You can usually keep working out with lower back pain, as long as you change what you do while it settles. For most common back pain, staying active helps more than resting: walk daily, keep training the movements that don’t hurt, pause or lighten the ones that clearly flare it (usually heavy deadlifts, loaded bending and twisting), and bring them back gradually. Get it assessed by a physiotherapist or doctor if it isn’t improving within a few weeks, and get urgent care for the red-flag symptoms below.
Red flags: when to stop and get help
Most lower back pain is not dangerous, but a few symptoms need medical attention. The NHS back pain guidance splits them into two groups. In Canada, the emergency route is 911 or your nearest emergency department.
| Get emergency care now if back pain comes with | Get an urgent doctor’s appointment if back pain comes with |
|---|---|
| Pain, tingling, weakness or numbness in both legs | Feeling hot, cold, shivery or generally unwell |
| Loss of feeling around the genitals or anus | Severe pain that started suddenly |
| New changes in bladder or bowel control | Pain that is getting worse quickly |
| New problems with sexual function |
Also see a doctor if the pain started after a fall or accident, or if anything about it worries you. None of these are things to train around.
What the guidelines actually say
The UK’s NICE guideline on low back pain recommends encouraging people to continue with normal activities, and suggests exercise programmes (strengthening, aerobic, mind–body or a combination) as part of managing a specific episode or flare-up. It also advises against routine imaging in general practice and against belts or corsets for managing low back pain.
The take-away for training: movement is part of recovery, not the enemy of it. What you need to manage is how much and what kind.
Keep, change or pause: the gym during a flare
This table is a starting point. Your physiotherapist’s advice for your back overrides it.
| Movement | During a flare | As it settles |
|---|---|---|
| Walking | Keep: short, frequent walks | Build back to 30–45 min |
| Bike, rower (easy) | Keep if pain-free; the rower may not suit everyone | Normal cardio |
| Heavy deadlifts, good mornings | Pause | Return light, as trap bar or Romanian deadlift, adding weight slowly |
| Back squats | Pause or swap to goblet squat to a box | Rebuild depth and load over weeks |
| Leg press | Try light with a short range; stop if the lower back lifts off the pad | Normal range |
| Bench press, rows, pulldowns | Usually fine; chest-supported rows are kindest | Normal |
| Overhead press | Seated or half-kneeling instead of standing | Back to standing |
| Core: bird dog, dead bug, side plank | Keep; gentle and controlled | Progress the holds |
| Sit-ups, Russian twists, loaded twisting | Pause | Rarely needed at all |
The lower-back-friendly workout puts these swaps into a full program. The bird dog and dead bug pages show how to do the core exercises properly.
A simple flare-up session
When your back is grumpy but you want to train, a 30-minute session like this keeps you moving without poking the bear:
- Walk or easy bike, 8–10 minutes.
- Bird dog, 2 × 6 per side, slow, with a two-second hold.
- Glute bridge, 3 × 10–12.
- Chest-supported dumbbell row, 3 × 10.
- Dumbbell bench press or push-up, 3 × 8–10.
- Side plank from the knees, 2 × 20 seconds per side.
- Walk, 5–10 minutes.
Use a simple rule while you train: some discomfort that stays mild and settles within a day is generally acceptable; pain that sharpens during a set, spreads down a leg, or is worse the next morning means you did too much. Agree your own limits with your physiotherapist.
Who to see, and what it costs in Ontario
A physiotherapist is the right first stop for most back pain that isn’t settling after a couple of weeks. Physiotherapists in Ontario are regulated, and you can check anyone’s registration on the College of Physiotherapists of Ontario public register. Government-funded physiotherapy in Ontario is limited to specific groups (such as people 65 and over, or after a hospital stay), so most working-age men pay privately or through workplace benefits. See your family doctor if you have any of the red flags above, if pain spreads into a leg, or if a physiotherapist recommends it.
A coach or trainer can’t diagnose or treat back pain. What a good one can do is run your training around it and coordinate with your physiotherapist. The guide to a personal trainer for back pain explains where that line sits.
Bringing the heavy lifts back
Once the pain has settled and you’ve been cleared, return to the big lifts in steps:
- Start with the easiest version (goblet squat, trap bar or Romanian deadlift with light dumbbells).
- Use about half your previous working weight for two weeks.
- Add weight only when the day after training feels normal.
- Keep core and hip work in the program permanently. Long sitting days are often part of the story; see tight hips from sitting.
There’s no promise that any program will stop back pain coming back, but staying strong and active gives you the best odds of shorter, milder flares. If you’d like a coach to plan your training around your back, in person in Toronto or online, weekly 1:1 coaching starts from $99 a week and works alongside your physiotherapist, not instead of them.
Questions people also ask
Should I stop working out if my lower back hurts?
Usually not completely. Guidance for low back pain encourages people to stay active and continue normal activities as far as possible. Pause the movements that clearly aggravate it, keep the ones that don't, and get it assessed if it isn't settling.
Can I deadlift with lower back pain?
Not heavy during a flare. Swap to movements that train the hips without stressing the back, such as glute bridges and light cable pull-throughs, and bring deadlifts back gradually, starting light, once a physiotherapist is happy and the pain has settled.
Is walking good for lower back pain?
For most people, yes. Regular short walks keep you moving without loading the spine much, and many men find their back feels better after a walk than after sitting.
Do I need an X-ray or MRI for lower back pain?
Usually not. Guidelines advise against routine imaging for low back pain in general practice, because scans often show changes that don't explain the pain. Your doctor will order imaging if your symptoms suggest it's needed.