Why Core Exercises Make Back Pain Worse: Stop These Mistakes Now

Core exercises can make back pain worse when the exercise is too difficult.

There is a frustrating situation I see quite often:

someone develops back pain, searches for the “best core exercises for back pain,” starts doing planks, crunches, leg raises, dead bugs or other abdominal exercises every day, and then wonders why the back feels worse instead of better.

The problem may not be that you have a weak core.

It may be that your core workout is asking your back to tolerate more load than it currently can handle.

This is an important distinction.

Core strengthening can absolutely be useful for people with low back pain.

Research supports trunk-focused exercise, motor-control training and stabilization exercises as potentially effective approaches for improving pain and function.

But these exercises are not universally appropriate in the same form, at the same intensity, or at the same stage of recovery. (JOSPT, 2023)

As a physiotherapist, I would therefore never judge a core exercise simply by asking, “Is this a good exercise?”

The better question is:

“Is this the right exercise for this person’s back right now?”

That small change in thinking can completely alter your rehabilitation.

Why core exercises can sometimes aggravate back pain

Your “core” is not one muscle.

It is a coordinated system involving the abdominal muscles, diaphragm, pelvic floor, multifidus, spinal muscles, hips and other muscles that help control the trunk during movement.

The purpose is not to keep your spine completely rigid all day.

Your spine is designed to move.

The goal of core training is to help you control movement and tolerate load, not to turn your torso into a permanently braced cylinder.

Research on motor-control exercise has found improvements in pain and disability in people with chronic nonspecific low back pain,

but it does not show that one particular core exercise is automatically superior for everyone. (Wolters Kluwer)

This is where many online “six-pack core workouts for back pain” go wrong.

They focus on making the abdominal muscles work harder rather than determining what your back actually needs.

1. You may be bracing your abdomen far too aggressively

One of the most overlooked problems is over-bracing.

You may have been told:

“Pull your stomach in.”

“Brace your core.”

“Push your abs out.”

“Keep your spine completely stable.”

If you interpret these instructions as “tense everything as hard as possible,” you can create unnecessary stiffness and fatigue.

Abdominal bracing does increase spinal stiffness and can contribute to spinal stability.

However, stability is not synonymous with maximal muscle tension.

Studies investigating intra-abdominal pressure demonstrate that pressure changes can influence lumbar stiffness, but that does not mean you should consciously brace maximally during every movement. (Elsevier)

In clinical practice, I often prefer graded bracing.

Think of it as using enough abdominal tension to control the movement without holding your breath or turning your entire torso rigid.

A simple test

Lie on your back with your knees bent.

Take a relaxed breath into your lower ribs.

Now gently tighten your abdominal wall as though someone is about to lightly poke your stomach.

You should still be able to breathe.

If you cannot breathe normally, your brace may be excessive.

2. Your plank may be too advanced for your current capacity

Planks look simple.

They are not necessarily easy.

A long plank can create substantial demand on the abdominal and spinal musculature.

If your trunk endurance is poor, the body may compensate as fatigue develops.

You may start with a reasonably controlled position and finish by:

• letting the lower back sag
• excessively tucking the pelvis
• holding your breath
• shrugging the shoulders
• gripping the glutes excessively
• shifting your weight
• shortening your breathing

At that point, you are no longer performing the same movement you started with.

This is why I rarely recommend chasing a longer plank simply because “60 seconds is better than 30 seconds.”

Longer is not automatically better rehabilitation.

Research examining trunk-focused exercise suggests that these programs can improve pain, disability and physical performance,

but the effects are influenced by exercise characteristics and individual factors. (JOSPT)

What I would change

Instead of immediately increasing duration, try:

10-20 seconds of excellent technique × several repetitions

rather than one exhausting hold.

Your objective is control, not survival.

3. You may be doing too many spinal-flexion exercises

Crunches, sit-ups and repeated abdominal flexion are not automatically dangerous.

But if bending repeatedly aggravates your symptoms, performing hundreds of repetitions because an internet workout promises a “stronger core” is not sensible rehabilitation.

This is particularly important when your pain consistently increases with flexion-based movements.

Recent research continues to examine the relationship between trunk flexion exposure and low back pain, and the answer is more complicated than “flexion is bad.”

The relationship depends on factors including occupational exposure, load, repetition and individual characteristics. (Sage Journals)

So I do not tell my patients to fear spinal flexion.

I teach them to restore tolerance to it progressively when appropriate.

That is very different.

4. Your leg raises may actually be loading your back more than your abs

Straight-leg raises are frequently marketed as an excellent lower-abdominal exercise.

But they can become problematic if you cannot control pelvic and lumbar movement.

As the legs move away from your body, the hip flexors generate substantial force.

If your abdominal and pelvic control is insufficient, your lumbar spine may compensate.

You may feel:

• pulling in the lower back
• increased arching
• pelvic rocking
• pressure around the lumbar area
• pain when lowering the legs

If this happens, the answer is not necessarily “strengthen your abs harder.”

The exercise may simply be too demanding.

A better progression

Start with a smaller range.

Try one leg at a time.

Keep the movement slow.

Stop before your pelvis starts moving excessively.

Then progress gradually.

This is one of the fundamental principles I use in physiotherapy:

Change the exercise before blaming the patient.

5. Your back may be doing the work your hips should be doing

Another lesser-known reason core exercises can aggravate the back is poor contribution from the hips.

Your gluteal muscles and hip muscles play an important role in transferring forces between the lower limbs and trunk.

A systematic review of hip-targeted interventions found that hip strengthening and stretching may improve pain and disability in some people with low back pain, although the certainty of evidence was low. (PMC)

This does not mean every person with back pain needs “stronger glutes.”

It means your rehabilitation should not automatically treat the abdomen as the only important region.

For example, if you perform a bridge but repeatedly arch through your lower back instead of extending through the hips, the exercise may become a lumbar-extension exercise disguised as a glute exercise.

That is why technique matters more than the exercise’s name.

6. You may be training your core while ignoring your breathing

Your diaphragm is part of the pressure-management system of the trunk.

When people perform demanding core exercises, they often unintentionally hold their breath.

Occasionally increasing abdominal pressure during heavy lifting is normal.

But continuously holding your breath during every repetition of a rehabilitation exercise can create unnecessary tension and make the exercise feel much harder than necessary.

Try this during a dead bug:

Inhale gently.

Exhale slowly as the arm or leg moves.

Maintain control.

Then inhale again.

If breathing completely destroys your ability to maintain the position, the exercise may currently be too difficult.

A surprisingly useful rule

If you cannot breathe during a core exercise, regress it before adding more repetitions.

7. You may be chasing muscle fatigue instead of functional improvement

A burning abdominal sensation can be satisfying.

But burning does not prove that an exercise is treating your back problem.

One of the lesser-known findings from research is that changes in deep abdominal muscle structure do not necessarily explain improvements in pain.

A systematic review found that motor-control exercise improved transversus abdominis contraction and pain/disability outcomes, but did not demonstrate superiority in resting muscle thickness over other interventions during shorter intervention periods. (KGL)

In other words:

Bigger-looking or harder-working abdominal muscles are not the entire objective.

Your ability to walk, bend, lift, sit, exercise and return to normal activities matters much more.

8. You may have increased your exercise volume too quickly

This is one of the most common mistakes.

Someone experiences back pain.

They decide to “fix their weak core.”

They start doing:

• 50 crunches
• 30 leg raises
• 3 plank variations
• 50 bicycle crunches
• 100 mountain climbers

every day.

Their back becomes irritated.

Then they conclude:

“Exercise makes my back worse.”

Usually, the more useful conclusion is:

The training dose was inappropriate.

Research examining stabilization exercise dosage suggests that exercise duration, frequency and program characteristics influence outcomes, although there is no universal dose that works for everyone. (Nature Portfolio)

Your tissues need time to adapt.

A good rehabilitation program should challenge you without repeatedly exceeding your recovery capacity.

9. You may be using “neutral spine” as a rigid rule

Neutral spine is useful.

But it is not a magical position where your back becomes injury-proof.

Your lumbar spine naturally changes position during movement.

If you become frightened of every degree of spinal movement, you can start moving stiffly and cautiously.

That can make ordinary activities feel threatening.

The goal of rehabilitation is usually capacity and confidence, not permanent avoidance of movement.

WHO’s current guidance for chronic primary low back pain emphasizes exercise, education and self-management as part of person-centred care rather than relying on a single intervention. (WHO guideline)

10. Your pain response may be telling you that the exercise needs modification

This is where physiotherapy assessment becomes valuable.

I want patients to notice what happens:

During the exercise

Immediately afterward

Later that day

The following morning

A mild, temporary increase in symptoms does not automatically mean damage.

But if every session produces progressively worse pain, increasing radiating symptoms or a sustained decline in function, continuing exactly the same program is not a good strategy.

A classic randomized trial demonstrated that people with low back pain can respond differently to different exercise directions, supporting the importance of matching exercise to individual symptom responses rather than assuming one exercise prescription fits everyone. (NCBI)

That principle remains clinically useful.

The biggest myth: “A weak core is causing my back pain”

This statement is too simplistic.

Some people with low back pain demonstrate changes in trunk muscle activation, strength or endurance.

But that does not mean every episode of back pain is caused by weak abdominal muscles.

In fact, research on physical capacity and future low back pain has not consistently shown that low trunk endurance predicts who will develop back pain. (PubMed)

Back pain is influenced by multiple factors, including physical loading, sleep, stress, activity levels, previous pain experiences, work demands and individual sensitivity.

This is why “strengthen your core” is sometimes useful advice but rarely a complete diagnosis.

What to do if core exercises are making your back worse

First, stop treating pain as a competition.

You do not need to push through progressively worsening symptoms simply because an exercise is labelled “rehabilitation.”

Instead, temporarily reduce the exercise that clearly aggravates you.

Then identify what part of the movement is causing difficulty.

Ask yourself:

Is the range too large?

Is the exercise too long?

Am I holding my breath?

Does my back arch or round excessively?

Does the pain increase with every repetition?

Do symptoms spread into the buttock or leg?

Am I already fatigued before beginning the exercise?

Your answers can provide valuable clues.

A safer way to rebuild your core

Start with breathing and low-load control

Try comfortable diaphragmatic breathing while lying or sitting.

Learn to gently activate your abdominal wall without breath-holding.

The goal is control, not maximum tension.

Progress to simple limb movements

Dead-bug variations can be useful when appropriately modified.

Begin with one limb.

Reduce the range.

Slow down.

Only progress when you can maintain comfortable trunk control.

Add hip and trunk strengthening

Bridges, supported squats, hip-hinge practice, bird-dog variations and carries may eventually be more useful than performing endless abdominal exercises.

The precise selection should depend on your symptoms and goals.

Build endurance gradually

Once you can perform an exercise comfortably, increase repetitions or duration gradually.

Do not simultaneously increase:

• resistance
• repetitions
• duration
• exercise complexity
• frequency

Choose one variable at a time.

Then train real-life movement

This is the step many online core programs miss.

Your core ultimately needs to work while you:

• walk
• climb stairs
• lift groceries
• pick up children
• bend
• sit and stand
• exercise
• work
• rotate
• carry objects

A stronger core that cannot tolerate normal life is not the final goal.

Should you stop planks if you have back pain?

Not necessarily.

A plank can be an excellent exercise for some people.

But modify it if:

• your back pain increases consistently
• your pelvis collapses
• you cannot breathe
• you are shaking excessively from fatigue
• symptoms spread into the leg
• you need to hold your breath to finish

Try a wall plank or elevated plank first.

Then gradually lower the support.

This creates a progression rather than forcing your body to perform an exercise it is not ready for.

Should you stop crunches?

Again, not automatically.

Spinal flexion is not inherently dangerous.

However, if repeated crunches reliably reproduce your symptoms, there is no prize for completing them.

Use a different movement temporarily and gradually rebuild flexion tolerance when clinically appropriate.

The objective is not to permanently avoid movement.

It is to restore your ability to tolerate movement.

One thing I would avoid: “core challenges”

Be careful with 30-day core challenges that prescribe hundreds of repetitions without considering your:

• previous injuries
• current pain
• training history
• sleep
• recovery
• work demands
• exercise technique
• individual movement response

A standardized challenge cannot see how your pelvis is moving or whether your pain is changing.

A physiotherapist can.

When back pain after core exercise needs medical assessment

Do not assume every new episode of back pain is simply muscle soreness.

Seek professional assessment if you develop:

• significant or worsening weakness in a leg
• numbness that is spreading
• new difficulty walking
• severe pain after significant trauma
• unexplained fever or systemic illness
• unexplained weight loss
• severe night pain that is unusual for you
• new bowel or bladder changes
• numbness around the groin or saddle region

These symptoms require prompt medical evaluation rather than another round of planks.

The physiotherapist’s rule: train the problem, not the trend

Core workouts are popular because they look simple and measurable.

You can count repetitions.

You can time a plank.

You can feel your abs burn.

But rehabilitation is not a popularity contest.

The best exercise is not necessarily the one with the most views on social media.

It is the one that helps you improve your movement capacity, strength, confidence and function without repeatedly aggravating your symptoms.

And there is encouraging evidence that core and motor-control exercises can help many people with chronic nonspecific low back pain.

A systematic review of 10 studies involving 1,081 participants found sustainable positive effects on pain and disability following motor-control stabilization exercise, although the quality of evidence was low to moderate. (PLOS One)

That is an important message.

The answer is not to fear core exercise.

The answer is to individualize it.

My clinical insight

If your back hurts every time you do core exercises, I would not immediately tell you that your core is weak.

I would first ask:

What movement is provoking your symptoms?

How much load are you using?

How well can you control the movement?

Are you breathing normally?

What happens after the exercise?

What does your back tolerate during everyday activities?

Those answers are far more clinically useful than simply counting how many seconds you can hold a plank.

Your core does not need to be constantly tight.

Your spine does not need to remain frozen.

And you do not need to perform hundreds of repetitions to build a resilient back.

The goal is a body that can move, adapt, recover and handle progressively greater demands.

That is what good core rehabilitation should ultimately give you.

Final takeaway

If your core exercises are making your back worse, do not automatically conclude that you need an even harder abdominal workout.

The exercise may be too advanced.

The range may be too large.

The volume may be excessive.

Your breathing may be poor.

Your hips may not be contributing effectively.

Or the exercise simply may not match the way your back currently responds to movement.

Core training can be valuable, but it should be progressive, symptom-informed and functional.

If your symptoms repeatedly worsen despite modifying the exercise, a physiotherapy assessment is a much better next step than searching for another “best core exercise for back pain” video.

A stronger core is useful.

A better-functioning body is the real goal.

Stay tuned with us for more health related topics.

Follow us on LinkedIn and Instagram for more.

Medical Disclaimer!

This article has been reviewed and written under the guidance of our Head Physiotherapist, Dr. Kruti Raj (PT, MUHS,CPT,CMPT). The information shared is intended for educational purposes only and should not be considered a substitute for personalized medical advice, diagnosis, or treatment.

Please consult us or any other qualified healthcare professional before beginning any exercise program, especially if you are experiencing pain, recovering from injury, or managing a medical condition.