Here’s What You Actually Need!
When you’re in pain, it’s totally natural to want a clear plan. Something that says: “Do this, and you’ll feel better.” And exercises can help with chronic pain. It’s just not about choosing the “right” one.
This kind of thinking can set us up to fail. If the first movement doesn’t help—or if it helps for a little while and then stops working—it’s easy to feel like something is wrong with your body. Like you’re broken. Like you missed your shot.
But pain is more complex than a weak muscle or tight joint. That’s especially true for chronic pain, where the nervous system plays a much bigger role than we often realize.
What Really Causes Chronic Low Back Pain?
Chronic low back pain is rarely about one specific injury or structure. Instead, it’s shaped by a wide range of factors, including:
- Nervous system sensitization (your system is “on high alert”)
- Beliefs about your body or what your pain means
- Fear of movement or re-injury
- Past experiences, including trauma
- Poor sleep or chronic stress
- Emotional or social disconnection
- Changes in identity or life roles
This is called the biopsychosocial model of pain. It’s not saying the pain is “all in your head.” It’s saying your whole life—your body, your thoughts, your feelings, and your environment—can influence how pain is felt and processed.
Understanding this is empowering. Because it means you’re not stuck. You don’t need a perfect diagnosis or a perfect exercise. You need a plan that supports all of you.
The Transverse Abdominis (CORE) Exercises Trend: What We Got Wrong
Let’s talk about a well-known story in physical therapy: the tale of the transverse abdominis.
Back in the 1990s, a study suggested that people with low back pain had a delayed firing of a deep core muscle called the transverse abdominis (TrA). The conclusion? If we could get this muscle to activate properly, we could fix the pain.
Physical therapists everywhere jumped on this. We started training people to “draw in” their core before any movement, teaching highly specific stabilization exercises, and promising that this approach was the gold standard.
But the science didn’t stay still.
Peter O’Sullivan—the author of that original study—has since done more research and publicly pointed out the flaws in his early work. Later studies couldn’t replicate the findings, and more importantly, improving TrA activation didn’t necessarily lead to less pain.
Even O’Sullivan now teaches that focusing narrowly on muscle timing or motor control isn’t the best path forward for most people. Instead, he emphasizes a more person-centered, flexible approach—one that honors each person’s story, beliefs, and movement habits.
This is a powerful reminder: even well-meaning professionals can get stuck chasing the wrong target.
What Actually Helps? Movement That Feels Safe
I want to say it again: movement helps chronic low back pain. But not because there’s something magical about any one exercise.
In fact, just about any movement can help—if it’s:
- Repeated consistently
- Done without fear or tension
- Adapted to your body and energy level
- Viewed as a tool to reconnect with your body—not a test to pass or fail
This kind of movement desensitizes the nervous system. When you move in a way that feels safe, non-threatening, and gradually progressive, your brain and body learn: “Hey, maybe this isn’t so dangerous after all.”
That’s called graded exposure. And it works.
It’s not about fixing alignment or activating one muscle group. It’s about helping your system calm down over time—so you can do more, with less pain, and greater confidence.
What About the McKenzie Method?
Let’s talk about another popular approach to chronic low back pain: the McKenzie Method. This technique, especially the repeated extension movements, is often prescribed for disc-related pain or stiffness.
For some people, it helps a lot. For others, not at all.
Here’s why: McKenzie works not because the extension movement is magical—but because it offers structure, repetition, and self-management.
It gives people something to do. It offers a sense of control. And when it feels good, it builds confidence.
But when it doesn’t work—or when people are told they must push through pain or follow it exactly—it can lead to frustration, fear, and the feeling that they’re “failing” at rehab.
That’s the opposite of what we want.
Remember: even helpful protocols like McKenzie aren’t universal fixes. They’re just tools—and the best tool is the one that works for you.
So… What Should You Do Instead?
Here’s the good news: you don’t need to chase the “perfect” chronic low back pain exercise. You need a plan that supports all the parts of you that are involved in pain.
That includes:
1. Movement You Enjoy
Choose activities that feel good, or at least non-threatening. That might be walking, swimming, stretching, dancing in the kitchen, or gentle strength work. The “right” movement is the one you’ll actually do—and do consistently.
2. Education
Learn about how pain works. Understanding that pain doesn’t always mean damage can be incredibly freeing. It helps reframe the experience and reduces fear.
3. Support for Emotional Health
Chronic pain can take a toll on your mental and emotional well-being. Make space for things like rest, connection, journaling, or therapy. Your nervous system responds to safety, not pressure.
4. Pacing and Flexibility
It’s okay to have ups and downs. Learning to pace yourself, take breaks, and adjust plans without guilt is part of the process.
5. Rewriting the Story You’ve Been Told
You are not broken. Nor are you weak. You don’t need to earn healing by doing everything right. Your story matters—and rewriting it with compassion, curiosity, and hope changes everything
Final Thoughts: You Are the Expert on Your Body
When it comes to chronic low back pain exercises, the most important thing I can tell you is this:
There is no magic exercise. But there is magic in you.
Your body is adaptable. Nervous systems can calm down. Your life is not over because you live with pain right now.
So move in ways that feel good. Let go of strict prescriptions. And remember: healing is possible—not through perfection, but through permission to be human, curious, and brave.
Learn more about chronic pain with my free course here.
