl 230), pp. 1–54.
→ Foundational paper on spinal stability and supporting musculature.

Hodges, P.W. and Richardson, C.A. (1996). Inefficient muscular stabilization of the lumbar spine associated with low back pain. Spine, 21(22), pp. 2640–2650.
→ Key evidence linking delayed transverse abdominis activation to lower back pain.

Hodges, P.W. and Richardson, C.A. (1999). Altered trunk muscle recruitment in people with low back pain. Journal of Orthopaedic & Sports Physical Therapy, 29(8), pp. 456–466.
→ Supports core stability and motor control approaches used in PT programming.

McGill, S.M. (2007). Low back disorders: Evidence-based prevention and rehabilitation. 2nd ed. Champaign, IL: Human Kinetics.
→ Basis for “Big 3” core stability exercises and spinal load management.

van Dieën, J.H., Selen, L.P.J. and Cholewicki, J. (2003). Trunk muscle activation in low-back pain patients. Journal of Electromyography and Kinesiology, 13(4), pp. 333–351.
→ Demonstrates altered muscle coordination and increased spinal load in LBP.

Hayden, J.A. et al. (2005). Exercise therapy for treatment of non-specific low back pain. Annals of Internal Medicine, 142(9), pp. 765–775.
→ Landmark review supporting exercise over rest or passive care.

Steiger, F. et al. (2012). Exercise therapy in nonspecific chronic low back pain. Best Practice & Research Clinical Rheumatology, 26(2), pp. 263–280.
→ Reinforces graded exercise, not stretch-only protocols.

Searle, A., Spink, M., Ho, A. and Chuter, V. (2015). Exercise interventions for chronic low back pain. Journal of Rehabilitation Medicine, 47(8), pp. 683–692.
→ Supports resistance training and progressive loading approaches.

Gordon, R. and Bloxham, S. (2016). A systematic review of the effects of exercise on chronic low back pain. Healthcare, 4(2), p. 22.
→ Confirms strength and conditioning benefits for pain and function.

Steele, J. et al. (2017). Resistance training for chronic low back pain. Journal of Sports Science & Medicine, 16(4), pp. 530–539.
→ Strong evidence that resistance training improves pain and physical function.

Saragiotto, B.T. et al. (2016). Motor control exercise for chronic non-specific low back pain. Cochrane Database of Systematic Reviews, Issue 1.
→ Supports motor control and stability-focused exercise prescription.

Koes, B.W., van Tulder, M. and Thomas, S. (2006). Diagnosis and treatment of low back pain. BMJ, 332(7555), pp. 1430–1434.
→ Confirms most non-specific low back pain improves with movement and time.