Exercises for a healthy spine: what physical therapists recommend

About 40% of adults have experienced back pain in the last three months, according to the Centers for Disease Control and Prevention. Whether you’re in that 40% or not, know that back pain isn’t inevitable or permanent. There are plenty of ways you can prevent and manage a back pain flare in the future. With exercise, stretches, and healthy habits, you can help keep your back and spine strong and healthy no matter what your age is, says Heather Broach, PT, DPT, a physical therapist at Hinge Health. “If every single person on the planet started a spine health program in early adulthood, PTs would be a lot less busy,” she stresses. 

Read on for spine health tips to keep yours supple and strong. You’ll also get a diverse mix of exercises recommended by Hinge Health physical therapists that target the structures in and around your spine to help it stay strong for years to come. 

Your spine anatomy

Your spine is made up of 33 vertebrae (bones) that are stacked on top of one another. They protect your spinal cord and run right down the middle of your back, from your head to your hips. Intervertebral discs act as shock absorbers between each vertebrae. Surrounding those vertebrae are many layers of big and small muscles that allow your back to bend, flex, lift, and stabilize. Ligaments hold your vertebrae together and provide support while you move, and tendons connect muscles to vertebrae. Nerves are strong, thick structures that collect and send information between your brain and body.

Your spine is an amazing structure. It holds up your head, shoulders, and upper body. It allows you to stand up straight, and to bend and twist. “Your spine itself is curved to absorb gravity, so that you can stay in an upright position,” explains Dr. Broach. “If we were built with straight spines, we’d fall right over.” Thanks to the curvature, your spine is able to handle forces from all directions — from above, below, the sides, and every plane of motion. “Unlike other parts of your body, your spine is capable of moving in all planes, which gives you a lot of options for movement,” she adds. 

How to maintain a healthy spine

Your spine is naturally strong and resilient, but here’s what you can do to help keep your spine healthy and resistant to pain flares at any age: 

Mix it up. “Patients ask me all the time what the best exercises are for their spine, and I tell them to just do as many different activities as they possibly can,” says Dr. Broach. “Go for a walk on Monday, do some gardening on Tuesday, take a yoga class on Wednesday.” Anything you can do that gets you moving and makes you happy is good for your back. “Variety is the spice of life, and it also allows you to move your spine in many different ways,” says Dr. Broach. 

If you smoke, get support to cut back. Smokers are nearly three times as likely to develop lower back pain as nonsmokers. Why? Smoking narrows blood vessels and affects your overall circulation so less blood and nutrients are able to reach your spine. If quitting smoking seems daunting, reach out to a professional for help. Small steps can make a big difference when it comes to your back health.   

Eat the right foods. Yes, a top-notch mattress or ergonomic office chair may help support your spine, but another way is to be mindful of what you put in your grocery cart. Research has found that people who eat an inflammatory diet (think: added sugar and processed foods) are more likely to experience spine pain than those who follow a diet rich in whole foods like fruits, vegetables, whole grains, and fatty fish like salmon and sardines.

Take a look at your sitting habits. As Hinge Health physical therapists say, “your next position is your best position.” In other words, changing positions helps keep back pain at bay. If you have to sit for a prolonged period, “pay attention to what your legs are doing,” advises Dr. Broach. If you like to sit with your legs crossed, try to periodically switch where you cross your legs and which leg rests on top of the other. You can also play around with a footstool — sometimes propping your feet up for a little while or changing positions gives your muscles a break and gets other muscles more active.  

Consider sleeping on your back. First and foremost, the “best” sleeping position is the one that’s most comfortable for you. But if you’ve been avoiding sleeping on your back because you assume it’s bad for back pain, it’s okay to reconsider. Research shows that it’s actually a very spine-friendly sleep position. You can also place a pillow under your knees and a small one underneath the small of your neck to help keep you comfortable when sleeping on your back. If you’re a side sleeper, consider placing a pillow under your neck and a pillow between your legs to reduce pressure on your spine.

Drink up. “Hydration is a huge part of spine health,” says Dr. Broach. Here’s why: The discs located between your vertebrae need water to remain supple and keep blood volume and blood flow up. Plus, staying hydrated encourages you to get up to use the restroom more frequently, which can be a huge help in preventing your back from getting stiff and sore throughout the day. Note: You might want to prioritize hydrating earlier in the day to avoid having to use the restroom in the middle of the night. 

Any type of movement can be good for back pain, but certain exercises are particularly helpful because they strengthen and stretch the structures in and around your spine, all of which need to work together to help your back function as you go about your daily activities. 

Try these spine health exercises recommended by Hinge Health physical therapists. Start by doing them daily and see how your back feels, then consider doing them as many times per day as is helpful for you.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment. 

PT tip: Find your movement sweet spot

If you’ve had a back injury, you may be hesitant to start activity again. While it’s normal to be wary, it’s important to know that movement is one of the most important ways you can reduce pain and build resilience. “There’s a sweet spot — the point between doing too little and overdoing it,” says Dr. Broach. You just want to find the right type and amount of movement that challenges your body, strengthens your muscles, and reduces your pain. 

“I just worked with a Hinge Health member who had such bad spinal pain that he could barely move,” says Dr. Broach. “He was scared to do any sort of exercise, but we just talked his way through it. I coaxed him through movement an inch or two at a time, and soon enough he was doing full side bends.” If you’re worried that movement will hurt or cause an injury, you’ll likely tense up. Knowing how much your body can handle, though, can help you nudge into your pain and find your true movement sweet spot. 

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Back, Lower Limb, and Upper Limb Pain Among U.S. Adults, 2019. (2021, July). Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/products/databriefs/db415.htm#:~:text=Interview%20Survey%2C%202019.-,Summary,30.7%25%20experienced%20upper%20limb%20pain.

2. Why Smoking Will Worsen Your Chronic Pain. (2021, March 15). Cleveland Clinic. https://health.clevelandclinic.org/why-smoking-will-worsen-your-chronic-pain/#:~:text=Decreasing%20blood%20and%20nutrient%20flow,make%20painful%20conditions%20more%20prominent.

3. Green, B. N., Johnson, C. D., Snodgrass, J., Smith, M., & Dunn, A. S. (2016). Association Between Smoking and Back Pain in a Cross-Section of Adult Americans. Cureus, 8(9). doi:10.7759/cureus.806

4. Dietary Inflammatory Index and Low Back Pain in an Adult Population of US. (2021, March 2). 2021 Association of Academic Physiatrists Annual Meeting. https://www.healio.com/news/orthopedics/20210302/high-dietary-inflammatory-index-may-be-associated-with-low-back-pain

5. Strath, L. J., Sims, A. M., Overstreet, D. S., Penn, T. M., Bakshi, R. J., Stansel, B. K., Quinn, T. L., Sorge, R. E., Long, D. L., & Goodin, B. R. (2022). Dietary Inflammatory Index (DII) is Associated with Movement-Evoked Pain Severity in Adults with Chronic Low Back Pain: Sociodemographic Differences. The Journal of Pain, 23(8), 1437–1447. doi:10.1016/j.jpain.2022.03.237

6. What Sleep Positions Are Best for Your Back? (2018, October 4). Ohio State Medical Center. https://wexnermedical.osu.edu/blog/what-sleep-positions-are-best-for-your-back#:~:text=The%20best%20sleep%20position%20to,natural%20curves%20of%20the%20spine.

7. Cary, D., Briffa, K., & McKenna, L. (2019). Identifying relationships between sleep posture and non-specific spinal symptoms in adults: A scoping review. BMJ Open, 9(6). doi:10.1136/bmjopen-2018-027633