Lumbar Extension: Purpose, Exercises, and More

How to Do Lumbar Extension Exercises

Lumbar extension exercises are used to increase range of motion (ROM) in people with lower back pain due to lumbar spinal stenosis.

A narrowing of the spinal canal that pinches nerves, spinal stenosis can limit your ability to walk or enjoy your normal activities. Its hallmark symptoms are back pain and pain or tingling in both legs when walking that resolves when at rest.

A man doing his stretches for his spinal stenosis
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Physical therapy (PT) can help people with lumbar spinal stenosis improve strength and ROM and relieve symptoms. Research shows PT can be as effective as surgery for spinal stenosis, with fewer dangerous side effects.

PT exercise for treating spinal stenosis typically involves spinal flexion. Flexion exercises like a forward bend help take the pressure off of the nerves that exit your spine and travel down your legs.

However, spinal extension—or bending backward—can also help to relieve symptoms. This article details how to do lumbar extension exercises and how they work to relieve lumbar spinal stenosis.

The Standing Back Extension Exercise

Check with your healthcare provider before starting this or any other exercise for spinal stenosis.

If you have spinal stenosis, one exercise you might try first is the standing lumbar extension exercise. Here is how you do it:

  • Stand with your feet about shoulder-width apart.
  • Place both hands behind your back just above your hips.
  • Slowly bend yourself backward. You can lean back against a kitchen counter for stability if necessary.
  • Hold the bent back position for up to 60 seconds, and monitor your symptoms as you are bending backward.
  • After 60 seconds, return to the upright position.

While performing the standing lumbar extension exercise, monitor your symptoms. Initially, you should feel increased back pain and leg pain or tingling.

As you hold the position, continue monitoring your symptoms to see if these symptoms decrease or centralize to your back. A decrease or centralization of your symptoms is a good sign and means that you should continue the exercise a few times a day to maintain your ROM and control of your symptoms.

If your symptoms continue to hurt in your low back and your legs continue to tingle, stop the exercise and proceed with your physical therapy flexion exercise program; standing lumbar extension is not appropriate for you.

Mechanics

The standing lumbar extension exercise is typically used by physical therapists trained in the McKenzie Method of Mechanical Diagnosis and Therapy.

Historically, all patients with lumbar spinal stenosis were prescribed lumbar flexion exercises to help open up the spinal canal and relieve pressure off of spinal nerves. Many patients with spinal stenosis benefit from flexing their spine.

Some patients, though, benefit from bending backward. The lumbar extension places stress and pressure on the backside of your intervertebral discs, those soft, squishy shock absorbers in your spine.

By bending backward and pressing against the discs, you may be able to slightly press them away from your spinal canal and nerves. This can give your spinal nerves a little more room and may relieve spinal stenosis symptoms.

The Bottom Line

Lumbar spinal stenosis can be a difficult diagnosis to manage. It can make walking challenging and limit your ability to work or enjoy recreational activities.

If you have stenosis, you may be tempted to engage in only flexion-based exercises for your condition. Some people may benefit from performing a standing lumbar extension to quickly get pressure off the spinal nerves and rapidly reverse symptoms. This can allow you to get back to your normal activity quickly and safely.

A Word From Verywell

Check-in with your healthcare provider to make sure you get an accurate diagnosis for your condition first, and then visit your physical therapist to learn the correct exercises to perform for your specific condition. Your PT can help you move better and feel better so you can get back to your normal, active lifestyle.

Frequently Asked Questions

  • What is lumbar flexion and extension?

    Flexion and extension exercises are both used to treat lower back pain. Flexion occurs with bending forward. Lumbar extension exercises bend backward.

  • Why do we need lumbar extension?

    Lumbar extension exercises improve range of motion, increase lower back strength, and help to relieve pain and stiffness in people with arthritis in the lumbar spine.

  • What muscles do lumbar extension?

    Lumbar extensions work the lumbar extensors, a group of muscles that include the erector spinae and multifidus. Extensions also work the gluteal and hamstring muscles. 

  • What does physical therapy for spinal stenosis involve?

    Research shows physical therapy can be as effective as surgery for spinal stenosis. Components of physical therapy for spinal stenosis may include:

    • Exercises to improve your spinal ROM
    • Exercises to increase core and hip strength
    • Therapeutic modalities to help decrease pain
    • Mobilization techniques to help improve your spinal mobility
    • Education for postural correction techniques


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6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading
  • McKenzie, R., & May, S. (2003). The lumbar spine mechanical diagnosis and therapy. (2nd ed., Vol. One). Waikanae: Spinal Publications New Zealand.