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Rehab Library · Back & neck

Low Back Pain Rehab Guide

A general guide to staying active and rebuilding strength and confidence after low back pain. Use it alongside the advice from your treating practitioner.

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About low back pain

Understanding back pain

Low back pain is very common, and most people experience it at some point in their lives. Often no single structure can be pinpointed as the cause, which is sometimes called non-specific low back pain.

Your spine is strong and well supported. Pain does not always mean damage, and many people find their back pain eases within a few weeks to months. Most people don't need a scan; your practitioner will let you know if one is needed.

What usually helps

• Staying as active as you comfortably can, rather than resting in bed.
• Gradually returning to your usual activities and work.
• Regular movement and exercise that you enjoy.
• Good sleep and managing stress, which can both affect pain.
• Understanding what is happening, so you can move with more confidence.

Before you start

This guide is general information. If you are seeing a practitioner for your back, follow the specific exercises and advice they give you. Move slowly and with control, breathe normally, and stop any exercise that causes sharp pain or pain spreading down your leg.

A simple pain guide

Some discomfort while you move is common and is not usually a sign of harm. As a general guide, keep pain at or below about 3 out of 10 during exercise, and it should settle back to your usual level by the next morning.

If pain goes higher or lingers, ease back on the range, number of repetitions or effort, and let your practitioner know.

Phase 1

Keep moving gently

In the first days of a flare-up, the aim is to keep your back moving and stay as active as you comfortably can. Little and often works well, a few times a day.

Short walks

5–10 minutes, a few times a day

Walking is one of the simplest ways to keep your back moving. Start with short, comfortable walks on flat ground and build up the time gradually.

Knee rolls

10 slow repetitions

Lie on your back with your knees bent and feet flat. Keeping your shoulders relaxed on the floor, slowly let both knees roll to one side as far as is comfortable, then to the other side.

Pelvic tilts

10 slow repetitions

Lie on your back with your knees bent. Gently flatten your lower back into the floor by tilting your pelvis, then gently arch it slightly away. Keep the movement small and smooth.

Cat–cow

8 slow repetitions

On your hands and knees, slowly round your back as you breathe out, then gently let it dip and lift your chest as you breathe in. Only move within a comfortable range.

Single knee to chest

20 seconds each side

Lie on your back with your knees bent. Gently draw one knee towards your chest with your hands until you feel a comfortable stretch in your lower back, then lower and swap sides.

Phase 2

Build strength

As your back settles, building strength in your hips, trunk and legs can help you feel more capable and confident. These are often done 3–4 times a week, gradually increasing the challenge.

Glute bridge

3 sets of 10–12

Lie on your back with your knees bent and feet flat. Squeeze your buttocks and lift your hips until your body forms a line from shoulders to knees. Hold for a breath, then lower slowly.

Bird dog

3 sets of 6–8 each side

On your hands and knees, slowly reach one arm forward and the opposite leg back, keeping your back steady and level. Hold for a few seconds, return, and swap sides.

Dead bug

3 sets of 6–8 each side

Lie on your back with your arms pointing to the ceiling and knees bent above your hips. Slowly lower one heel towards the floor while keeping your lower back steady, then return and swap sides.

Sit to stand

3 sets of 10

Sit towards the front of a firm chair with your feet hip-width apart. Lean forward slightly and stand up, pushing through your heels, then sit back down slowly with control.

Side plank from knees

3 holds of 15–20 seconds each side

Lie on your side, propped on your forearm with your knees bent. Lift your hips so your body forms a straight line from head to knees. Hold, breathe, then lower and swap sides.

Phase 3

Return to everyday activities

The final stage builds strength in the movements you use every day, like bending, lifting and carrying, so you can get back to work, family life and sport with confidence.

Hip hinge

3 sets of 10

Stand with your feet hip-width apart and knees soft. Push your hips back as you lean your body forward, keeping your back long, then stand tall again. Add a light weight held close to your body as it gets easier.

Step-ups

3 sets of 8–10 each leg

Step up onto a low, stable step, pushing through your front foot, then step back down with control. Hold a rail or wall for balance if needed.

Suitcase carry

3 walks of 20–30 metres each side

Hold a light bag or weight in one hand and walk tall, without leaning to either side. Swap hands and repeat. Gradually increase the weight over time.

Practise your own activities

Build up gradually

Reintroduce the things that matter to you, like gardening, lifting children, running or the gym. Start lighter and shorter than usual, then build up over a few weeks.

Everyday tips

• Break up long periods of sitting every 30–45 minutes.
• Try heat, such as a warm shower or heat pack, if you find it soothing.
• Find a comfortable sleeping position, like a pillow between your knees on your side.
• Keep loads close when lifting, and split heavy loads.
• See our Lifting, Sleep & Carrying Guide for more.

When to seek prompt medical review

• Numbness around your groin, buttocks or inner thighs, or new problems controlling your bladder or bowels. Seek emergency care immediately.
• Weakness in your leg or foot that is getting worse.
• Back pain after a significant fall or accident.
• Fever, or feeling generally unwell with your back pain.
• Unexplained weight loss, or a history of cancer.
• Severe pain at night or at rest that is not easing.

This resource is general information only and is not a substitute for individual assessment and advice. Prepared by Dr Emma Cormack (Chiropractor), Vital Chiropractic, Mona Vale.

Need help with your back?

Book an appointment with Dr Emma at Vital Chiropractic in Mona Vale for an assessment and a plan tailored to you.

Book now

Vital Chiropractic
Suite 4, 1767 Pittwater Road,
Mona Vale NSW 2103
emma@vitalchiropractic.com.au

Vital Chiropractic

Founded by Dr Emma Cormack, an Australian registered chiropractor and kinesiologist.

Suite 4, 1767 Pittwater Road, Mona Vale NSW 2103

Opening hours

Open Monday – Friday
Closed Saturday & Sunday