Whether you have never had an acute bout of low back pain, or you are well-versed in this arena, here is one of the best exercises for acute low back pain. This exercise helps MOST people, not everyone. With the spine, most people have what we call a directional preference, and that direction tends to be extension.
Read on for more.
**Disclaimer: This is not medical advice, this is for informational purposes only. **


What is acute low back pain?

Low back pain is pain, muscle tension, or stiffness localized below the ribs and above the inferior gluteal folds (bottom of your buttocks). Low back pain can include or exclude sciatica (or pain/numbness/tingling down your leg(s).
Nonspecific low back pain is pain not attributed to a recognizable pathology (e.g., infection, tumor, osteoporosis, rheumatoid arthritis, fracture, inflammation). This type of back pain is the most common.
Traditionally, acute low back pain has been defined as back pain lasting a couple days up to two weeks. Chronic or persistent low back pain extends beyond 12 weeks, when the tissues and structures should have healed. Some researchers argue that the definition of acute and chronic are insufficient to describe the reality of back pain.

When is low back pain serious?

I mean, acute low back pain always feels serious, right? Pain is pain, and it sucks.
However, only about 2% of people with low back pain have some serious pathology underlying their back pain. Here are signs and symptoms that indicate something more serious is going on with your back pain, and may need a referral out to a doctor.
If you answer yes to any of the questions below, it is considered a red flag. All the while, your answers are taken within the context of your history and your presentation.
Have you had sudden or unexplained weight loss in the last month?
Do you have any pain that is worse at night, and is unrelieved by position change? (Many people have pain at night do to mechanical low back pain, but the unique factor here is that NO position change improves their symptoms, and pain is worse at night.)
Have you had any loss of bowel or bladder function?
Do you have saddle parasthesia or numbness? (This is numbness between the legs, inner thighs and groin.)
Have you had any traumatic event happen recently? Like a car wreck or fall that resulted in their back pain?

What about resting for my pain?

It is natural that when you are in an intense amount of pain, you want to avoid all movement and just rest on the couch. For a very short period of time, this is okay.
For instance, if you are experiencing an excruciating amount of pain and cannot move without making that pain increase, then I would recommend to find a resting position and focus on breath.
Calming the nervous system is just as important in tissue injury as the tissue itself actually healing. If the tissue heals but your nervous system stays sensitive, then we are into the realm of persistent pain issues.
Yes, work on calming your nervous system but don’t avoid movement for more than a day. Research supports early movement with low back pain, instead of resting for multiple days on end.

What are the best exercises for acute low back pain?

There are a lot of recommendations to find on Google on what the best exercise is for low back pain. However, when it comes to ACUTE low back pain, simplicity is best. You don’t need a ton of exercises at this stage. 
Simple is better, and MOST people respond well to extension (bending your spine backward). Notice that I said most–some people don’t have a preference for direction or have a preference for flexion. Research has shown that most respond to extension.
If you have experienced acute low back pain, you probably are cringing at the thought of purposely pushing into extension when you are in such pain. Stay with me.
As always, I would recommend seeing a PT first and foremost so that can give you a thorough movement assessment to get to the root of your problem.

How to perform the exercise:

Start by lying on your belly, legs fairly wide with toes pointed inward.
Lying On Belly for acute low back pain
Place your arms by your armpits. Then, ONLY WITH YOUR ARMS push up as far as you can. DO NOT USE YOUR BACK MUSCLES OR YOUR GLUTES to lift you up. (I am a bad model here, because my glutes are firing, but yours should not be)
This is not a yoga pose like cobra or upward facing dog. This is completely passive movement on your spine–no back muscles firing here.
Best Exercise for acute low back pain
You can go up as far as you can. You can stop here.
Best Exercise for acute low back pain
Or here. But my guess is that you will not be able to come up as high as I am below. Sometimes it can take a week or two to actually be able to extend your spine where your elbows are straight (not shown).
Best Exercise for acute low back pain
Come back down nice and slow. Then, repeat that movement 10 times.
If your pain is better or the same, then keep doing this exercise. If this worsens your pain and you notice the pain extending farther away from it’s original starting point, then stop the exercise.
If this exercise is too intense for you, you can try doing it lying over a pillow or two, shown below.
best exercise for acute low back pain
best exercise for acute low back pain
Remember, this will not feel awesome. It may seem counterintuitive, but just experiment.
Perform 10 repetitions and if you notice after you complete them that your back pain is better, the same, or even more central (coming out of the glute/leg if that is your symptom), then you are on the right track.
If you are on the right track, perform this every two hours, 10 reps each time.
Like I said above, I would recommend seeing a physical therapist who could walk you through this and help monitor your symptoms. If you are looking for some relief at home instead of lying on the couch, try this out!


Acute low back pain can be very painful, and extended rest is not the best option. Most people respond to extension exercises well when it comes to acute low back pain. However, you must do it correctly as stated above. Remember, back pain is not a death sentence, and completely treatable.
I hope this helps!
Emily Warren

Dr. Emily Warren

Dr. Emily is a Doctor of Physical Therapy and Integrative Spine Specialist. She is the owner of Emily Warren Physical Therapy in Salt Lake City, Utah. She lives with her husband, 2 girls, 1 pup and enjoys anything outdoors. She wants people with back and neck pain to feel empowered and hopeful, and get back to the active lives they want. She has helped many people resolve their pain through physical therapy and online coaching. Check out her website HERE for more information on how she can help you