Standing Lumbar Flexion for Low Back Pain

If you have low back pain, exercise and postural correction are some of the best courses of action that you can take to decrease your pain and improve your mobility. A few visits to your physical therapist can help you determine which exercises are best for you to do and help you progress properly through your low back exercises. Your physical therapist can also teach you some things you should stop doing if you have low back pain.

Jogger bending down to touch her toes on busy wooden walkway
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Sometimes, exercises that bend your back backward are best for you. Other times flexion, or forward bending, exercises are the best way to manage your low back pain.

The standing lumbar flexion exercise is a great maneuver to perform if you have low back pain that seems to benefit from flexion type exercises.

Who May Benefit From Standing Lumbar Flexion?

People with certain diagnoses often benefit from spinal flexion. These diagnoses include, but are not limited to:

  • Spinal stenosis
  • Lumbar degenerative disc disease
  • Lumbar facet syndrome
  • Lumbar spondylolisthesis

While people with these diagnoses typically benefit from bending forward, not everyone benefits from it. Be sure to speak with your healthcare provider, understand your diagnosis and low back symptoms, and work with your physical therapist to be sure that forward flexion of your spine is the correct exercise for your back.

When Should You Avoid Lumbar Flexion?

Some people should avoid excessive forward bending, as this may cause further damage or injury to your spine. Reasons to avoid flexion include, but are not limited to: CITE

  • Lumbar herniated disc
  • Vertebral compression fracture
  • Worsening of symptoms with forward bending
  • Neurological signs such as difficulty urinating or controlling bowel movements (requires immediate medical attention)
  • Pain and acute weakness in your leg

Again, check with your healthcare provider or physical therapist before starting this or any other exercise program for your spine.

How to Perform Standing Spinal Flexion

Before starting standing lumbar flexion, you should gradually progress with more gentle lumbar flexion exercises. These would include first performing a week or two of lumbar flexion in lying, followed by a couple of weeks of lumbar flexion in sitting. CITE Once these exercises are easy and pain-free, you may then progress with lumbar flexion in standing.​

To perform the exercise, follow these simple steps:

  • Stand with your feet shoulder-width apart.
  • Be sure you have enough space around you to move about without bumping into anything.
  • Slowly bend yourself forward by sliding your hands down the front of your thighs.
  • Reach down as far as you can and let your low back bend forward.
  • To add overpressure and increase the amount of stretch on your back, grab your ankles and gently pull yourself into more forward flexion.
  • Hold the end position for a second or two, and then slowly return to your starting position.

As you are exercising, be sure to monitor changes in your symptoms. Pain that is worsening in your back or traveling down your leg is an indication that you should stop the exercise. If your pain is decreasing in your leg or centralizing to your back, then the exercise can be continued. CITE

Standing lumbar flexion can be repeated for 10 repetitions several times per day. It can be used to help decrease your symptoms of low back or leg pain, or it can be used to stretch tight hamstrings and back muscles.

If you suffer from low back pain, then standing lumbar flexion may be an exercise to incorporate into your daily routine to help decrease your pain and improve your overall spinal mobility. The exercise can also be used in the prevention of future low back problems and pain. Combined with postural correction and regular physical activity and exercise, standing back flexion may be another tool to help keep your spine healthy.

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2 Sources
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  1. American Academy of Orthopaedic Surgeons. Preventing back pain at work and at home. Updated February 2017.

  2. Lurie J, Tomkins-Lane C. Management of lumbar spinal stenosis. BMJ. 2016;352:h6234. doi:10.1136/bmj.h6234