The World’s Best Back Exercise?

Updated: Jul 20, 2021

As a chiropractor, patients often ask me what exercises they should be doing to keep their low backs feeling great. This should be a simple answer, right? Infomercials on television boast impressive results with simple home gym equipment, rolling tools, and stretching bands, so you would think recommending a back program should be straightforward. Unfortunately, the one size fits all approach rarely works. Finding the right exercise is like having the right tool for the job; while I am sure you could eventually hammer in a screw it would be much easier and time efficient to use a drill.

So, what considerations should be made when deciding what exercise is best for your spine? While I always recommend talking to a healthcare practitioner before starting a new exercise regimen, determining the specific type of low back pain is an important place to start. Low back pain can fall into four general categories:

Pattern 1: Pain that gets worse when bending forward, generally caused by irritation of the discs in our spine.

Pattern 2: Pain that gets worse when bending backward, generally caused by the joints at the back of our spine, known as facet joints.

Pattern 3: This pain travels down the leg and is due to a compressed nerve. It is felt constantly, and all movements hurt.

Pattern 4: This pain is also felt in the legs but is mostly made worse by waking or standing and is relieved by sitting or bending forward. It is the result of nerve compression secondary to degeneration of the spine.

Depending on which category a patient falls into will change the exercise recommendation. A rule of thumb is to do the opposite of what caused the pain. For example, pattern one pain is aggravated by bending forward so rehab involves bending backwards, whereas pattern 2 follows the exact opposite recommendation. Still, before prescribing an exercise it is important to do a physical assessment to make sure the pain a patient is feeling is really coming from their spine or muscles. There are many conditions that can mimic low back pain. If we have an issue with one of our organs this can often be mistaken for low back pain. Some examples include pain from our kidneys, main blood vessel of the abdomen, or even from a rash like shingles. Part of my job as a Chiropractor is to rule these conditions out or refer patients with these conditions to a specialist.

If it is determined that your pain falls into one of the patterns described above, an important part of care is finding positions that can provide pain relied. Below are some examples of relieving positions used for each type of back pain.

To learn what exercises would be best for you and for a detailed wellness assessment book an appointment today. Here at the Thomas Back and Body we use the most up-to-date research and patient-focused care to ensure you receive the highest quality treatment.


Alleyne J, Hall H, Rampersaud R. Clinically Organized Relevant Exam (CORE) Tool for the Low Back Pain Toolkit for Primary Care Providers. Centre for Effective Practice. Funded by the Government of Ontario; 2013.

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