How Much Exercise Do You Really Need to Improve Low Back Pain?
How Much Exercise Do You Really Need to Improve Low Back Pain?
New research suggests that when it comes to exercising for back pain, more isn't necessarily better.
If you've been struggling with low back pain, you've probably heard that exercise can help. But how much exercise do you actually need? Is a daily gym session necessary? Should you be doing Pilates, yoga, walking or strengthening exercises?
A new systematic review published in September 2026 in the British Journal of Sports Medicine offers some encouraging answers.
Researchers examined 239 randomised controlled trials investigating exercise for chronic low back pain, looking at how often people exercised, how long they exercised and how these factors influenced pain and disability.
The findings suggest that relatively small amounts of regular exercise can make a meaningful difference.
What did the researchers discover?
The researchers found that low to moderate amounts of exercise were associated with improvements in pain and disability over the short term.
Their statistical models suggested that:
For reducing back pain: Approximately three exercise sessions per week, lasting around 30 minutes, were associated with the greatest estimated improvements in pain intensity.
For improving daily function: Approximately four sessions per week, lasting around 25 minutes, were associated with the greatest estimated improvements in back-related disability.
For getting started: Meaningful improvements were estimated at lower exercise doses too, suggesting that you don't need to exercise every day or spend hours at the gym to benefit.
Importantly, these figures were estimated separately. They aren't a single prescription that everyone needs to follow.
The researchers also found that increasing exercise beyond moderate amounts generally produced little additional short-term benefit.
However, the evidence was rated as low to very low certainty, so these findings should be viewed as useful guidance rather than strict rules.
What type of exercise is best for back pain?
One of the interesting findings was that benefits were observed across several different types of exercise, including:
Strength and resistance training
Pilates and yoga
Aerobic exercise
Stabilisation and motor-control exercises
Stretching and combined exercise programmes
Different exercise types had different estimated effective doses, but the overall message was that there isn't one universally best exercise programme.
This is encouraging because it means there is room to choose activities that suit your interests, capabilities and lifestyle.
If you enjoy walking, swimming, yoga or working out at the gym, there may be ways to incorporate these activities into your back pain management.
Start small, build confidence and keep moving
One of the biggest challenges for people experiencing persistent back pain is knowing where to begin.
Pain can make movement uncomfortable, and it's understandable to worry that exercise might make things worse.
The good news from this research is that you don't necessarily need a demanding exercise programme to get started.
A practical approach might involve:
Start with manageable activity. Choose movements you feel comfortable attempting.
Aim for consistency. Short, regular sessions may be more manageable than occasional long workouts.
Gradually build your activity. Increase the amount or difficulty as your confidence and capacity improve.
Choose activities you enjoy. An exercise programme needs to fit into your life if you're going to stick with it.
Get guidance when needed. An individual assessment can help identify appropriate exercises and ways to progress.
These are practical suggestions rather than a specific programme tested by the review.
How does this fit with chiropractic care?
At Riverside Chiropractic, our approach to managing low back pain goes beyond addressing symptoms alone.
For many patients, the initial focus is on reducing pain and improving comfort and movement. Depending on your presentation and preferences, this may involve chiropractic treatment, advice and reassurance.
As symptoms improve, we can focus more on exercise, building physical capacity and developing self-management strategies.
The aim isn't simply to help you feel better during an appointment. It's to help you return to the activities that matter to you and become more confident managing your back.
Whether that's gardening, playing with your children or grandchildren, returning to sport, or simply getting through a working day more comfortably, movement can be an important part of recovery.
The takeaway: You don't have to do everything. Just get started.
This research reinforces an important message: a manageable amount of regular exercise may be enough to make a meaningful difference to persistent low back pain.
There is no single perfect exercise or universally optimal amount. The most appropriate approach will depend on your symptoms, goals, preferences and physical capacity.
If you've been putting off exercise because you don't know where to start, consider getting some guidance rather than waiting until your back feels perfect.
Also, interestingly, one of the takeaway messages is the personal context and opportunities are bigger barriers to getting started. These are things like work, childminding, other commitments that take priority over your health.
Now, Let's talk about how you can prioritise your health first!
Need help with your back?
At Riverside Chiropractic in Launceston, Dr Matt Bulman helps people manage low back pain through individualised chiropractic care, exercise advice and self-management strategies.
Appointments are available during the week, including evenings and weekends.
Research reference
Arora NK, Saueressig T, Schleimer T, et al. (2026). Optimal exercise dose in adults with chronic low back pain disorders: Systematic review with dose-response network meta-analysis. British Journal of Sports Medicine.
