When you're experiencing back pain, your impulse may be to keep your back immobile, so you don't trigger further pain. This idea seems like it would be especially true for adding resistance to your workout in the form of weight machines, free weights, or resistance bands.

Studies have shown that weight training may be safe and can in fact help relieve pain when done correctly and for the right conditions. 1 Dreisinger TE. Exercise in the management of chronic back pain. Ochsner J. 2014;14(1):101–107. , 2 Michaelson P, Holmberg D, Aasa B, Aasa U. High load lifting exercise and low load motor control exercises as interventions for patients with mechanical low back pain: A randomized controlled trial with 24-month follow-up. J Rehabil Med. 2016;48(5):456-63. , 3 Welch N, Moran K, Antony J, et al. The effects of a free-weight-based resistance training intervention on pain, squat biomechanics and MRI-defined lumbar fat infiltration and functional cross-sectional area in those with chronic low back. BMJ Open Sport Exerc Med. 2015;1(1):e000050. Published 2015 Nov 9. doi:10.1136/bmjsem-2015-000050 , 4 Lee JS, Kang SJ. The effects of strength exercise and walking on lumbar function, pain level, and body composition in chronic back pain patients. J Exerc Rehabil. 2016;12(5):463–470. Published 2016 Oct 31. doi:10.12965/jer.1632650.325 Read on to see how you may safely participate in strength training to help your back.

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Weight training develops muscle health

When you have back pain for a prolonged period of time, your back muscles may have less mass, greater fatty content, and more stiffness, which can cause them to fatigue more easily and result in worsening pain. 1 Dreisinger TE. Exercise in the management of chronic back pain. Ochsner J. 2014;14(1):101–107. , 4 Lee JS, Kang SJ. The effects of strength exercise and walking on lumbar function, pain level, and body composition in chronic back pain patients. J Exerc Rehabil. 2016;12(5):463–470. Published 2016 Oct 31. doi:10.12965/jer.1632650.325 Over time, this pain and easy fatiguability may lead to fear of movement, resulting in deconditioning and instability in your back. 4 Lee JS, Kang SJ. The effects of strength exercise and walking on lumbar function, pain level, and body composition in chronic back pain patients. J Exerc Rehabil. 2016;12(5):463–470. Published 2016 Oct 31. doi:10.12965/jer.1632650.325

See Back Muscles and Low Back Pain

Weight training exercises can improve the health of your back by 1 Dreisinger TE. Exercise in the management of chronic back pain. Ochsner J. 2014;14(1):101–107. :
  • Increasing the function of the muscles in your back and core
  • Improving muscle strength
  • Increasing your lean muscle mass
  • Increasing the range of motion of your spine
  • Decreasing your body fat

Weight training exercises work on the basic principle of progressively increasing the loads, as tolerated, to gradually improve your capacity of performing daily activities. 1 Dreisinger TE. Exercise in the management of chronic back pain. Ochsner J. 2014;14(1):101–107.

See Bodybuilding, Weightlifting and Back Pain

3 essential guidelines to follow while using weights for back pain relief

When you consider weight training, it is important to understand the following guidelines to safely help relieve your back pain. While weighted exercises may be the right treatment for some, others may be prone to further injury depending on the underlying pain source:

1. Make sure your pain is not serious in nature.

If your back pain originates from an issue such as a previous spinal surgery, tumor, nerve root compression accompanied by neurological symptoms (sciatica), spinal fracture, and/or spinal infections, weight training may not be suitable for you. 3 Welch N, Moran K, Antony J, et al. The effects of a free-weight-based resistance training intervention on pain, squat biomechanics and MRI-defined lumbar fat infiltration and functional cross-sectional area in those with chronic low back. BMJ Open Sport Exerc Med. 2015;1(1):e000050. Published 2015 Nov 9. doi:10.1136/bmjsem-2015-000050

A trained medical professional can help provide an accurate diagnosis and determine if weight training is safe to perform with your back pain.

2. Take guidance from a trained therapist or instructor.

Whether you have used weights before or not, the techniques for weight training to alleviate back pain can be different from regular weight or resistance exercises. A trained physical or occupational therapist can provide guidance on the correct technique, frequency, and type of training that is suitable for your condition.

Training under a therapist can significantly reduce the risk of further injury and damage to your spine. After an initial training period, you may continue to perform the exercises by yourself, as prescribed.

See Physical Therapy Benefits For Back Pain

3. Use smaller weights to build your strength progressively.

Don’t hit the heavy squat rack right away—there are other ways you can effectively load your spine:

  • Start with smaller weights and exercise slowly. Begin your weight training program with smaller, tolerable weights and exercise slowly. Using rapid movements or incorrect lifting, pulling, or resistance techniques may cause additional damage to already susceptible tissues. 1 Dreisinger TE. Exercise in the management of chronic back pain. Ochsner J. 2014;14(1):101–107. It may be necessary to start with low-load motor control exercises (simple stretches) without weights to activate and stretch the muscles and improve balance.

    See Stretching for Back Pain Relief

  • Exercise machines may be better than free weights. Exercise machines can provide a safe and effective method of delivering progressive resistance to your exercises. These machines may also help reduce the potential for injury compared to using free weights. 1 Dreisinger TE. Exercise in the management of chronic back pain. Ochsner J. 2014;14(1):101–107. Maintaining proper support on your back with a leg press or chest press machine may be helpful.
  • Consider combining regular walks with your weight training program. Low impact aerobic exercises, such as walking helps increase the flow of blood and essential nutrients to the muscles and soft tissues of the back, which can promote healing and reduce stiffness. 4 Lee JS, Kang SJ. The effects of strength exercise and walking on lumbar function, pain level, and body composition in chronic back pain patients. J Exerc Rehabil. 2016;12(5):463–470. Published 2016 Oct 31. doi:10.12965/jer.1632650.325

    See Low-Impact Aerobic Exercise

Research indicates that combining a regular walking routine with weight training exercises can be more effective in managing back pain. 4 Lee JS, Kang SJ. The effects of strength exercise and walking on lumbar function, pain level, and body composition in chronic back pain patients. J Exerc Rehabil. 2016;12(5):463–470. Published 2016 Oct 31. doi:10.12965/jer.1632650.325

Dos and don'ts for strength training with back pain

If you're ready to give weight training a try, keep these tips in mind:

  • To reap the most benefit from strength training, aim to do it 2 or 3 times a week for half an hour.
  • Focus especially on exercises that can build strength in your core muscles (back, abdominals, obliques, buttocks, and proximal leg muscles).
  • You don't have to join a gym or buy expensive equipment to do strength training. You can do it at home, and the resistance can come from small hand weights, resistance bands, or even gravity.
  • To protect your back, avoid exercises that involve extreme or abrupt moves. Instead, focus on slow, steady resistance training that takes advantage of the eccentric (muscle lengthening exercises) and concentric (muscle shortening exercises) strengthening.
  • If you're experiencing a sustained increase in your back pain, take some time off or modify from strength training until it subsides.
  • Some soreness is okay and to be expected, but sharp pain is not normal. If you feel any sharp, sudden pain while exercising, stop right away.

Warm up for a few minutes before exercising by using heat therapy and doing simple stretches. Ice therapy can be beneficial when used after exercise to decrease inflammation and alleviate pain.

See How to Use Ice Massage Therapy for Back Pain

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Make a note of your progress

Record the baseline measurement of your weights when you begin your training and make a note every time you progress to a higher weight. Consistent improvements in your pain, flexibility, strength, and function, can help you stay motivated to continue with the exercise program. 1 Dreisinger TE. Exercise in the management of chronic back pain. Ochsner J. 2014;14(1):101–107.

Weight training can help alleviate your back pain and improve your ability to perform everyday activities. Talk with a certified medical professional today to see if weight training is a suitable and safe treatment for your back pain. Once you have your doctor’s consent, follow these suggested tips to experience effective and lasting pain relief.

Learn more:

Back Strengthening Exercises

Strengthening Exercise Program for Low Back Pain Relief

  • 1 Dreisinger TE. Exercise in the management of chronic back pain. Ochsner J. 2014;14(1):101–107.
  • 2 Michaelson P, Holmberg D, Aasa B, Aasa U. High load lifting exercise and low load motor control exercises as interventions for patients with mechanical low back pain: A randomized controlled trial with 24-month follow-up. J Rehabil Med. 2016;48(5):456-63.
  • 3 Welch N, Moran K, Antony J, et al. The effects of a free-weight-based resistance training intervention on pain, squat biomechanics and MRI-defined lumbar fat infiltration and functional cross-sectional area in those with chronic low back. BMJ Open Sport Exerc Med. 2015;1(1):e000050. Published 2015 Nov 9. doi:10.1136/bmjsem-2015-000050
  • 4 Lee JS, Kang SJ. The effects of strength exercise and walking on lumbar function, pain level, and body composition in chronic back pain patients. J Exerc Rehabil. 2016;12(5):463–470. Published 2016 Oct 31. doi:10.12965/jer.1632650.325

Dr. Eric Sturos is a physiatrist in Nashville, Tennessee. He specializes in the nonsurgical treatment of muscle, bone, soft tissue, and nervous system injuries. Dr. Sturos has authored and co-authored peer reviewed journal articles, book chapters, and published abstracts.

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