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Can exercise prevent recurrent low back pain?

Created: ; Last Update: February 14, 2019; Next update: 2022.

Regular exercise can help prevent low back pain from returning. It's important to keep it up over the long term, though. Various strategies can make it easier to do this.

Pain in the lower back (the lumbar and sacral regions of the spine) is very common: Up to 80 % of all people have this kind of pain at some point. Low back pain normally gets better on its own within a few days or weeks. Because it's usually not clear what's causing the pain, it's referred to as "non-specific back pain." This kind of pain is rarely caused by something serious. But it might keep coming back again.

It is often said that the best way to prevent back pain is "more exercise." An international group of researchers wanted to find out whether this claim is true. They did a search for studies looking at whether strengthening exercises, endurance training and aerobic exercise helped to prevent non-specific low back pain. The researchers summarized the results of 21 good-quality studies involving more than 30,000 participants.

In most of the studies, the exercises were led by a physiotherapist. The studies looked at various types of exercise programs. The programs included things like exercises to strengthen and stabilize the core muscles, as well as exercises to stretch the muscles in the calves, hips and thighs. In some of the programs the participants had two 60-minute exercise sessions per week, and in others they did the exercises for 5 minutes every day.

What did the researchers find?

The research summary shows that exercise can effectively prevent back pain:

  • Without exercise, between 41 and 57 out of 100 people had low back pain again within one year,
  • compared to only 27 to 31 out of 100 people who followed an exercise program.

In other words, regular exercise prevented back pain from returning in 14 to 26 out of 100 people.

The studies did not report on side effects. When you start doing exercise, it can lead to muscle ache.

If you already have back pain at the time, it may even get worse at first. But there's no reason to be afraid of moving your body if you have non-specific back pain. On the contrary: The pain is likely to last longer if you don't move enough. For this reason, experts now recommend staying as physically active as possible rather than avoiding movement or even resting in bed.

Staying active in the long term

There is no such thing as an optimal exercise program for everyone. Different types of exercise will be suitable for different people, depending on things like their level of fitness, any other medical conditions they may have, how severe their back pain is, and their personal preferences. No matter what you do, it's important to make sure you stick to your exercise program in the long term too.


  • Steffens D, Maher CG, Pereira LS, Stevens ML, Oliveira VC, Chapple M et al. Prevention of Low Back Pain: A Systematic Review and Meta-analysis. JAMA Intern Med 2016; 176(2): 199-208. [PubMed: 26752509]
  • IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

    Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. We do not offer individual consultations.

    Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

© IQWiG (Institute for Quality and Efficiency in Health Care)
Bookshelf ID: NBK284937


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