This page gathers the stretches in the American Academy of Orthopaedic Surgeons (AAOS) Spine Conditioning Program, with the safety guidance that comes with them. The NHS suggests trying exercises and stretches for back pain, but says to stop if your pain gets worse and see a GP for advice. The AAOS says exercising to restore motion and strength to the lower back can be very helpful in relieving pain.
Overview
The NHS says back pain often improves on its own within a few weeks, and to stay active and try to continue with your daily activities. It says not to stay in bed for long periods of time, and suggests trying some exercises and stretches for back pain, but to stop if your pain gets worse and see a GP for advice.
The AAOS says physical therapy for low back pain can include active therapy, which consists of stretching, weightlifting and cardiovascular exercises, and that exercising to restore motion and strength to the lower back can be very helpful in relieving pain.
The stretches below come from the AAOS Spine Conditioning Program. The AAOS says that after an injury or surgery, an exercise conditioning program can help you return to daily activities. It says that to ensure the program is safe and effective for you, it should be performed under your doctor's supervision, and to talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals.
Common causes
- Overactivity: the AAOS says muscle soreness from activity is one of the more common causes, often brought about by an activity your body is not used to
- Disc problems: tears, herniation or age-related degeneration (AAOS)
- Spinal stenosis or degenerative spondylolisthesis, which the AAOS links to aging and wear and tear
- Compression fractures: the AAOS says these are a common cause of back pain in the elderly, and that in people with osteoporosis, minor trauma can cause bones in the spine to break
Warning signs
Each item says what its source advises, from emergencies to seeing a doctor. For the emergency signs, the NHS says not to drive yourself to A&E: ask someone to drive you, or call 999 and ask for an ambulance.
- Back pain with pain, tingling, weakness or numbness in both legs: the NHS says to call 999 or go to A&E
- Back pain with a loss of feeling around your genitals or anus: the NHS says to call 999 or go to A&E
- Back pain with changes in your bladder or bowels, such as difficulty peeing, or peeing or pooing yourself: the NHS says to call 999 or go to A&E
- Back pain with changes in how your penis or vagina feels during sex, or not being able to get or keep an erection or to orgasm: the NHS says to call 999 or go to A&E
- Back pain with chest pain, or back pain that started after a serious accident, such as a car accident: the NHS says to call 999 or go to A&E
- Weakness in your legs, or loss of bladder and bowel control: the AAOS says to seek medical attention right away
- Back pain with feeling hot, cold, shivery or generally unwell, severe pain that starts suddenly, or pain that's getting worse quickly: the NHS says to ask for an urgent GP appointment or get help from NHS 111
- Back pain that does not get better within a few weeks, or comes with fever, chills or unexpected weight loss: the AAOS says to call your doctor
- Back pain if you have vascular or arterial disease or a history of cancer, or pain that is always present regardless of your activity level or position: the AAOS says to talk to your primary care doctor
- Back pain that does not improve after treating it at home for a few weeks, stops you doing your day-to-day activities, or worries you or that you're struggling to cope with: the NHS says to see a GP (a primary care doctor)
- Back pain with weight loss you can't explain, a lump or swelling in your back, or a change in your back's shape: the NHS says to see a GP
- Back pain that does not improve after resting or is worse at night, is worse when sneezing, coughing or pooing, or comes from between your shoulders rather than your lower back: the NHS says to see a GP
- Pain that gets worse when you do exercises and stretches: the NHS says to stop and see a GP for advice. For the exercises below, the AAOS says you should not feel pain during an exercise, and to talk to your doctor or physical therapist if you do
UK terms on this page
Some of this advice comes from the NHS, the UK's National Health Service, so it names UK services.
- GP: a general practitioner. GP at hand, an NHS GP practice, describes an NHS GP as a medical doctor who works in primary care and is usually the first point of contact for medical advice, treatment or a diagnosis.
- NHS 111: the NHS says 111 can help if you think you need medical help right now, and can direct you to the best place to get help if you cannot contact your GP during the day, or when your GP is closed.
- A&E: accident and emergency. The NHS says it is for serious injuries and life-threatening emergencies, and is also known as the emergency department.
- 999: the UK emergency number. In the US, MedlinePlus says to call 911 or the local emergency number.
In the US, MedlinePlus lists these options for an unexpected illness or injury: a nurse advice line from your health insurance plan or employer, your health care provider, an urgent care clinic, or going to an emergency department right away. It says that if a person could die or be permanently disabled, it is an emergency, and to call 911 or the local emergency number if you cannot wait.
Sources: GP at hand, What is an NHS GP? Understanding their role and importance in Healthcare; NHS, When to use NHS 111 online or call 111 (last reviewed 2022); NHS, When to go to A&E (last reviewed 2023); MedlinePlus, When to use the emergency room - adult
Treatment and self-care
Warming up (AAOS)
The AAOS says to warm up with 5 to 10 minutes of low impact activity, like walking or riding a stationary bicycle, before the exercises. It says to do the stretching exercises before moving on to the strengthening exercises, and to repeat the stretches at the end.
How long the AAOS program runs
The AAOS lists each exercise as daily, and says the program should be continued for 4 to 6 weeks, unless otherwise specified by your doctor or physical therapist. It says that after your recovery, doing the exercises 2 to 3 days a week will maintain strength and range of motion in your back.
Strengthening exercises in the same program
The AAOS program pairs the stretches with strengthening exercises, including bird dog, plank, modified side plank, hip bridge and abdominal bracing. It says strengthening the muscles that support your spine will help keep your back and upper body stable, and that keeping these muscles strong can relieve back pain and prevent further injury.
Aerobic exercise (AAOS prevention advice)
The AAOS says it may not be possible to prevent low back pain, but that you can lessen the impact of low back problems. It suggests combining aerobic exercise, like walking or swimming, with specific exercises to keep the muscles in your back and abdomen strong and flexible. The NHS says activities like walking, swimming, yoga and pilates may also help ease back pain.
Do not ignore pain (AAOS)
The AAOS says you should not feel pain during an exercise, and to talk to your doctor or physical therapist if you have any pain while exercising. The NHS says to stop if your pain gets worse and see a GP for advice.
Stretches in the AAOS program
The AAOS Spine Conditioning Program describes these stretches for the back, with step-by-step directions and repetitions for each on its page. The program also includes head rolls, which the AAOS says you should feel all around your neck and into your upper back. The AAOS says to warm up first, and that you should not feel pain during an exercise.
Knee to chest
Lying on your back, one knee is brought toward the chest and held for 5 seconds, then the other, then both together. The AAOS says you should feel this stretch in your lower back, as well as in the front of your hip and inner thigh.
Sitting rotation stretch
Sitting with both legs straight out, one leg crosses over the other and you slowly twist toward the bent leg, holding for 30 seconds on each side. The AAOS says you should feel this stretch in your buttocks, as well as at your sides.
Modified seat side straddle
Sitting with one leg out to the side and the other bent, and keeping your back straight, you bend from your hips toward the foot of the straight leg and hold for 5 seconds, then round your spine, bring your hands to your shin or ankle and hold for 30 seconds. The AAOS says you should feel this stretch in the back of your thighs and into your lower and middle back.
Kneeling back extension
On hands and knees, you rock forward onto your arms and let your lower back drop toward the floor, then rock back to sit your buttocks toward your heels, holding each position for 5 seconds. The AAOS says you should feel this stretch in your lower back and your abdominals.
Watch
6 Best Low Back Stretches For MAX Pain Relief
Bob & Brad
Embedded for general education.
Frequently asked
- What are the best stretches for lower back pain?
- The sources here don't rank stretches. The AAOS Spine Conditioning Program includes knee to chest, sitting rotation, modified seat side straddle and kneeling back extension stretches, alongside strengthening exercises such as bird dog, hip bridge and abdominal bracing. The NHS back pain page has a video in which a physiotherapist shows some simple back stretches. The AAOS says to talk to your doctor or physical therapist about which exercises will best help you.
- How often should you do them?
- The AAOS lists each exercise in its program as daily, for 4 to 6 weeks unless your doctor or physical therapist specifies otherwise. It says that after your recovery, doing the exercises 2 to 3 days a week will maintain strength and range of motion, and that the program should be performed under your doctor's supervision.
- Can stretching make back pain worse?
- The NHS says to stop if your pain gets worse and see a GP for advice. The AAOS says you should not feel pain during an exercise, and to talk to your doctor or physical therapist if you do. The AAOS also says weakness in your legs or loss of bladder and bowel control are signs to seek medical attention right away, and the NHS lists emergency signs such as a loss of feeling around your genitals or anus.
- Which specialist can guide back exercises?
- The AAOS says its program should be performed under your doctor's supervision, and to talk to your doctor or physical therapist about which exercises will best help you. You can find physical therapists near you in the SpinalCare directory.
Sources
This page organises information from the cited sources for general education and is not medical advice. A qualified clinician can advise on your own care. Last updated October 21, 2026.