My lower back hurts. Can I exercise?
Why back pain doesn’t always mean you should stop
Anna Maria Vamvakidou | Pilates Instructor & Movement Specialist
What I See in Practice
Low back pain is something I encounter very frequently in my work with people. Some already have a diagnosis, others don’t. Some are afraid to move, while others try to continue as usual without knowing whether what they’re doing is helping or making things worse.
And almost always, the same question comes up:
Should I stop or continue?
Pain Does Not Always Mean Stop
The first reaction to pain is usually avoidance. To stop exercising, to limit movement, to protect ourselves. In some cases, this is necessary, especially during an acute phase.
However, in most cases, complete avoidance doesn’t help. The body is not designed for inactivity. When it doesn’t move, it gradually loses strength, stability, and its ability to manage load.
The Role of Movement
Well-structured movement can be part of the solution. It’s not only about reducing pain, but also about restoring function. It helps the body regain control, distribute load more efficiently, and move with greater safety.
The question is not whether you should move.
It’s how you should move.
Can You Train With Pain?
In many cases, you can continue training even when pain is present. However, this requires a different approach.
The issue is not the weight or the exercise itself. It’s how they are used. When pain is present, training should emphasize control, stability, and proper load distribution. It’s not just about strength, it’s about the quality of movement.
Stability Before Load
One of the most important elements is stability. When the core does not function effectively, the body finds alternative ways to perform movement. It creates compensations and shifts stress to areas that are not able to handle it properly.
This is often where pain persists. Improving stability does not mean avoiding load. It means managing it more effectively.
Coaching Matters
The same exercise can be either beneficial or harmful, depending on how it is performed. Guidance plays a crucial role.
A trainer needs to adapt the exercise to the individual, adjust the load, and provide cues that promote control, not intensity without direction. It’s not about what you do, but how you do it.
From Avoidance to Exposure
For many years, pain management was largely based on avoidance. Today, we know that gradual and controlled exposure to movement is often more effective.
This means the body needs to be retrained through small, controlled stimuli, with proper technique and progressive loading.
What Actually Helps
What truly helps is neither complete rest nor blindly continuing training. It’s adaptation.
The ability to understand what the body needs at each stage and to work on it with precision.
The Key Principle
If this had to be summarized in one sentence, it would be this:
Pain does not mean you should stop, it means you need to change the way you move.
Final Thought
Low back pain is not necessarily a reason to stop exercising. It is a reason for better understanding, a more targeted approach, and proper guidance.
Because very often, movement, when done correctly, can be part of the solution, not the problem.
If you’d like to explore how to approach this safely and with direction, we can work on it together.
References
The above insights are grounded in current research on movement, load management, and the role of exercise in low back pain.
- World Health Organization (2020). Guidelines on physical activity and sedentary behaviour
- National Institute for Health and Care Excellence (2020). Low back pain and sciatica in over 16s: assessment and management
- American College of Sports Medicine (2021). Exercise management in musculoskeletal conditions
- McGill, S. (2016). Back Mechanic
