Physical Therapy Exercises for Lower Back Pain: Complete Home Treatment Guide

Lower back pain is the most common cause of pain in adults. Its treatment can be tricky but very effective. At-home physical therapy exercises for lower back pain are effective ways to not only cure the pain but learn ways to prevent it in the future. Let's review evidence-based treatments and what I, as a licensed Physical Therapist, have seen help hundreds of my patients!

A good physical therapy program can be essential to getting your lower back feeling better. This is a comprehensive program that I go over with my clients to help them strengthen, mobilize, and improve the range of motion of the lower back. Do this routine at home for 3-4 weeks every other day, and you can expect to see a difference in how your body feels! Let's get started!

Understanding Your Back Pain

Your back can hurt for many reasons, and the root cause can be hard to find. I see clients that have sciatica, degeneration, and more in their back. I see clients with sciatica, degeneration, and various other conditions - and they all get better, often without finding the exact cause. Back pain, especially chronic pain, is often a representation of habits of health. For example, how much do you move, what do you do to improve your body?

Only 10% of back pain can be identified with an image such as MRI or X-ray. You may feel like you need one, but often you don't. You are better off with a physical examination, and this is clear in the literature¹.

The short answer is that back pain is caused by many factors and if we knew what caused everyone's back pain, no one would suffer from back pain. 

Ideally, taking what you feel combined with how you move will shed light on the best places to start when you suffering from back pain.

Before You Begin At-Home Physical Therapy

When dealing with back pain, it's essential to understand the right approach to exercise. Here are key principles to follow:

1. Quality over quantity: Take your time and focus on proper form. This allows your body to get the most out of the exercises.
2. Slow and controlled movement: Many times we get into trouble when we do too much, too quick. I rarely hear of people getting hurt while going slow.
3. Flirt with discomfort, never go past it: This is key! Back pain can be very uncomfortable, and when you add exercise, it can be scary. "No pain, no gain" IS NOT the way to treat your back pain. Listen to your body and stop if you need to stop

I have seen exercise fix back pain many times in my career and other times not. It never makes any of my clients worse but they can feel like it's harmful at times without the right education. It's about the right amount at the right time.

Acutely, the best rest may be appropriate. This is usually only one day. When you look at the evidence the top treatments for back pain are education and exercise. Yes, medication, physical therapy, chiropractic, and acupuncture have their place, but they aren't needed in many cases². When pain lingers for more than 3-4 weeks or so, then they can be effective.

If I had to boil down lower back pain and exercise it's about dosage.

Just like medication, if you take too much, you can overdose it. If you don't do enough, you won't have the change you are looking for. To add another layer to it, there are some exercises that should be avoided with some conditions. It's complicated but simple at the same time.

Most often, stretching and mobility exercises can really help lower back pain.

At-Home Physical Therapy Exercise Program

Each of the physical therapy exercises listed below is great for lower back pain, and you can do them right from the comfort of your own home. The essential thing for you to know is that you need to listen to your body! If you begin doing some of the exercises and you feel pain, stop. Only go through the range of motion until you feel a bit of mild discomfort. Flirt with the discomfort; do not cause pain! During this routine, just listen to your body and stop if you need to stop. Scale back the exercise if you need to. Any movement is good for you, so take your time and do what feels good for you! Let's get started.

Disclaimer

• Lumbar Rotation
• Posterior Tilting
• Bridges
• Glute Stretch with a Pulse
• Single Leg Bridge
• Prayer Stretch
• Cat Camel
• Thread the Needle
• Table Top
• Bird Dog
• Downward Dog to Up Dog
• Windmills

Lumbar Rotation

Start on your back for this exercise, either on the floor or in your bed. You will then put your feet on the ground and rock your knees side to side. As you do this, you should feel a stretch on the other side of your lower back. How far you go on this stretch is based on how you feel, so listen to your body. Do about 20 of these and you will feel your back loosen up.

Posterior Tilting

Posterior Tilting is done in the same position as the lumbar rotation, work on flexion and extension of the back. You are going to flatten your back onto the ground and then increase the space between the ground and your back. This will work on range of motion and your motor control. Do this for 20 reps.

Bridges

In the same position, you are going to drive through with your heels and bring your hips up. Squeeze your glutes at the top of the stretch. This is going to help with strengthening. Don't worry too much about how high you lift your hips, just attempt to hold the contraction and feel your glutes work as you lift. Do 20 reps of this.

Glute Stretch

Bring your knees to your chest, and hold onto one knee with your hands. Let the other one extend back onto the floor. Pull the knee that you are holding to the opposite side of your body. This stretch should be felt in your glute, not in your groin. So if you feel pain in your groin, stop. Relax and then try again. Do this for 10 reps.

Single Leg Bridge

This exercise is a little more difficult. You are going to get in the same position you did earlier with the regular bridges. This time, put one leg in the air and the other will be on the ground driving through the heel to get those hips up. do this for about 20 reps. If this is too difficult, no worries! Go back to the regular bridging and you will work your way up to the single leg.

Prayer Stretch

Now we are going to move into a different position. Get on your hands and knees and you are going to place your hands out in front of you, and sit your butt back on your feet. This is such a good stretch for your lower back. Hold the stretch for 10 seconds, release, and then go again.

Cat Camel

Up on your hands and knees, you are going to tuck your pelvis in and then poke your butt out. This is going to help with flexion and extension of your lower back. Do this for about 12 reps.

Thread the Needle

In the same position, take one arm and thread it through the other. Then you are going to reach back around and try to touch the ceiling. The perfect amount of reps of these is based on you and your body! I usually recommend doing this for about 10 reps on each side.

Table Top

For this, start on your hands and knees and then tuck your toes in, and then push up and lift your body off the ground. This is going to help with that strengthening. Tighten your core and hold this for 30 seconds or as long as you can. This is a difficult one as well. So if you are unable to do this, do not get discouraged! Just move on to the next one.

Bird Dog

This is going to help with your trunk strengthening. On your hands and knees, stretch your right arm out and your left leg out. Then switch to the other side. As you are doing this, be sure to squeeze your glutes. If you cannot stretch your arms and legs out too far, that is okay! Do as much as you can and do what feels good to your body! I usually say do 10 reps of this movement.

Downward Dog to Upward Dog

This is a mobility exercise. You are going to start in a plank position and then move up in to an upward dog. Here, pedal your feet for about 10 reps. Then you will go down into a downward dog and stretch out that back. This helps with the extension of the spine. Make sure to keep your hips relaxed and enjoy that nice stretch for about 5 reps.

Windmills

The last movement will be on your back again. Grab one knee and bend it over your opposite leg. Then reach to the side. You will be able to feel a great stretch in your lower back! Do this for about 5 reps. .

Making These At-Home Exercises Work For You

Physical therapy exercises for lower back pain require you to take your time. Really focus on engaging what you're supposed to engage. This allows your body to get the most out of the exercises. You may be good at some and worse at others - this is completely normal.

If you stay consistent and do these 12 exercises every other day for 3 to 4 weeks, I guarantee that you will be able to see a difference in your range of motion, mobility, and strength. This routine is amazing to get rid of lower back stickiness!

When to Expect Results

• Most people notice improvement in flexibility within the first week
• Strength gains typically begin to show after 2-3 weeks
• Consistency is key - doing the exercises regularly is more important than doing them perfectly

When to Seek Professional Help

If you experience any of these situations:

• Pain that gets worse or doesn't improve after a few weeks
• Numbness or tingling that extends into your legs
• Severe pain that interferes with sleep
• Loss of bladder or bowel control (seek immediate medical attention)

In conclusion, implementing a structured physical therapy program can help tackle back pain. While we may not always know the exact cause or reason for the discomfort, that doesn't mean you can't improve. Try these exercises and give yourself some grace as you go. Realize you may not be perfect at first but modify and adapt as needed. You got this!

Revision Health Services offers massage and physical therapy locally in Jacksonville, Nocatee, and Ponte Vedra, Florida. To find out if our services could be the best fit for you, reach out and let's chat!

Until next time, stay healthy, keep moving, and take care of yourself.

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