Why Exercise When You Have Low Back Pain?
Most people know regular exercise will improve their appearance and general health, but few realize the positive effects that good physical conditioning can have on their low back pain. Many studies show dramatic improvements of low back pain in individuals who are physically fit.

In addition, the person in good physical shape is much less likely than the average person to injure their back during work or daily activities.

The benefit of exercise for your low back depends on 3 key principles:

• First, you must attain satisfactory aerobic fitness.
• Second, you should focus part of your workout on the muscle groups that support your back.
• Third, you must avoid exercises that place excessive stresses on your back.

Ideal Aerobic Exercise for Lower Back Pain
The ideal aerobic exercise involves the large muscle groups of your body (arms and legs) in a smooth, cyclical fashion.

Recommended exercises for people with low back pain include:

• swimming
• fast walking
• cycling
• using a ski machine or elliptical exerciser.

You should achieve the appropriate heart rate (dependent on your age) for 30 minutes at 3 three times per week.

• Of course, you should consult your doctor and review your aerobic program before getting started. He or she can give you the appropriate target for your heart rate during aerobic exercise. It is always optimal to approach your aerobic goals slowly, especially if you have not exercised recently.

Strenthening and Stretching: Essential When You Have Low Back Pain
Part of your workout routine should include stretching and strengthening the muscles of your low back, abdomen, pelvis, and thighs. Flexibility in these areas will greatly decrease the chance of further injury to the back.

By strengthening these muscle groups, the body's weight distribution and posture are improved, resulting in less stress on the low back. It is best to perform these exercises after a good warm up, such as your aerobic routine.

Ask your health club staff or physical therapist for instructions on specific stretching and strengthening exercises to prevent back pain.

Avoid These Exercises
While the merits of good conditioning cannot be overstated, the wrong type of exercise may actually make your low back pain worse.

• Activities that impart excessive stress on the back—such as lifting heavy weights, squatting, and climbing—are not advised.
• In addition, high-impact exercises such as running, jumping, and step aerobics can aggravate a low back condition.

When walking, wear well-cushioned shoes with good arch supports and use a treadmill or a track made for athletics. Cycling on a recumbent stationary bike can relieve stress on the back.

Watch Low Back Pain Exercise Videos on SpineUniverse
With the help of a physical therapist, SpineUniverse created a video series of exercises and stretches you can do every day to help keep a healthy back (and to try to prevent or reduce lower back pain).

• Watch our back pain exercise videos—but please remember that before starting any exercise program, you should check with your doctor to make sure it's safe and right for you.

With the help of your doctor, physical therapist, and health club staff, you can achieve proper physical fitness and reduce or prevent lower back pain.

SpineUniverse Editorial Board Commentary
In this article, Dr. Kolettis nicely summaries the important issues involved in the question: Can Exercises Control Back Pain? This question has been studied in various scientific articles, often with mixed results. It can sometimes be quite difficult to scientifically "prove" that one form of exercise will fully treat a variety of low back problems. The scientific evidence, biomechanical principles, and sometimes common sense can be helpful to both the clinician and the patient.

Dr. Kolettis combines this knowledge in his article. It appears that the combination of proper aerobic exercise, stretching and strengthening will yield the best benefit. While weight-lifting, squatting and other high-demand activities might be avoided in the deconditioned patient or one with significant pain, the goal is to return to full activities. The worse thing for back pain is inactivity, especially prolonged sitting. We should be encouraging our patients to be as active as possible, combining aerobic exercise, stretching and strengthening exercises, which can help in controlling back pain.
—Gerard Malanga, MD