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| Meta Title | Low back pain: Learn More – Why movement is so important for back pain - InformedHealth.org - NCBI Bookshelf |
| Meta Description | One of the most important things that people with long-lasting or recurring low back pain can do is stay as physically active as possible in daily life and exercise regularly. Things that have been proven to help include special exercises to strengthen and stabilize the back, as well as physical activities like pilates, tai chi and yoga. |
| Meta Canonical | null |
| Boilerpipe Text | One of the most important things that people with long-lasting or recurring low back pain can do is stay as physically active as possible in daily life and exercise regularly. Things that have been proven to help include special exercises to strengthen and stabilize the back, as well as physical activities like pilates, tai chi and yoga.
Not moving enough can weaken your core muscles, make the
back pain
worse, and also lead to other health problems. Because of this, practically all medical associations worldwide recommend that people who have long-lasting or recurring back pain should exercise regularly and get as much movement as possible in daily life.
There are good reasons for this advice: For a start, exercise and sports are among the few treatments that have been scientifically proven to relieve back pain. It is also helpful to realize that you can do something about the pain yourself. And it's important to go about your daily life as normally as possible, and not let the pain limit your activities too much. Isolating yourself or no longer doing things you enjoy will make it even harder to cope with back pain.
If you're in a lot of pain, taking painkillers such as ibuprofen can help you to stay active in daily life. But you shouldn't take them for longer than two weeks.
Box
Exercise isn't the only thing that helps to relieve back pain. Depending on the situation, other options include relaxation techniques, painkillers and (particularly if your back pain is chronic) psychotherapy.
How well does exercise reduce back pain?
More than 200 studies have looked into the effects of various types of exercise in people who have back pain. This makes exercise therapy by far the best-studied treatment approach.
Effectiveness in chronic back pain
Most of the studies involved people who had back pain for a long time – typically for at least 3 months. Almost 25,000 people took part in total.
At the beginning of the studies, most of them had moderate pain: On average, they rated the severity of their pain as 50 on a scale of 0 to 100, with 100 being the maximum pain. In the weeks and months following the exercise programs, the pain improved by an average of 15 points. In people who didn't do exercise therapy, the pain hardly improved. The studies also showed that the pain-relieving effects of exercise programs last over some time.
Average change in back pain over time, with and without exercise program
Box
Exercise therapy can noticeably reduce chronic back pain, but doesn't always make it go away completely. It is not possible to reliably predict how the symptoms will continue to develop over time in different people.
Effectiveness in acute back pain
There is less research on the effectiveness of exercise in people who have had back pain for less than six weeks. Here, studies tend to suggest that the symptoms don't improve any faster with targeted exercises than without. But even then, it's a good idea to go about your normal everyday life as much as possible – and not to think about the pain all the time.
Once the acute pain has got better, it's a good time to start doing targeted exercises. Research on back pain prevention has shown that doing regular exercise can reduce the phases of pain by almost half. So it's worth becoming active and staying active, especially for people who have back pain that keeps returning.
Can exercise also be harmful if you have back pain?
Some people with back pain worry that exercise and sports could make their symptoms worse. Or they might be worried that the pain is a sign of a back injury. But that isn't the case when it comes to non-specific back pain, which is usually caused by a combination of different factors. These include weak or tense core muscles, inappropriate physical strain, a
problem with the way pain is processed in the brain
, as well as stress and other types of emotional strain. Exercise counteracts this in many ways: It strengthens the muscles, improves mobility and causes the body to release pain-relieving hormones such as endorphins. People who get more movement also seem to be less sensitive to pain.
Like other treatments, though, exercise therapy can also have side effects. It may lead to things like sore muscles or a temporary increase in back pain. For example, research on the effects of yoga found that the pain got worse for some time in 3 out of 100 people.
Box
If there are no signs that the back pain is being caused by a (rare) serious problem, there is no reason to be afraid of exercise.
What types of exercise are suitable?
The types of exercise that have proven helpful include:
Strengthening and stabilizing exercises
for the muscles in the abdomen (belly), back, hips and pelvis.
Pilates:
A total body workout with a focus on strengthening the deep core muscles.
Tai chi:
Originally an Asian martial art, tai chi is now practiced with slow, flowing movements. It can improve your balance and coordination skills, strengthen your muscles, and is said to help you relax your body and mind.
Yoga:
A practice from India that aims to improve your body awareness and health. Yoga typically involves getting into various positions or carrying out certain sequences of movements that aim to promote strength and mobility, body awareness and a good posture.
Going on walks:
Research suggests that going on a walk or brisk walking (Nordic walking) can help relieve back pain when done regularly – for instance, every two days for 30 to 60 minutes.
A doctor or physical therapist can help you to find an appropriate type of exercise that suits you and that you enjoy.
You may need patience to start off with: It can take several weeks for the exercise to have an effect. Your body also needs to get used to the extra movement.
What types of support are available?
There are various options when it comes to doing targeted exercise therapy. Some are particularly suitable for people who would like to become more active on their own, while others are more suitable for those who wish to have personal support or would prefer to do the exercise in a group.
In Germany, public health insurers and pension funds often cover part of the costs. For example:
Physical therapy
: Doctors can issue up to three physical therapy prescriptions for back pain. One prescription covers six treatment sessions lasting around 20 minutes each.
Prevention and exercise classes
: These include pilates, yoga and back-strengthening classes. There are online classes too. You can find out what costs are covered by visiting your health insurer's website, for example.
Medically prescribed apps
(
digital health applications
, or DiGAs for short): A number of apps for the treatment and prevention of back pain are now paid for by public health insurers if the apps have been prescribed by a doctor. DiGA apps include exercise programs, information and support for managing back pain.
Group rehabilitation exercise classes (
Rehasport
): These classes can be prescribed by a doctor – for example, once you have completed physical therapy.
What can help you stick to it?
In order for exercise to help over the long term too, you have to keep it up. This requires a lot of motivation, and many people find it tough after a while – particularly if they have a very busy job or home life. It is then important to find a way to fit the exercise into your daily routine.
Many people find it easier to exercise regularly if they sign up for classes on certain days, exercise together with friends, or use a fitness tracker to see their progress.
If you spend a lot of time sitting in an office, you can be kind to your back by taking regular breaks and moving your body – for instance, by getting up out of your chair, stretching, doing short exercises and going on a walk in your lunch break.
Other ways to get more exercise into your daily routine include the following:
Not using escalators or elevators (lifts), and always taking the stairs instead.
Regularly getting off one stop before your actual bus or tram stop, and walking the rest of the way.
Trying to walk or cycle as much as possible.
Getting up and walking around while you're talking on your phone.
What about patient education classes?
Patient education classes for people with back pain (known as "RĂĽckenschule" in Germany) provide you with facts and techniques to help prevent or relieve the pain. They usually have both a theoretical and practical part. The classes typically include modules on the
anatomy of the spine and the back
, advice on how to move in ways that don't put harmful strain on your back, and back-strengthening exercises. Like other exercise classes, these back-focused ones are offered by German public health insurers as prevention classes (Präventionskurs).
Research suggests that these patient education classes can help over the short term. But there has been much less research on them than on exercise therapy. Because of this, experts only recommend doing them in addition to exercise therapy.
Sources
IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.
Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.
Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods. |
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InformedHealth.org \[Internet\]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-.
[](https://www.ncbi.nlm.nih.gov/books/n/pmh_iqwig/ "Table of Contents Page")
## InformedHealth.org \[Internet\].
[Show details](https://www.ncbi.nlm.nih.gov/books/NBK284944/#__NBK284944_dtls__)
Cologne, Germany: [Institute for Quality and Efficiency in Health Care (IQWiG)](https://www.informedhealth.org/); 2006-.
- [Contents](https://www.ncbi.nlm.nih.gov/books/n/pmh_iqwig/)
[\< Prev](https://www.ncbi.nlm.nih.gov/books/n/pmh_iqwig/i2378.behandlung-mu/ "Previous page in this title")[Next \>](https://www.ncbi.nlm.nih.gov/books/n/pmh_iqwig/i2378.behandlung-z4-ral7-ahob/ "Next page in this title")
# Low back pain: Learn More – Why movement is so important for back pain
Last Update: December 16, 2025; Next update: 2028.
**One of the most important things that people with long-lasting or recurring low back pain can do is stay as physically active as possible in daily life and exercise regularly. Things that have been proven to help include special exercises to strengthen and stabilize the back, as well as physical activities like pilates, tai chi and yoga.**
Not moving enough can weaken your core muscles, make the [back pain](https://www.ncbi.nlm.nih.gov/books/n/pmh_iqwig/i2378/) worse, and also lead to other health problems. Because of this, practically all medical associations worldwide recommend that people who have long-lasting or recurring back pain should exercise regularly and get as much movement as possible in daily life.
There are good reasons for this advice: For a start, exercise and sports are among the few treatments that have been scientifically proven to relieve back pain. It is also helpful to realize that you can do something about the pain yourself. And it's important to go about your daily life as normally as possible, and not let the pain limit your activities too much. Isolating yourself or no longer doing things you enjoy will make it even harder to cope with back pain.
If you're in a lot of pain, taking painkillers such as ibuprofen can help you to stay active in daily life. But you shouldn't take them for longer than two weeks.
[](https://www.ncbi.nlm.nih.gov/books/NBK284944/box/i2378.behandlung-z4.info.4/?report=objectonly "Box")
#### [Box](https://www.ncbi.nlm.nih.gov/books/NBK284944/box/i2378.behandlung-z4.info.4/?report=objectonly)
Exercise isn't the only thing that helps to relieve back pain. Depending on the situation, other options include relaxation techniques, painkillers and (particularly if your back pain is chronic) psychotherapy.
## How well does exercise reduce back pain?
More than 200 studies have looked into the effects of various types of exercise in people who have back pain. This makes exercise therapy by far the best-studied treatment approach.
### Effectiveness in chronic back pain
Most of the studies involved people who had back pain for a long time – typically for at least 3 months. Almost 25,000 people took part in total.
At the beginning of the studies, most of them had moderate pain: On average, they rated the severity of their pain as 50 on a scale of 0 to 100, with 100 being the maximum pain. In the weeks and months following the exercise programs, the pain improved by an average of 15 points. In people who didn't do exercise therapy, the pain hardly improved. The studies also showed that the pain-relieving effects of exercise programs last over some time.
Average change in back pain over time, with and without exercise program
[](https://www.ncbi.nlm.nih.gov/books/NBK284944/box/i2378.behandlung-z4.info.7/?report=objectonly "Box")
#### [Box](https://www.ncbi.nlm.nih.gov/books/NBK284944/box/i2378.behandlung-z4.info.7/?report=objectonly)
Exercise therapy can noticeably reduce chronic back pain, but doesn't always make it go away completely. It is not possible to reliably predict how the symptoms will continue to develop over time in different people.
### Effectiveness in acute back pain
There is less research on the effectiveness of exercise in people who have had back pain for less than six weeks. Here, studies tend to suggest that the symptoms don't improve any faster with targeted exercises than without. But even then, it's a good idea to go about your normal everyday life as much as possible – and not to think about the pain all the time.
Once the acute pain has got better, it's a good time to start doing targeted exercises. Research on back pain prevention has shown that doing regular exercise can reduce the phases of pain by almost half. So it's worth becoming active and staying active, especially for people who have back pain that keeps returning.
## Can exercise also be harmful if you have back pain?
Some people with back pain worry that exercise and sports could make their symptoms worse. Or they might be worried that the pain is a sign of a back injury. But that isn't the case when it comes to non-specific back pain, which is usually caused by a combination of different factors. These include weak or tense core muscles, inappropriate physical strain, a [problem with the way pain is processed in the brain](https://www.ncbi.nlm.nih.gov/books/n/pmh_iqwig/i2607.ursachen-n7/), as well as stress and other types of emotional strain. Exercise counteracts this in many ways: It strengthens the muscles, improves mobility and causes the body to release pain-relieving hormones such as endorphins. People who get more movement also seem to be less sensitive to pain.
Like other treatments, though, exercise therapy can also have side effects. It may lead to things like sore muscles or a temporary increase in back pain. For example, research on the effects of yoga found that the pain got worse for some time in 3 out of 100 people.
[](https://www.ncbi.nlm.nih.gov/books/NBK284944/box/i2378.behandlung-z4.hint.9/?report=objectonly "Box")
#### [Box](https://www.ncbi.nlm.nih.gov/books/NBK284944/box/i2378.behandlung-z4.hint.9/?report=objectonly)
If there are no signs that the back pain is being caused by a (rare) serious problem, there is no reason to be afraid of exercise.
## What types of exercise are suitable?
The types of exercise that have proven helpful include:
- **Strengthening and stabilizing exercises** for the muscles in the abdomen (belly), back, hips and pelvis.
- **Pilates:** A total body workout with a focus on strengthening the deep core muscles.
- **Tai chi:** Originally an Asian martial art, tai chi is now practiced with slow, flowing movements. It can improve your balance and coordination skills, strengthen your muscles, and is said to help you relax your body and mind.
- **Yoga:** A practice from India that aims to improve your body awareness and health. Yoga typically involves getting into various positions or carrying out certain sequences of movements that aim to promote strength and mobility, body awareness and a good posture.
- **Going on walks:** Research suggests that going on a walk or brisk walking (Nordic walking) can help relieve back pain when done regularly – for instance, every two days for 30 to 60 minutes.
A doctor or physical therapist can help you to find an appropriate type of exercise that suits you and that you enjoy.
You may need patience to start off with: It can take several weeks for the exercise to have an effect. Your body also needs to get used to the extra movement.
## What types of support are available?
There are various options when it comes to doing targeted exercise therapy. Some are particularly suitable for people who would like to become more active on their own, while others are more suitable for those who wish to have personal support or would prefer to do the exercise in a group.
In Germany, public health insurers and pension funds often cover part of the costs. For example:
- [Physical therapy](https://www.ncbi.nlm.nih.gov/books/n/pmh_iqwig/i3565/): Doctors can issue up to three physical therapy prescriptions for back pain. One prescription covers six treatment sessions lasting around 20 minutes each.
- [Prevention and exercise classes](https://portal.zentrale-pruefstelle-praevention.de/portfolio/gkv-sv/suche?onlineKurse=false&umkreis=10): These include pilates, yoga and back-strengthening classes. There are online classes too. You can find out what costs are covered by visiting your health insurer's website, for example.
- [Medically prescribed apps](https://diga.bfarm.de/de) ([digital health applications](https://www.informedhealth.org/what-are-digital-health-applications-digas.html), or DiGAs for short): A number of apps for the treatment and prevention of back pain are now paid for by public health insurers if the apps have been prescribed by a doctor. DiGA apps include exercise programs, information and support for managing back pain.
- Group rehabilitation exercise classes ([Rehasport](https://www.dein-rehasport.de/)): These classes can be prescribed by a doctor – for example, once you have completed physical therapy.
## What can help you stick to it?
In order for exercise to help over the long term too, you have to keep it up. This requires a lot of motivation, and many people find it tough after a while – particularly if they have a very busy job or home life. It is then important to find a way to fit the exercise into your daily routine.
Many people find it easier to exercise regularly if they sign up for classes on certain days, exercise together with friends, or use a fitness tracker to see their progress.
If you spend a lot of time sitting in an office, you can be kind to your back by taking regular breaks and moving your body – for instance, by getting up out of your chair, stretching, doing short exercises and going on a walk in your lunch break.
Other ways to get more exercise into your daily routine include the following:
- Not using escalators or elevators (lifts), and always taking the stairs instead.
- Regularly getting off one stop before your actual bus or tram stop, and walking the rest of the way.
- Trying to walk or cycle as much as possible.
- Getting up and walking around while you're talking on your phone.
## What about patient education classes?
Patient education classes for people with back pain (known as "Rückenschule" in Germany) provide you with facts and techniques to help prevent or relieve the pain. They usually have both a theoretical and practical part. The classes typically include modules on the [anatomy of the spine and the back](https://www.ncbi.nlm.nih.gov/books/n/pmh_iqwig/i2375/), advice on how to move in ways that don't put harmful strain on your back, and back-strengthening exercises. Like other exercise classes, these back-focused ones are offered by German public health insurers as prevention classes (Präventionskurs).
Research suggests that these patient education classes can help over the short term. But there has been much less research on them than on exercise therapy. Because of this, experts only recommend doing them in addition to exercise therapy.
## Sources
- Hayden JA, Ellis J, Ogilvie R et al. [Exercise therapy for chronic low back pain](https://www.ncbi.nlm.nih.gov/pubmed/34580864). Cochrane Database Syst Rev 2021; (9): CD009790. \[[PMC free article: PMC8477273](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8477273/)\] \[[PubMed: 34580864](https://pubmed.ncbi.nlm.nih.gov/34580864)\]
- Hayden JA, Ellis J, Ogilvie R et al. [Some types of exercise are more effective than others in people with chronic low back pain: a network meta-analysis](https://www.ncbi.nlm.nih.gov/pubmed/34538747). J Physiother 2021; 67(4): 252-262. \[[PubMed: 34538747](https://pubmed.ncbi.nlm.nih.gov/34538747)\]
- IJzelenberg W, Oosterhuis T, Hayden JA et al. [Exercise therapy for treatment of acute non-specific low back pain](https://pubmed.ncbi.nlm.nih.gov/37646368/). Cochrane Database Syst Rev 2023; 8(8): Cd009365. \[[PMC free article: PMC10467021](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10467021/)\] \[[PubMed: 37646368](https://pubmed.ncbi.nlm.nih.gov/37646368)\]
- Steffens D, Maher CG, Pereira LS et al. [Prevention of Low Back Pain: A Systematic Review and Meta-analysis](https://www.ncbi.nlm.nih.gov/pubmed/26752509). JAMA Intern Med 2016; 176(2): 199-208. \[[PubMed: 26752509](https://pubmed.ncbi.nlm.nih.gov/26752509)\]
- Wieland LS, Skoetz N, Pilkington K et al. [Yoga for chronic non-specific low back pain](https://www.ncbi.nlm.nih.gov/pubmed/36398843). Cochrane Database Syst Rev 2022; (11): CD010671. \[[PMC free article: PMC9673466](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9673466/)\] \[[PubMed: 36398843](https://pubmed.ncbi.nlm.nih.gov/36398843)\]
- World Health Organization (WHO). [WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings](https://www.ncbi.nlm.nih.gov/books/NBK599212/). In: WHO Guidelines Approved by the Guidelines Review Committee. Geneva: WHO; 2023.
- IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.
Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.
Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.
© IQWiG (Institute for Quality and Efficiency in Health Care)
Bookshelf ID: NBK284944
[Contents](https://www.ncbi.nlm.nih.gov/books/n/pmh_iqwig/)
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InformedHealth.org \[Internet\]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Low back pain: Learn More – Why movement is so important for back pain. \[Updated 2025 Dec 16\].
### In this Page
- [How well does exercise reduce back pain?](https://www.ncbi.nlm.nih.gov/books/NBK284944/#i2378.behandlung-z4.howwelldoesexerciser)
- [Can exercise also be harmful if you have back pain?](https://www.ncbi.nlm.nih.gov/books/NBK284944/#i2378.behandlung-z4.canexercisealsobehar)
- [What types of exercise are suitable?](https://www.ncbi.nlm.nih.gov/books/NBK284944/#i2378.behandlung-z4.whattypesofexercisea)
- [What types of support are available?](https://www.ncbi.nlm.nih.gov/books/NBK284944/#i2378.behandlung-z4.whattypesofsupportar)
- [What can help you stick to it?](https://www.ncbi.nlm.nih.gov/books/NBK284944/#i2378.behandlung-z4.whatcanhelpyoustickt)
- [What about patient education classes?](https://www.ncbi.nlm.nih.gov/books/NBK284944/#i2378.behandlung-z4.whataboutpatienteduc)
- [Sources](https://www.ncbi.nlm.nih.gov/books/NBK284944/#i2378.behandlung-z4.gi-sources.15)
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| Readable Markdown | **One of the most important things that people with long-lasting or recurring low back pain can do is stay as physically active as possible in daily life and exercise regularly. Things that have been proven to help include special exercises to strengthen and stabilize the back, as well as physical activities like pilates, tai chi and yoga.**
Not moving enough can weaken your core muscles, make the [back pain](https://www.ncbi.nlm.nih.gov/books/n/pmh_iqwig/i2378/) worse, and also lead to other health problems. Because of this, practically all medical associations worldwide recommend that people who have long-lasting or recurring back pain should exercise regularly and get as much movement as possible in daily life.
There are good reasons for this advice: For a start, exercise and sports are among the few treatments that have been scientifically proven to relieve back pain. It is also helpful to realize that you can do something about the pain yourself. And it's important to go about your daily life as normally as possible, and not let the pain limit your activities too much. Isolating yourself or no longer doing things you enjoy will make it even harder to cope with back pain.
If you're in a lot of pain, taking painkillers such as ibuprofen can help you to stay active in daily life. But you shouldn't take them for longer than two weeks.
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Exercise isn't the only thing that helps to relieve back pain. Depending on the situation, other options include relaxation techniques, painkillers and (particularly if your back pain is chronic) psychotherapy.
## How well does exercise reduce back pain?
More than 200 studies have looked into the effects of various types of exercise in people who have back pain. This makes exercise therapy by far the best-studied treatment approach.
### Effectiveness in chronic back pain
Most of the studies involved people who had back pain for a long time – typically for at least 3 months. Almost 25,000 people took part in total.
At the beginning of the studies, most of them had moderate pain: On average, they rated the severity of their pain as 50 on a scale of 0 to 100, with 100 being the maximum pain. In the weeks and months following the exercise programs, the pain improved by an average of 15 points. In people who didn't do exercise therapy, the pain hardly improved. The studies also showed that the pain-relieving effects of exercise programs last over some time.
Average change in back pain over time, with and without exercise program
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Exercise therapy can noticeably reduce chronic back pain, but doesn't always make it go away completely. It is not possible to reliably predict how the symptoms will continue to develop over time in different people.
### Effectiveness in acute back pain
There is less research on the effectiveness of exercise in people who have had back pain for less than six weeks. Here, studies tend to suggest that the symptoms don't improve any faster with targeted exercises than without. But even then, it's a good idea to go about your normal everyday life as much as possible – and not to think about the pain all the time.
Once the acute pain has got better, it's a good time to start doing targeted exercises. Research on back pain prevention has shown that doing regular exercise can reduce the phases of pain by almost half. So it's worth becoming active and staying active, especially for people who have back pain that keeps returning.
## Can exercise also be harmful if you have back pain?
Some people with back pain worry that exercise and sports could make their symptoms worse. Or they might be worried that the pain is a sign of a back injury. But that isn't the case when it comes to non-specific back pain, which is usually caused by a combination of different factors. These include weak or tense core muscles, inappropriate physical strain, a [problem with the way pain is processed in the brain](https://www.ncbi.nlm.nih.gov/books/n/pmh_iqwig/i2607.ursachen-n7/), as well as stress and other types of emotional strain. Exercise counteracts this in many ways: It strengthens the muscles, improves mobility and causes the body to release pain-relieving hormones such as endorphins. People who get more movement also seem to be less sensitive to pain.
Like other treatments, though, exercise therapy can also have side effects. It may lead to things like sore muscles or a temporary increase in back pain. For example, research on the effects of yoga found that the pain got worse for some time in 3 out of 100 people.
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If there are no signs that the back pain is being caused by a (rare) serious problem, there is no reason to be afraid of exercise.
## What types of exercise are suitable?
The types of exercise that have proven helpful include:
- **Strengthening and stabilizing exercises** for the muscles in the abdomen (belly), back, hips and pelvis.
- **Pilates:** A total body workout with a focus on strengthening the deep core muscles.
- **Tai chi:** Originally an Asian martial art, tai chi is now practiced with slow, flowing movements. It can improve your balance and coordination skills, strengthen your muscles, and is said to help you relax your body and mind.
- **Yoga:** A practice from India that aims to improve your body awareness and health. Yoga typically involves getting into various positions or carrying out certain sequences of movements that aim to promote strength and mobility, body awareness and a good posture.
- **Going on walks:** Research suggests that going on a walk or brisk walking (Nordic walking) can help relieve back pain when done regularly – for instance, every two days for 30 to 60 minutes.
A doctor or physical therapist can help you to find an appropriate type of exercise that suits you and that you enjoy.
You may need patience to start off with: It can take several weeks for the exercise to have an effect. Your body also needs to get used to the extra movement.
## What types of support are available?
There are various options when it comes to doing targeted exercise therapy. Some are particularly suitable for people who would like to become more active on their own, while others are more suitable for those who wish to have personal support or would prefer to do the exercise in a group.
In Germany, public health insurers and pension funds often cover part of the costs. For example:
- [Physical therapy](https://www.ncbi.nlm.nih.gov/books/n/pmh_iqwig/i3565/): Doctors can issue up to three physical therapy prescriptions for back pain. One prescription covers six treatment sessions lasting around 20 minutes each.
- [Prevention and exercise classes](https://portal.zentrale-pruefstelle-praevention.de/portfolio/gkv-sv/suche?onlineKurse=false&umkreis=10): These include pilates, yoga and back-strengthening classes. There are online classes too. You can find out what costs are covered by visiting your health insurer's website, for example.
- [Medically prescribed apps](https://diga.bfarm.de/de) ([digital health applications](https://www.informedhealth.org/what-are-digital-health-applications-digas.html), or DiGAs for short): A number of apps for the treatment and prevention of back pain are now paid for by public health insurers if the apps have been prescribed by a doctor. DiGA apps include exercise programs, information and support for managing back pain.
- Group rehabilitation exercise classes ([Rehasport](https://www.dein-rehasport.de/)): These classes can be prescribed by a doctor – for example, once you have completed physical therapy.
## What can help you stick to it?
In order for exercise to help over the long term too, you have to keep it up. This requires a lot of motivation, and many people find it tough after a while – particularly if they have a very busy job or home life. It is then important to find a way to fit the exercise into your daily routine.
Many people find it easier to exercise regularly if they sign up for classes on certain days, exercise together with friends, or use a fitness tracker to see their progress.
If you spend a lot of time sitting in an office, you can be kind to your back by taking regular breaks and moving your body – for instance, by getting up out of your chair, stretching, doing short exercises and going on a walk in your lunch break.
Other ways to get more exercise into your daily routine include the following:
- Not using escalators or elevators (lifts), and always taking the stairs instead.
- Regularly getting off one stop before your actual bus or tram stop, and walking the rest of the way.
- Trying to walk or cycle as much as possible.
- Getting up and walking around while you're talking on your phone.
## What about patient education classes?
Patient education classes for people with back pain (known as "Rückenschule" in Germany) provide you with facts and techniques to help prevent or relieve the pain. They usually have both a theoretical and practical part. The classes typically include modules on the [anatomy of the spine and the back](https://www.ncbi.nlm.nih.gov/books/n/pmh_iqwig/i2375/), advice on how to move in ways that don't put harmful strain on your back, and back-strengthening exercises. Like other exercise classes, these back-focused ones are offered by German public health insurers as prevention classes (Präventionskurs).
Research suggests that these patient education classes can help over the short term. But there has been much less research on them than on exercise therapy. Because of this, experts only recommend doing them in addition to exercise therapy.
## Sources
- IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.
Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.
Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods. |
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