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What is the best exercise for lower back pain - Capital Osteopathy - Ottawa

What is the Best Exercise for Lower Back Pain?

As an Osteopath, my clients often ask me what the best exercise for lower back pain is.

Should I do yoga? What about swimming? I have heard Pilates is the best exercise for lower back pain.

When talking to individuals about exercise for lower back pain, my answer will always depend on their presenting symptoms. However, there is an exercise I recommend to all my clients with lower back pain.

What is the best exercise for lower back pain?

Before I tell you what I consider what the best let’s discuss the pros and cons of the different choices.


I am a huge fan of yoga. It has been shown to have many health benefits. Yoga helps to strengthen core muscles and increases flexibility which is key to preventing lower back pain.

In my opinion, yoga is one of the most physically demanding exercises I have tried. It seems to work every muscle in your body. It appears that if you have a physical weakness, then yoga will expose it.

On this note, I have observed that a number of my yoga teachers have lower back issues. Because of this observation, I do not think yoga causes lower back pain. Rather I believe that yoga highlights that somebody has an underlying reason why they developed lower back pain. For one of my instructors who I am treating the cause of lower back pain was her irritable bowel syndrome (IBS). Once we started to help her IBS, her owner back pain improved.

I need a community to motivate me to exercise. I am not a big fan of doing exercise on your own. I never give tasks to people because they rarely find the time or motivation to do them. Yoga classes have a double benefit of exercise and the healing properties of a community.


I have never been a strong swimmer, so I have never enjoyed it as an exercise. In fact, whether you enjoy doing an exercise is an important factor to consider when choosing the best one you if you have lower back pain. You are more likely to do it if you like it!

Just like yoga, it is an all body exercise which could represent a problem. However, at the same time it is non-weight bearing so is less physically demanding.

Swimming lacks the benefits of community. A good compromise might be aquaerobics that a group setting.

My biggest reservation about swimming is to do with pool water. Unless you have a nearby lake or fresh water pool most people are restricted to using chlorinated public pools. We use Chlorine for its antibacterial properties. However, although it helps to kill bacteria in the pool, it is harmful to our bacteria or microbiome.


A large proportion of my Ottawa clients enjoys cycling. In the summer some cycle to work.

For somebody who has lower back pain cycling is an excellent form of exercise because it is non-weight bearing.

Like swimming most people cycle on their own so motivation can be an issue.

Cycling is also dependent on the weather. And in the winter only a few brave Ottawans are seen on their bike.


Walking is probably the oldest form of exercise known to man. It requires no special equipment or facilities. You can do it virtually anywhere and at any time of the year.

It requires no special equipment or facilities. You can do it almost anywhere and at any time of the year.

You can do it almost anywhere and at any time of the year.

Living in the country, I do less walking than I did in town because I have to drive everywhere. Hence for myself, there is a motivation issue.

Owning a dog would be motivation. However, I am not sure my five cats would appreciate the gesture.

If you do live in town then walking is the perfect exercise. Especially if you live close enough to walk to work.

The best exercise for lower back pain

The above four forms of exercise are the ones I consider the most for people with lower back pain.  Is there a best exercise for lower back pain for you? The answer is yes, but it is dependent on a few key factors including enjoyment, motivation and community. The most popular exercise I prescribe for people with lower back pain is walking but would not recommend it to myself because it does not fit with me.

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Lower back pain treatment options

If you suffer from lower back pain, you are not alone. In a Canadian study, researchers found approximately 11% of the adult population studied had been disabled by lower back pain in the previous six months. If like myself in the past your lower back pain has stopped you in your tracks it is time to look for some professional help. But who should you go to first? In this blog, I outline the merits of different lower back pain treatment options with a specific emphasis on physical therapies.

A trusted professional healthcare practitioner

In the majority of cases, the cause of lower back pain is purely muscular there are occasions when it can be more serious in nature and require medical attention. Below is a list of some such conditions:

  • Kidney stones
  • Ovarian cysts
  • Fibroids
  • Endometriosis
  • Pancreatic Cancer
  • Osteoporosis
  • Psoriatic and Rheumatoid Arthritis

Based on this information, it is important that you firstly consult a trusted professionally trained health care practitioner. For most this may be your family physician but I would also consider a chiropractor, physiotherapist or osteopathic manual practitioner. All these professions undergo extensive training in the proper diagnosis of lower back pain.

Lower back pain treatment options

Family Physician

If you have consulted with your family doctor and they have ruled out any underlying conditions they will often prescribe rest, muscle relaxants and pain killers. If the pain persists, they order an x-ray of your back, and eventually an MRI scan. If all else fails, then the final treatment option may be surgery especially if you have a herniated disc.


Chiropractors undergo extensive training in the diagnosis and treatment of musculoskeletal conditions. Diagnosis of lower back pain is based on taking a comprehensive case history, physical examination and occasionally an x-ray. In general, a chiropractor will predominantly use spinal adjustments in the treatment of lower back pain, but they also employ other treatment modalities. For example, the chiropractor I see also uses the Graston method and acupuncture.

Massage Therapists

Although massage therapists are a regulated profession in Ontario, they are not allowed to diagnose any medical conditions. They do however undergo an intensive four-year training course. Massage therapy has a reputation for being just for relaxation; however, the massage therapist I see can treat specific conditions such as lower back pain. As well as using physical techniques, massage therapist will also give exercises.

Osteopathic Manual Practitioners

Just like Chiropractors, Osteopaths also receive extensive training. Osteopathy is a relatively new treatment option available in Canada while in Europe is much more established. Diagnosis of lower back pain is also based on a case history and thorough physical exam, but X-rays are only ordered if appropriate. Osteopaths can use many different techniques in the treatment of lower back pain including cranial osteopathy, massage, spinal manipulation, and visceral manipulations. They may also give you exercises and some lifestyle advice.


Typically you have to go to school for six years to become a physiotherapist. Like chiropractors and osteopaths, physiotherapists are taught how to differentiate between musculoskeletal and more dangerous causes of lower back pain.  For lower back pain, physiotherapists commonly use various types of medical equipment including tens machines and ultrasound as well as dry needling and advising on exercises.

Above I have described the different lower back pain treatment options with a specific emphasis on physical therapists. No matter what therapy you choose, it is critical that you get a proper diagnosis for your symptoms. If in any doubt I recommend first seeing you family physician. When choosing a particular therapy, if none of the above approaches appeals to you I suggest speaking to friends or family for a recommendation.

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