Lower back pain exercises — physical therapy El Paso
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Lower Back Pain Exercises:
A Physical Therapist's Guide

Dr. Andrew Cisneros, PT, DPT, MS · April 2026 · 9 min read · Solas PT — El Paso, TX

Most lower back pain responds extremely well to the right exercises — but the wrong exercises can make it significantly worse. As a physical therapist who treats back pain daily, I want to give you an honest, evidence-based guide: what to do, what to avoid, and when exercise alone isn't enough.

Lower back pain is one of the most common conditions I see at Solas PT. It affects about 80% of adults at some point in their lives, and the majority of cases — even severe ones — improve significantly with the right physical therapy approach. That approach almost always includes targeted exercise.

The key word is targeted. Generic "back pain exercises" lists from the internet often mix exercises that are appropriate for some people but harmful for others. A person with a herniated disc needs a completely different program than someone with tight hip flexors or weak glutes. This guide gives you the foundational exercises that help most people, along with the red flags that mean you should see a PT before starting any program.

Important: If your back pain is severe, accompanied by leg numbness or weakness, or has lasted more than 6 weeks without improvement, see a physical therapist before starting an exercise program. Pain that travels down the leg may indicate nerve involvement that requires assessment before loading the spine.

Why Exercise Is the Best Medicine for Lower Back Pain

Rest used to be the standard advice for back pain. We now know it's one of the worst things you can do. Prolonged rest causes the muscles that support your spine — particularly the multifidus and transverse abdominis — to weaken and atrophy within days. That weakness creates a cycle: pain leads to rest, rest leads to weakness, weakness leads to more pain.

Movement, done correctly, does the opposite. It increases blood flow to the discs and surrounding tissue, reduces inflammation, and retrains the neuromuscular system to protect the spine under load. A 2021 review in the Journal of Orthopaedic & Sports Physical Therapy found that exercise therapy reduces chronic low back pain intensity by an average of 10–15 points on a 100-point scale — comparable to most medications, without the side effects.

The exercises below are organized the way I structure most back pain programs: start with gentle mobility work, build core stability, then add hip strength, since the hips are one of the most overlooked drivers of lower back pain.

Gentle Exercises for Lower Back Pain: Where to Start

These are the first exercises I give to patients who are in acute pain or are just getting started. They're low-load, gentle, and safe for most people — including those with disc herniations, muscle strains, or general stiffness. Do them on a firm surface (yoga mat on a hard floor, not a soft mattress).

Exercise 01 — Mobility

Knee-to-Chest Stretch

One of the most consistently effective gentle exercises for lower back pain. It decompresses the lumbar spine, releases tight paraspinal muscles, and is safe even during acute flare-ups.

How to do it: Lie on your back with knees bent. Bring one knee toward your chest and hold for 20–30 seconds. Switch sides. Then bring both knees to your chest simultaneously and hold. Do 3 reps per side. You should feel a gentle stretch — never sharp pain.

Exercise 02 — Mobility

Cat-Cow Stretch

A classic physiotherapy exercise for lower back pain that improves segmental spinal mobility and reduces morning stiffness. The rhythmic movement pumps synovial fluid through the facet joints and encourages disc hydration.

How to do it: On hands and knees, alternate between arching your back toward the ceiling (cat) and letting it sag toward the floor (cow). Move slowly and with your breath — inhale into cow, exhale into cat. Do 10 full cycles. This is an excellent back pain relief exercise at home that you can do every morning before getting out of bed.

Exercise 03 — Mobility

Lumbar Rotation Stretch

Reduces rotational stiffness in the lumbar spine and stretches the piriformis — a muscle that, when tight, can mimic or contribute to sciatica-like symptoms and lower back pain.

How to do it: Lie on your back with knees bent and feet flat. Let both knees drop slowly to one side while keeping your shoulders on the floor. Hold 20–30 seconds. Return to center and repeat on the other side. 3 reps per side. If this causes sharp radiating pain, stop and see a PT.

Exercise 04 — Mobility

Child's Pose

Borrowed from yoga, child's pose is one of the best gentle exercises for lower back pain because it simultaneously decompresses the lumbar spine and stretches the thoracolumbar fascia — the thick connective tissue wrapping the low back that becomes chronically tight in desk workers.

How to do it: From a kneeling position, sit back toward your heels and reach your arms forward along the floor. Let your spine lengthen and your lower back open. Hold 30–60 seconds, breathing deeply. If your knees are uncomfortable, place a folded blanket behind them.

Core Exercises for Lower Back Pain: The Foundation

Core training for back pain is widely misunderstood. The goal isn't a six-pack — it's spinal stability. The deep core muscles (multifidus, transverse abdominis, pelvic floor, diaphragm) act like a corset around your lumbar spine. When they're weak or poorly coordinated, every movement you make — sitting, standing, lifting — puts more stress on your discs and joints.

The best core exercises for lower back pain are low-load, focused on bracing and control — not crunches, sit-ups, or heavy leg raises, which spike lumbar disc pressure significantly. Start here.

Exercise 05 — Core Stability

Dead Bug

The single most effective core exercise for back pain rehabilitation. It trains the deep stabilizers without loading the spine, and forces coordination between opposite arm and leg — exactly how your core needs to function during walking and daily activity.

How to do it: Lie on your back. Raise arms toward the ceiling and bend knees to 90°. Press your lower back firmly into the floor (this is the brace — maintain it throughout). Slowly extend one leg out and lower the opposite arm overhead. Return and repeat on the other side. Do 8–10 reps per side. Never let your lower back arch off the floor.

Exercise 06 — Core Stability

Bird Dog

A McGill Big 3 exercise — one of the most research-supported core exercises for lower back pain. It trains the multifidus and erector spinae to stabilize the spine while the limbs move, which is exactly what they're supposed to do during daily activities.

How to do it: On hands and knees, brace your core gently. Extend one arm forward and the opposite leg back simultaneously, keeping your hips level (don't let them rotate). Hold 3–5 seconds. Return and switch sides. Do 8–10 reps per side. Quality over speed — a slow, controlled rep beats a fast sloppy one every time.

Exercise 07 — Core Stability

Modified Plank (Forearm)

Planks train the entire anterior core chain — abs, hip flexors, and the muscles that prevent your spine from extending under load. A forearm plank is more appropriate for back pain than a full push-up plank because it reduces shoulder stress and allows better focus on core bracing.

How to do it: Forearms on the floor, elbows under shoulders. Toes on the floor. Create a straight line from head to heels. Brace your abs and squeeze your glutes — don't just hang in the position. Hold 20–30 seconds to start. Progress to 60 seconds over several weeks. If your low back hurts during a plank, drop to your knees.

Exercise 08 — Core & Glute

Glute Bridge

Simultaneously strengthens the glutes, hamstrings, and lumbar extensors while teaching your body to generate hip power without overloading the low back. Weak glutes are one of the most common — and most overlooked — contributors to chronic lower back pain.

How to do it: Lie on your back, knees bent, feet flat. Drive through your heels and lift your hips until your body forms a straight line from knees to shoulders. Squeeze your glutes at the top — don't hyperextend your lower back. Hold 2–3 seconds, lower slowly. Do 3 sets of 10–15 reps. Progress to single-leg bridges when this becomes easy.

Hip Stretches for Lower Back Pain: The Missing Link

If you only focus on your back, you're missing half the problem. The hip flexors, piriformis, and glutes all attach directly to the lumbar spine and pelvis. When these muscles are tight or weak, they pull the spine out of alignment and force the lower back to compensate on every step you take.

I tell patients: tight hips are often the reason your back hurts. Fix your hips, and the back frequently improves without doing anything directly to it.

Exercise 09 — Hip Mobility

Hip Flexor Stretch (Kneeling Lunge)

The psoas major is a hip flexor that attaches directly to the lumbar vertebrae. When it's chronically tight — which it is in most people who sit for work — it compresses the lumbar spine and tilts the pelvis forward, creating an exaggerated curve that strains the low back all day long.

How to do it: Kneel on one knee (the side you're stretching), with the other foot forward. Tuck your pelvis slightly under (posterior pelvic tilt) before shifting forward — this is what actually stretches the hip flexor. You should feel a stretch in the front of the kneeling hip. Hold 30–45 seconds. 3 reps per side. Do this daily if you sit for work.

Exercise 10 — Hip Mobility

Piriformis Stretch (Figure-4)

The piriformis runs directly over the sciatic nerve. When it's tight, it can compress the nerve and create symptoms that feel exactly like sciatica — pain, burning, or tingling down the back of the leg. This stretch directly targets it.

How to do it: Lie on your back. Cross one ankle over the opposite knee, creating a figure-4 shape. Reach through the gap and pull the uncrossed leg toward your chest. You'll feel the stretch deep in the crossed-leg glute. Hold 30–45 seconds. 3 reps per side. If you feel numbness rather than a stretch, stop and have a PT assess you.

Exercise 11 — Hip Strength

Clamshell

Targets the gluteus medius — the hip abductor that stabilizes your pelvis with every step. Weakness here causes the hip to drop during walking, which shifts load asymmetrically onto the lower back. This is one of the most commonly weak muscles I find in patients with chronic unilateral back pain.

How to do it: Lie on your side with knees bent at 90°, hips stacked. Without rolling your top hip back, lift your top knee as high as possible. Hold 2 seconds at the top. Lower slowly. Do 3 sets of 15 reps per side. Add a resistance band above the knees when bodyweight becomes easy.

Lower Back Pain Exercises to Avoid

This is the section most exercise lists skip — but it matters just as much as what you should do. Some exercises are commonly recommended for back pain but consistently make things worse for people with disc involvement, spinal stenosis, or acute pain.

⚠️ Sit-Ups and Traditional Crunches

Repeated lumbar flexion under load significantly increases disc pressure. Research by Dr. Stuart McGill showed that a full sit-up can generate compressive forces on the lumbar spine exceeding 3,000 N. For someone with an already irritated disc, this is the last thing you want. Replace them with dead bugs and planks.

⚠️ Standing Toe Touches

Standing and bending forward to touch your toes loads the posterior disc wall maximally. For most acute back pain — especially disc-related — this is a provocative position that should be avoided until you've been assessed. Hamstring tightness can be addressed with supine hamstring stretches instead.

⚠️ Double Leg Raises

Raising both legs simultaneously while lying on your back creates a massive lever arm that pulls your lumbar spine into extension. This spikes disc and facet joint pressure. Even people with strong cores struggle to maintain neutral spine during double leg raises. Single-leg variations with strict bracing are far safer.

⚠️ High-Impact Cardio During a Flare

Running, jumping, and plyometrics generate significant spinal compression forces. During an acute back pain episode, stick to walking, swimming, or cycling until the pain has settled. Walking is actually one of the best exercises for back pain — it loads the spine gently while promoting blood flow and encouraging upright posture.

⚠️ Heavy Deadlifts Without Proper Form Assessment

Deadlifts can be excellent for back pain rehabilitation — but only with proper hip-hinge mechanics and an appropriate load. Loading a rounded lumbar spine repeatedly is a recipe for disc injury. If you want to return to heavy lifting, work with a PT first to assess and correct your movement pattern.

The real rule: If an exercise consistently increases your pain during or after performing it — especially pain that radiates down your leg — stop immediately. Pain is not always "weakness leaving the body" when it comes to the spine. Trust your body and get an assessment.

Lower Back Pain Exercises at Home: Building a Daily Routine

You don't need equipment to start recovering from back pain. Here's a simple home routine using the exercises above, designed for someone in the early stages of a program or managing chronic pain between PT sessions.

Morning routine (10 minutes): Cat-cow × 10 reps, knee-to-chest stretch × 3 per side, lumbar rotation × 3 per side, child's pose × 60 seconds. Do this before getting out of bed or immediately after.

Strengthening routine (15–20 minutes, 3–4x per week): Dead bug × 3 sets of 8 per side, bird dog × 3 sets of 8 per side, glute bridge × 3 sets of 12, clamshell × 3 sets of 15 per side, kneeling hip flexor stretch × 3 per side. These form the foundation of most back pain programs I prescribe in-clinic.

Daily habit: Walk for 20–30 minutes. Walking is genuinely one of the most effective exercises for lower back pain — it's low-impact, maintains lumbar range of motion, and keeps the spinal muscles active without overloading them. If you can only do one thing, walk.

Not getting results from home exercises?

If your lower back pain keeps returning or isn't improving with exercise, a one-on-one assessment with Dr. Cisneros will identify the root cause — whether it's a disc, facet joint, or movement pattern issue — and build a plan specific to your diagnosis, not just your symptom. Cash-based, no referral needed, same-week appointments in West El Paso.

Book a Back Pain Assessment (915) 318-7381

When Exercise Isn't Enough: Time to See a PT

Home exercise works well for mild to moderate back pain that has a clear mechanical cause (tight muscles, weak core, poor posture). But there are situations where going it alone can delay recovery or cause harm.

See a physical therapist if your pain has lasted more than 4–6 weeks without meaningful improvement, if pain is radiating down your leg (especially past the knee), if you've had multiple episodes of back pain in the past year, if you've recently had a fall or trauma, or if over-the-counter medication isn't touching the pain. A PT can identify the exact cause — whether it's a disc, facet joint, muscle, or movement pattern issue — and build a program specific to your diagnosis, not just your symptom.

At Solas PT in El Paso, every session is one-on-one with Dr. Cisneros. No aides, no shared treatment tables, no rushing through exercises with a printout. You get 45–60 minutes of focused assessment and treatment every visit. Most back pain patients see meaningful improvement within 3–5 sessions.

Frequently Asked Questions

If I had to pick one, it's the glute bridge. It simultaneously strengthens the glutes, hamstrings, and lumbar extensors, decompresses the discs while in the supine position, and teaches proper hip extension mechanics without loading the spine under gravity. It's safe for nearly everyone, requires no equipment, and addresses one of the most common contributors to back pain — weak glutes. That said, a single exercise is rarely enough — a complete program always outperforms any one move.

Most people notice some improvement within 2–4 weeks of consistent exercise. Acute muscle strains often resolve faster — sometimes within 1–2 weeks. Disc-related pain and chronic cases typically take 6–12 weeks of progressive exercise to see significant change. The biggest mistake is stopping when you feel better — that's exactly when the strengthening work is most important, because the underlying weakness that caused the episode hasn't been corrected yet.

Yes — walking is one of the best things you can do for lower back pain. It's low-impact, maintains spinal mobility, promotes blood flow to the discs, and activates the core and glutes with every step. Aim for 20–30 minutes daily. If walking increases your pain significantly, shorten the duration and see a PT to identify why — it may indicate a specific diagnosis that changes your program.

Yes, with some caveats. Gentle yoga — specifically poses like child's pose, cat-cow, supine twists, and supported bridge — are excellent for back pain and align closely with what PTs recommend. However, deep forward folds, intense backbends (like full wheel), and poses requiring extreme lumbar flexion can aggravate disc injuries. If you want to use yoga for back pain, start with a restorative or beginner class and avoid any pose that increases radiating leg pain.

Move, don't rest — but move intelligently. Complete rest beyond 1–2 days worsens outcomes for almost all forms of back pain. Gentle movement maintains disc health, prevents muscle atrophy, and reduces the fear-avoidance cycle that often turns acute pain into chronic pain. The exercises in this guide are designed to be safe during most back pain episodes. The exception: if you have severe pain, neurological symptoms (leg weakness, bowel or bladder changes), or pain from a recent trauma, see a healthcare provider before exercising.

No. Texas is a direct access state, which means you can book a PT appointment without a physician referral. You can call Solas PT directly, get assessed, and start a personalized back pain exercise program this week — no waiting rooms, no referrals, no insurance games. Most patients see Dr. Cisneros within a few days of reaching out.

Ready for a Program Built for You?

Generic exercise lists can only take you so far. If your lower back pain keeps coming back — or isn't responding to home exercises — a one-on-one assessment with Dr. Cisneros will identify exactly why, and build a plan that fixes the root cause, not just the symptom.

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Call or Text: (915) 318-7381

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