This document provides guidelines for developing a safe exercise program for individuals with back pain. It recommends speaking with a healthcare provider before starting an exercise routine and progressing slowly. Light to moderate exercise can help prevent back stiffness and re-injury while strengthening the back muscles. The key to sticking with an exercise plan is to set small, realistic goals and find a buddy for added motivation and accountability. Safety is important, so see a doctor immediately if new or severe symptoms arise.

1. How to develop a safe
exercise program 1
Written by: Joanne Zeis
Reviewed by: Kevin L. Zacharoff, MD, October 2015

2. Learning Goals
➢In this lesson, you will:
❖Understand the benefits of exercise
❖Understand some general guidelines for exercising with back pain
❖Learn how to set personal exercise goals

3. The Benefits of Exercise
➢While many people think that exercising with back pain is not a good
idea, light to moderate exercise is actually helpful:
❖Exercising can prevent stiffness and re-injury of the back.
❖Exercising can make it easier to perform everyday activities, such as
housework and getting dressed.
❖Strengthening the back, becoming more flexible, and keeping the spine
aligned are all keys to functioning better when dealing with pain.

4. Before You Begin, Keep the Following
Tips in Mind:
➢Speak with your health care provider first before starting an exercise
program, and before trying any of the exercises shown here.
➢A physical therapist or personal trainer can suggest the best, and safest,
positions for each exercise.
➢Choose loose, comfortable clothing for exercising.
➢If you are walking as part of your exercise program, choose supportive
shoes.
➢Remember to progress at your own pace.
➢Don’t forget to breathe!
➢Use caution if you have a sudden flare-up of back pain. Gentle motion and
walking may help to ease your symptoms.

5. ➢Once you start your exercise program, see your doctor right away if:
❖You have any weakness in your legs or feet
❖You can’t control your bladder or bowels
❖Sudden back pain wakes you up during the night
❖You have any new symptoms, or increased pain that feels unbearable

6. Sticking With It
➢The key to sticking with any exercise plan is to set realistic, achievable
goals:
❖Start small! It’s OK for your first goals to be little ones. For example:
❖Being able to sit through an entire meal with your family
❖Taking your dog for a walk
❖Sitting in the car for a longer period of time than usual
❖Tell as many people as possible about your exercise plans. Saying it out loud
boosts your level of commitment, and helps you to keep going on days when
you might not want to continue.
❖Grab a buddy: find someone to do the exercises with you. Your workout will
be more fun with company, and you’ll be less likely to give up.
❖Try not to become discouraged if you face some minor setbacks.

7. Conclusions
➢Starting an exercise program isn’t easy, especially if your back has been
uncomfortable or hurting for a while. Congratulations for making the
decision to get your back stronger, and to keep it healthy.
➢While getting your back in shape is a great goal, always remember to do it
safely:
❖Speak with your health care provider before starting any exercise programs,
including the ones seen here.
❖Set realistic goals. It’s OK if your first goals are small ones.
❖Start out slowly, and work your way up to longer exercise sessions.
❖Don’t expect overnight success
❖If you have weakness in your legs or feet, problems controlling your bladder or
bowels, or have an increase in pain levels, see your doctor as soon as possible.

8. Additional Resources:
➢Sinel, M.S. & Deardorff, W.W. (1999). Back Pain Remedies for
Dummies. New York: Wiley Publishing. (Chapter 14: Exercising your
way to a healthy back & Chapter 21: Ten reasons to see a doctor for
back pain)