The Best and Worst Exercises for Back Pain (Ranked by a Corrective Therapist)

Back pain advice is everywhere — on YouTube, in physiotherapy pamphlets, on wellness apps, in the gym. Most of it is generic. Some of it is actively counterproductive for specific presentations. This guide is not generic: it is structured around the movement dysfunctions we most commonly see in our clients with back pain, and it separates what works from what makes things worse.

One important caveat: there is no universal answer to "what exercise is best for back pain?" The right exercise depends entirely on what is driving the pain. What follows is a pattern-based guide — useful for most common presentations, but not a substitute for an individual assessment.

Exercises that help most lower back pain

1. Hip 90/90 mobility work

Most lower back pain is driven, at least in part, by hip stiffness. The 90/90 position — sitting with both hips at 90 degrees, one internally rotated and one externally rotated — trains both directions of hip rotation simultaneously. Five minutes daily, done correctly, produces measurable improvements in hip mobility within two weeks. More hip mobility = less lumbar compensation.

2. Dead bug variations

The dead bug is not flashy. It is one of the most effective deep core activation exercises that exists. It trains the transversus abdominis and multifidus — the deep stabilisers that have typically been inhibited in chronic back pain presentations — while keeping the spine in a neutral, low-load position. Do it slowly. Do it with full exhale before each movement. Do not substitute speed for control.

3. Glute bridges (with correct technique)

Glute bridges reactivate the glutes, which are typically inhibited in lower back pain. The key is squeezing from the glutes — not the hamstrings or lower back. If you feel this in your lower back, you are not using your glutes. Shift focus. The bridge itself should feel like work in the back of the hip, not the spine.

4. Thoracic extension over a foam roller

Most desk workers have a stiff, kyphotic thoracic spine (upper and mid-back). When the thorax cannot extend, every rotational and extension demand falls to the lumbar spine. Five minutes of extension mobilisation over a foam roller — placed horizontally across the mid-back, not the lower back — is one of the fastest mobility improvements available for lower back pain driven by thoracic restriction.

5. Walking (30+ minutes, flat surface)

Walking is the most underrated back pain intervention in existence. It provides rhythmic spinal loading, activates the hip extensors, drives thoracic rotation, and stimulates the deep spinal stabilisers in a way that no gym exercise quite replicates. It also reduces cortisol, which matters — pain is often magnified by stress-related nervous system sensitisation.

The best exercise for your back is the one that addresses what is actually wrong with your movement, not the one with the most Instagram endorsements.

Exercises that often make back pain worse

1. Sit-ups and crunches

For most lower back pain presentations, sit-ups compress the lumbar discs in a flexed position under load — the exact scenario most clinical guidelines recommend avoiding. Crunches train the rectus abdominis, which is almost never the weak link in lower back pain. They are not evil exercises in healthy spines. They are the wrong prescription for a symptomatic spine.

2. Hamstring stretching (without context)

Tight hamstrings are often a symptom of lumbar instability, not the cause of back pain. The nervous system keeps the hamstrings short as a protective bracing strategy when the deep spinal stabilisers are not doing their job. Aggressive hamstring stretching can reduce this protective tone before the spine has the stability to manage without it. Restore deep core stability first. The hamstrings often lengthen spontaneously.

3. Heavy loaded squats and deadlifts (without corrective preparation)

Heavy compound lifts are excellent for long-term spine health. Loaded squats and deadlifts in a spine that cannot maintain a neutral curve under load, however, compress the lumbar discs and facets in ways that accelerate degeneration. Build the mobility and motor control first. The weight will come — and it will be safe and productive when it does.

4. Twist-and-flex machines at the gym

Rotary torso machines, seated cable rows with excessive forward lean, and most "core" machines in commercial gyms combine lumbar flexion with rotation under load — a mechanism associated with disc injury. They are almost never indicated in the early or middle stages of back pain recovery.

Where to go from here

If you are dealing with back pain and not sure which of these categories applies to you, a movement assessment is the fastest way to get a clear answer. In 60 minutes we can identify what is driving your pain, show you exactly which exercises are appropriate for your presentation, and build a programme around your specific movement pattern.

Take the free posture screen to get started, or book a full assessment directly. If you have already decided you want a structured programme, see the Pain Relief pathway.