Exercises for Lower Back Pain: NHS Guide

A stiff lower back transforms simple tasks—tying your shoes, sitting through meetings—into daily frustrations. The solution is targeted movement, not rest, and NHS physiotherapists across the UK consistently recommend the same handful of exercises to loosen things up. Below is a step-by-step guide drawn from NHS trusts, physiotherapists, and verified clinical resources.

BHF workout duration: 15 minutes · NHS exercises listed: Knee rolls, pelvic tilts · Healthline stretches: 8 simple options · HSS PT recommendations: Forward bends, seated stretches

This table shows the specialist sources and key moves referenced across NHS and international physiotherapy guidance for lower back pain relief.

What is the best exercise for lower back pain?

There is no single exercise that works best for every person, but several moves appear across NHS trusts with strong consistency. Among the most frequently recommended are knee rolls, pelvic tilts, and the cat-cow yoga pose. Each of these targets a different aspect of back health—mobility, muscle activation, or spinal alignment—so a short routine combining two or three of them tends to outperform doing just one move repeatedly.

Knee-to-chest stretch

Lie on your back with knees bent and feet flat on the floor. Bring one knee gently toward your chest, holding for 10–30 seconds, then switch sides. According to NHS Ayrshire & Arran (NHS Trust), knee rolls can be performed for 60 seconds continuously or in 10-second holds, up to four times daily. Arthritis UK also lists the move with 10-second holds on each side, repeated three times per side.

Pelvic tilts

Lying face up with knees bent, flatten your lower back against the floor by tightening your stomach muscles. Hold for approximately 5 seconds, then release. MSK Dorset NHS recommends 5 repetitions, while the Mayo Clinic notes that up to 30 repetitions per day can support lower back flexibility.

Cat-Cow pose

Starting on hands and knees, alternate between arching your back upward (cat) and letting it sag downward (cow). A YouTube demonstration by Dr O’Donovan and physiotherapist Ella Boys (Medical Doctor & Physiotherapist) shows this alongside Child’s Pose, Glute Bridge, and Knees to Chest as part of an eight-exercise lower back routine.

What are the big 3 exercises for lower back pain?

Several NHS and physiotherapy sources converge on a core set of three movement patterns that address the most common drivers of lower back pain: weak core muscles, tight hamstrings, and restricted hip mobility. These are not the only useful exercises, but they form a reliable starting foundation.

Core strengthening basics

Core training improves the stability of the spine. A study referenced by orthopaedic surgeon William M. Winom highlights that back pain patients who added core strengthening to their routine saw measurable functional improvements over those who did not. The Glute Bridge is a foundational core move: according to the WWL NHS Foundation Trust (Level 1 physiotherapy plan), the Glute Bridge involves lying on your back with knees bent, lifting your buttocks while squeezing your glutes, holding for 2 seconds, and completing 10 repetitions.

Knee hugs

From a lying position, bring both knees toward your chest and wrap your arms around them. Hold for 10–20 seconds, then release. NHS guidelines across multiple trusts list this move as a go-to for gently decompressing the lumbar spine.

Seated hamstring stretch

Sit on the floor with one leg extended and the other bent. Lean forward from your hips toward the extended foot, holding for 20–30 seconds per side. Tight hamstrings are a common contributor to lower back discomfort, and stretching them regularly helps reduce compensatory strain on the lumbar region.

How to loosen a tight lower back?

A tight lower back usually means the muscles around the lumbar spine are gripping to protect an area they sense as vulnerable. Loosening them involves gentle movement, not force, and staying consistent over days rather than expecting instant results.

Forward bends

Sitting tall with legs extended, exhale and fold forward from your hips, reaching toward your feet. Hold for about 5 seconds and return to sitting. According to NHS Ayrshire & Arran (NHS Trust), forward bends in sitting can be repeated 10 times in 3–4 sessions per day.

Seated trunk rotations

Sit upright with legs extended, cross one leg over the other, and rotate your torso toward the bent knee. The Mayo Clinic (US medical institution) describes a lower back rotational stretch involving 5–10 second holds on each side, repeated 2–3 times per side.

Double knee hug

Lying flat, draw both knees toward your chest and hold them with both arms. This simultaneously stretches the lower back and releases tension in the hip flexors.

What lower back pain exercises to avoid?

Not all movement helps during a lower back pain episode. Some exercises place load or torque on the lumbar spine in ways that can intensify pain, particularly when done during an acute phase.

High-impact moves

Running on hard surfaces, jumping exercises, or high-intensity interval training during an acute pain episode can jar the lumbar joints. The Dynamic Health Physiotherapy NHS (NHS Physiotherapy Service) advises keeping activity gentle and low-impact until pain subsides.

Heavy lifts

Deadlifts, barbell squats with heavy load, and weighted lunges place significant compressive force on the lower back. These are best postponed until a physiotherapist has assessed your specific condition.

Extreme twists

Deep spinal twists while standing or lying down, especially when combined with load, can stress the intervertebral discs. Save rotational stretches for later stages of recovery once you have regained pain-free range of motion.

What are 5 red flags of low back pain?

Most lower back pain resolves within weeks with gentle movement and conservative care, but a small number of cases involve underlying conditions that require urgent medical attention.

When to seek medical help

• Numbness or tingling that radiates down one or both legs and causes weakness
• Loss of bladder or bowel control (cauda equina syndrome — a medical emergency)
• Unexplained fever combined with back pain
• Pain that is worse at night or when lying down (as opposed to when moving)
• Unexplained weight loss accompanying persistent back pain

Urgent symptoms

If you experience any combination of the symptoms above — especially neurological signs like foot drop or sudden incontinence — seek urgent care or visit an accident and emergency department. Do not wait for a routine physiotherapy appointment. The NHS (official NHS site) also recommends contacting a GP or physiotherapist promptly if pain is new, severe, or has no clear trigger.

Step-by-step exercise routine

The following routine draws from NHS physiotherapy sources and can be performed at home without equipment. Aim for 3–4 sessions per week with a rest day between sessions for muscle recovery.

Before you begin

• Wear comfortable clothing that allows a full range of motion
• Find a clear floor space, ideally on a yoga mat or carpet
• Only proceed if you feel comfortable — stop immediately if any movement causes sharp pain

Step 1 — Knee rolls warm-up

Lie on your back, knees bent, feet flat on the floor. Keeping your shoulders relaxed, lower your knees gently to one side, hold for 10 seconds, then switch sides. Repeat 3 times per side. NHS Ayrshire & Arran recommends this as a warm-up because it gently mobilises the lumbar spine without loading it.

Step 2 — Pelvic tilts

From the same starting position, flatten your lower back against the floor by drawing your belly button toward your spine. Hold for 5 seconds, then release. MSK Dorset NHS specifies complete 5 repetitions, keeping the movement slow and controlled.

Step 3 — Glute bridge

Still lying on your back with knees bent, press through your feet to lift your hips off the floor until your body forms a straight line from shoulders to knees. Squeeze your glutes at the top, hold for 2 seconds, then lower slowly. The WWL NHS Foundation Trust specifies 10 repetitions per session.

Step 4 — Cat-Cow

Move onto hands and knees, with wrists directly under shoulders and knees under hips. As you inhale, arch your back and lift your head (cow). As you exhale, round your spine and tuck your chin (cat). Flow between positions for 60 seconds, breathing smoothly throughout.

Step 5 — Child’s Pose

From hands and knees, sit your hips back toward your heels and reach your arms forward along the floor, resting your forehead on the mat. Hold for 10 seconds, then return to all fours. NHS Ayrshire & Arran lists this as a recovery pose to be performed 5 times per session.

Step 6 — Knee-to-chest stretch

Lie on your back and draw one knee toward your chest, holding with both hands. Keep the opposite leg extended or slightly bent. Hold for 10–20 seconds, then switch sides. Repeat 3 times per side.

Step 7 — Seated hamstring stretch

Sit with one leg extended and the other foot placed against the inner thigh of the extended leg. Reach forward from your hips, keeping your back straight. Hold for 20–30 seconds per side.

Recovery guidance

• Rest for at least 30 seconds between sets
• If any movement causes pain lasting more than 2 hours afterward, reduce the number of repetitions
• Consult a physiotherapist if pain worsens at any point

If the exercise causes pain that lasts for more than 2 hours after finishing the exercise, then decrease the repetitions.

— WWL NHS Foundation Trust (Physiotherapy Department)

Keep active and don’t stay in the same position for long periods — research shows that bed rest for more than a couple of days can make the pain worse.

— Dynamic Health Physiotherapy (NHS Physiotherapy Service)

Only do these if you feel comfortable to and don’t push yourself beyond the limit of comfort initially.

— Dr O’Donovan (MD) & Ella Boys (Physiotherapist)

The picture that emerges from NHS trusts, physiotherapists, and international medical sources is consistent: a tight or aching lower back responds better to gentle, regular movement than to rest. The exercises above — knee rolls, pelvic tilts, glute bridges, cat-cow, and hamstring stretches — form a practical starting routine that most people can begin at home today, with no equipment beyond a mat. The key caveat is listening to your body. Red flags such as neurological symptoms, unexplained fever, or pain that worsens at night warrant a prompt visit to a GP or urgent care rather than self-treatment. For the majority without those warning signs, committing to three or four short sessions per week, staying active between sessions, and adjusting volume if pain lingers beyond two hours after exercising is a reasonable, evidence-grounded path toward relief.

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Beyond knee rolls and pelvic tilts in the NHS guide, the McGill Big 3 stability protocol builds enduring core stability to prevent future flare-ups.

Frequently asked questions