From the Guidelines
For patients with lower back pain exacerbated by prolonged sitting or standing, I recommend a balanced weekly exercise program focusing on core strengthening, flexibility, and low-impact aerobic activities, as this approach has been shown to reduce pain and improve function in patients with chronic low back pain 1.
Key Components of the Exercise Program
- Core strengthening exercises: modified planks (15-30 seconds, 3 sets), bird-dogs (10 repetitions each side, 3 sets), and gentle bridges (10-15 repetitions, 3 sets) to strengthen the muscles that support the spine
- Flexibility work: gentle stretches like child's pose, cat-cow stretches, and hamstring stretches, holding each for 20-30 seconds and repeating 3 times to improve range of motion and reduce muscle tension
- Low-impact aerobic activities: daily walking for 20-30 minutes at a comfortable pace, gradually increasing duration as tolerated to promote blood flow and reduce stiffness
Weekly Schedule
- Monday, Wednesday, and Friday: strength training (15-20 minutes)
- Tuesday, Thursday, Saturday: flexibility (10-15 minutes)
- Daily: walking (20-30 minutes)
Additional Recommendations
- Maintain proper posture during exercises to avoid exacerbating the condition
- Avoid movements that cause pain and take frequent breaks from prolonged sitting/standing (every 30 minutes)
- Use a lumbar support cushion while sitting and wear supportive footwear while standing to provide additional relief
- Gradually progress the exercise program to allow the body to adapt without aggravating symptoms, as individualized regimens, supervision, stretching, and strengthening have been associated with the best outcomes 1
From the Research
Exercise Recommendations for Lower Back Pain
To manage lower back pain, especially when sitting or standing for prolonged times, exercise is a crucial component of treatment 2, 3. The goal is to improve flexibility, strength, and posture, which can help alleviate pain and prevent future episodes.
Weekly Training Schedule
A weekly training schedule for a patient with lower back pain could include:
- Monday (Upper Body and Core):
- Warm-up: 5-10 minutes of light cardio (jogging, cycling, or swimming)
- Strengthening exercises: Focus on upper body and core muscles (push-ups, rows, planks)
- Cool-down: 5-10 minutes of stretching
- Tuesday (Lower Body):
- Warm-up: 5-10 minutes of light cardio
- Strengthening exercises: Focus on lower body muscles (squats, lunges, leg press)
- Cool-down: 5-10 minutes of stretching
- Wednesday (Rest Day)
- Thursday (Flexibility and Balance):
- Warm-up: 5-10 minutes of light cardio
- Flexibility exercises: Focus on hamstrings, hip flexors, and lower back (static stretches)
- Balance exercises: Single-leg squats, balance boards, or BOSU ball training
- Cool-down: 5-10 minutes of stretching
- Friday (Core and Lower Body):
- Warm-up: 5-10 minutes of light cardio
- Strengthening exercises: Focus on core and lower body muscles (deadlifts, leg curls, leg extensions)
- Cool-down: 5-10 minutes of stretching
- Saturday (Active Recovery):
- Light cardio: 30-60 minutes of low-intensity cardio (jogging, cycling, or swimming)
- Sunday (Rest Day)
Additional Recommendations
- Walking Breaks: Incorporate regular walking breaks every 25-30 minutes to reduce prolonged standing-induced low back pain 4.
- Sitting Time: Limit sitting time to less than 7 hours per day, and engage in regular physical activity to reduce the risk of chronic low back pain 5.
- Progressive Overload: Gradually increase the intensity and difficulty of exercises over time to continue challenging the muscles and promoting progress.
- Proper Posture: Maintain proper posture during exercises and daily activities to reduce the risk of injury and alleviate low back pain.