Best Physiotherapy Exercises for Lower Back Pain
- Lee Grandchamp
- Aug 4
- 8 min read
Lower back pain is one of the most common musculoskeletal conditions, affecting up to 80% of people at some point in their lives. Fortunately, most cases are non-specific, meaning they are not caused by serious conditions such as fractures, infections, or severe nerve damage. In these cases, staying active and following a structured physiotherapy exercise program is often more effective than prolonged bed rest.
Gentle stretching, mobility exercises, and core strengthening can help reduce pain, improve flexibility, restore movement, and lower the risk of future flare-ups. When performed consistently and with proper technique, these exercises support recovery and help you return to everyday activities with greater confidence.
This guide includes 12 physiotherapist-recommended lower back exercises that you can safely perform at home. While these exercises are suitable for many people, they are intended for general educational purposes. If your pain is severe, persists, or is accompanied by numbness, tingling, or leg weakness, consult a qualified physiotherapist or physician before starting a new exercise program.
Understanding Lower Back Pain
Lower back pain generally falls into two broad categories:
Musculoskeletal (mechanical) Back Pain
Which comes from the muscles, ligaments, joints, or discs of the spine. This is the most common type and is often linked to poor posture, muscle strain, prolonged sitting, deconditioning, or repetitive movement patterns. It typically stays localized to the back, though it can sometimes refer into the buttock or thigh.
Neurologic Back Pain
This involves irritation or compression of a spinal nerve, for example, from a herniated disc or spinal stenosis. This type of pain often radiates further down the leg (sometimes called sciatica) and may come with numbness, tingling, or weakness.
Most cases of new low back pain are mechanical and improve on their own within a few weeks. Historically, bed rest was a common recommendation, but current physiotherapy and medical guidelines favor early, gentle movement instead. Prolonged inactivity can stiffen the spine, weaken supporting muscles, and slow recovery, while controlled movement helps maintain blood flow to spinal tissues, keeps joints mobile, and prevents the deconditioning that makes pain linger longer.
That said, movement should be graded and pain-informed pushing through sharp or worsening pain isn't the goal. This is where a physiotherapist's guidance becomes valuable.
How Physiotherapy Helps With Lower Back Pain
A physiotherapist treating lower back pain typically combines a few approaches:
Manual therapy
Hands-on techniques such as soft tissue massage and mobilization to reduce muscle tension and improve joint movement.
Joint mobilization
Gentle, graded movement of the spinal joints to restore range of motion and reduce stiffness.
Guided therapeutic exercise
A structured program of stretching and strengthening exercises, progressed over time based on how the person responds.
Together, these approaches offer several benefits:
Improved flexibility
In the hips, hamstrings, and spine, which reduces strain on the lower back during daily movement.
Enhanced core stability
Since the deep abdominal and back muscles act like a natural support belt for the spine.
Reduced risk of recurrence
As building strength and movement habits addresses some of the underlying contributors to pain, rather than just easing symptoms in the moment.
A physiotherapist also tailors the pace and choice of exercises to the person's specific presentation, since not every exercise is appropriate for every type of back pain.
12 Best Physiotherapy Exercises for Lower Back Pain
The exercises below are commonly used in physiotherapy programs for general, non-specific lower back pain. Move slowly, stay within a comfortable range, and stop any exercise that sharpens your pain or sends symptoms down your leg.
1. Cat-Cow Stretch
How to do it:
Start on your hands and knees, wrists under shoulders and knees under hips. Inhale as you drop your belly and lift your chest and tailbone (Cow), then exhale as you round your spine toward the ceiling, tucking your chin and pelvis (Cat).
Sets/reps:
10–15 slow repetitions, once or twice a day.
Form tip:
Move through your whole spine, not just your neck or lower back - let the motion flow evenly from your tailbone to your head.
2. Knee-to-Chest Stretch
How to do it:
Lie on your back with knees bent. Gently pull one knee toward your chest using both hands, keeping the other foot flat on the floor. Hold, then switch sides.
Sets/reps:
Hold 20–30 seconds per side, 2–3 repetitions each.
Form tip:
Keep your lower back gently pressed toward the floor rather than arching as you pull the knee in.
3. Pelvic Tilts
How to do it:
Lie on your back with knees bent and feet flat. Tighten your abdominal muscles and flatten your lower back against the floor by slightly tilting your pelvis, then release.
Sets/reps:
10–15 repetitions, holding each tilt for 5 seconds.
Form tip:
This is a subtle movement - focus on engaging your deep core muscles rather than pushing hard with your legs or hips.
4. Bird Dog
How to do it:
Start on hands and knees. Extend one arm straight ahead while extending the opposite leg straight behind you, keeping your hips and shoulders level. Hold, then return and switch sides.
Sets/reps:
8–10 repetitions per side, holding each for 3–5 seconds.
Form tip:
Keep your spine neutral and avoid letting your hips rotate - imagine balancing a cup of water on your lower back.
5. Bridges
How to do it:
Lie on your back with knees bent and feet flat, hip-width apart. Squeeze your glutes and lift your hips off the floor until your body forms a straight line from shoulders to knees, then lower slowly.
Sets/reps:
10–15 repetitions.
Form tip:
Push through your heels and avoid overarching your lower back at the top of the movement.
6. Child's Pose
How to do it:
Kneel on the floor, sit back onto your heels, and reach your arms forward, lowering your chest toward the ground.
Sets/reps:
Hold for 20–30 seconds, repeating 2–3 times.
Form tip:
Let your lower back relax and lengthen rather than actively stretching - this should feel gentle, not intense.
7. Dead Bug
How to do it:
Lie on your back with arms reaching toward the ceiling and knees bent at 90 degrees ("tabletop" position). Slowly lower one arm overhead and the opposite leg toward the floor while keeping your lower back pressed down, then return and switch sides.
Sets/reps:
8–10 repetitions per side.
Form tip:
Only lower your arm and leg as far as you can go without your lower back arching off the floor.
8. Clam Shells
How to do it:
Lie on your side with hips and knees bent, feet stacked together. Keeping your feet touching, lift your top knee upward like an opening clamshell, then lower it slowly.
Sets/reps:
10–15 repetitions per side.
Form tip:
Keep your hips stacked and avoid rolling your pelvis backward as you lift the knee.
9. Thoracic/Lumbar Extension (Cobra-Style)
How to do it:
Lie face down with forearms or hands on the floor under your shoulders. Gently press up, lifting your chest while keeping your hips on the floor and your lower back relaxed.
Sets/reps:
8–10 repetitions, holding each for a few seconds.
Form tip:
Rise only as high as feels comfortable - this is a gentle backward bend, not a full press-up, and shouldn't cause pinching in the lower back.
10. Wall Sits
How to do it:
Stand with your back against a wall, feet shoulder-width apart and a step away from the wall. Slide down into a partial squat, keeping your back flat against the wall, and hold.
Sets/reps:
Hold 15–30 seconds, repeating 3–4 times.
Form tip:
Keep your knees aligned over your ankles and avoid letting them collapse inward.
11. Hip Flexor Stretch
How to do it:
Kneel on one knee in a half-kneeling position, with the other foot planted in front. Gently shift your weight forward until you feel a stretch at the front of the hip of the kneeling leg.
Sets/reps:
Hold 20–30 seconds per side, 2–3 repetitions each.
Form tip:
Keep your torso upright and tuck your pelvis slightly under to deepen the stretch safely - avoid arching your lower back.
12. Toe Touches (Standing Forward Bend)
How to do it:
Stand with feet hip-width apart and slowly hinge forward from your hips, letting your arms and head hang toward your toes, bending your knees as needed.
Sets/reps:
Hold 15–20 seconds, repeating 2–3 times.
Form tip:
Move slowly and only go as far as feels comfortable - this stretch can aggravate some types of back pain, so skip it if it increases leg or back symptoms.
Tips for Doing These Exercises Safely
Warm up first. A short walk or a few minutes of light movement before stretching helps loosen tissues and reduces the risk of straining a cold muscle.
Move slowly and with control. Fast or jerky movements increase the chance of aggravating your symptoms - slow, deliberate reps are more effective and safer.
Stop if pain sharpens. Mild, dull discomfort during stretching can be normal, but sharp, shooting, or worsening pain - especially pain radiating down a leg - is a signal to stop and reassess.
Prioritize consistency over intensity. Doing these exercises regularly at a moderate, comfortable level tends to produce better results than pushing hard for one session and then skipping days.
Consider heat before stretching. Applying a warm compress or heating pad for 10–15 minutes before your routine can help relax tight muscles and make stretching more comfortable. Ice is generally more useful after activity if you notice increased soreness or inflammation.
When to See a Physiotherapist for Lower Back Pain
While many cases of lower back pain improve with rest from aggravating activities and gentle exercise, certain symptoms warrant a professional assessment rather than a home program alone. Consider booking a physiotherapy appointment if you experience:
Numbness, tingling, or weakness in the legs or feet
Pain that radiates down one or both legs, especially past the knee
Back pain that started after a fall, accident, or other injury
Pain that hasn't improved - or has gotten worse - after 1–2 weeks of self-care
Loss of bladder or bowel control, or numbness in the groin area (seek emergency care immediately, as this can indicate a serious spinal condition)
A physiotherapy assessment for lower back pain typically starts with a discussion of your symptoms, medical history, and daily activities, followed by a physical examination of your movement, strength, and posture. From there, your physiotherapist will build a treatment plan suited to your specific findings which may include manual therapy, a progressive exercise program, and guidance on movement or ergonomic changes to support recovery.
Conclusion
Lower back pain is common, but for most people it responds well to staying active rather than staying still. The exercises above covering mobility, stretching, and core strengthening offer a solid starting point for easing discomfort and supporting a healthier back. That said, everyone's back pain is different, and a program that works for one person may not be right for another.
If your pain persists, keeps coming back, or comes with any of the warning signs above, a personalized assessment can make a real difference in how quickly and completely you recover. Book a physiotherapy consultation today to get a tailored treatment plan built around your specific symptoms and goals.
About the Author
Ramachandiran (Rama) Krishnamoorthy, Registered Physiotherapist
Rama is a Registered Physiotherapist with over 17 years of clinical experience. He holds a Bachelor's and Master's degree in Physiotherapy and specializes in musculoskeletal, neurological, sports, and post-surgical rehabilitation. His evidence-based approach combines manual therapy, personalized exercise programs, and patient education to help clients achieve their recovery goals.
Frequently Asked Questions
Can physiotherapy exercises cure lower back pain permanently?
Physiotherapy exercises can reduce pain, improve strength and flexibility, and lower the risk of recurring back pain. While they help manage symptoms effectively, a permanent cure cannot be guaranteed.
How often should I do these exercises?
Gentle stretching and mobility exercises are often recommended daily, while strengthening exercises are typically performed 3–4 times a week. Your physiotherapist can adjust the routine to suit your condition.
Is walking good for lower back pain?
Yes. Walking is a low-impact activity that can reduce stiffness, improve mobility, and support recovery. Start with short walks and gradually increase the duration as your symptoms improve.
Should I stretch or strengthen first?
Most physiotherapy programs begin with gentle stretching and mobility exercises to ease stiffness, followed by strengthening exercises as pain improves. Your physiotherapist will recommend the best progression for your needs.
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