Lifting Weights for a Stronger Back:
Why the Gym Might Be Exactly What Your Spine Needs
By Dr. Dan Tomassi, Chiropractor
Exercise is proven back medicine!
Let’s start with the big picture. The most comprehensive review of the evidence — a Cochrane systematic review pooling 249 separate trials — concluded that exercise therapy reduces pain and improves function in people with chronic low back pain [1]. This is about as strong as health evidence gets, and it’s why exercise sits at the heart of every major back-pain guideline worldwide, including those from the UK’s NICE, the World Health Organization, and the American College of Physicians [1,2].
Strength training in particular pulls its weight. A 2025 review of resistance-training trials found significant improvements in pain, disability and quality of life for people with ongoing low back pain [3]. Building strength doesn’t just mask the problem — it helps address it.
The shift in thinking:
Your spine isn’t fragile. Like the rest of your body, it adapts and gets stronger when you load it sensibly.
“But won’t lifting hurt my back?”
This is the question we hear most, and the evidence is genuinely reassuring.
Consider a trial called LIFTMOR, which took a group of postmenopausal women with low bone density — exactly the people traditionally warned off heavy lifting — and put them through twice-weekly, high-intensity strength training including deadlifts and squats [4]. Across more than 2,600 supervised training sessions, there was just one minor back muscle strain and no fractures, while bone density and physical function improved [4]. If appropriately coached lifting is safe and beneficial for fragile bones, it’s a powerful reassurance for the rest of us.
Research has also challenged one of the most stubborn beliefs of all: that you must always keep your back perfectly straight. A review of the evidence found that bending your spine while lifting is not clearly a cause of back pain, and doesn’t reliably separate people who have back pain from those who don’t [5]. Good technique and gradual progression still matter, but the fear of ever rounding your back isn’t well supported.
Not sure where to start, or nervous about your back?
Book an assessment with Dr. Dan Tomassi at CCS Health and we’ll build a plan around your comfort and confidence.
You don’t have to lift heavy to benefit
Here’s the freeing part: there’s no single “correct” way to strengthen your back. Research comparing heavy lifting with gentler, targeted core exercises found both approaches reduced pain effectively [6]. Deep-core and motor-control exercises have their own solid evidence base too [7].
That means the best program is the one that suits you — your starting point, your preferences, and what you’ll stick with. Whether that’s barbells, resistance bands, bodyweight movements or machine work, the strengthening principle holds.
Strength is an investment in your future self
The benefits of resistance training reach well beyond back pain. Building and maintaining muscle helps protect against the natural decline in strength and mobility that comes with age, supporting your ability to stay independent and active [8]. Weight-bearing and resistance exercise also supports bone health — as the LIFTMOR trial demonstrated [4]. Global health guidelines now recommend muscle-strengthening activity on at least two days a week for adults of all ages [8].
In short, the work you do in the gym today pays dividends for decades.
How to begin safely
· Get assessed first. Especially if you have current pain or haven’t trained before — a tailored start beats a generic one.
· Prioritise technique. Good form, learned early, lets you progress with confidence.
· Progress gradually. Add a little load or a few reps over time, rather than chasing big jumps.
· Expect some muscle soreness. That’s normal adaptation — different from a sharp warning pain.
· Be consistent. Two or three focused sessions a week, done regularly, is where the magic happens.
Let’s build your strength and your confidence
The gym isn’t the enemy of a sore back. Done well, it’s one of your best allies. At CCS Health, we assess your movement, address what’s limiting you, and help you build a strengthening plan that’s safe, progressive and genuinely enjoyable.
Ready to get stronger?
Book your assessment with CCS Health today!
References
1. Hayden JA, Ellis J, Ogilvie R, Malmivaara A, van Tulder MW. Exercise therapy for chronic low back pain. Cochrane Database of Systematic Reviews. 2021;(9):CD009790.
2. Qaseem A, Wilt TJ, McLean RM, Forciea MA; Clinical Guidelines Committee of the American College of Physicians. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Annals of Internal Medicine. 2017;166(7):514–530.
3. González-Gómez L, et al. Does resistance training improve pain intensity, quality of life, and disability in people with chronic nonspecific low back pain? A systematic review and meta-analysis. Disability and Rehabilitation. 2025 (published online).
4. Watson SL, Weeks BK, Weis LJ, Harding AT, Horan SA, Beck BR. High-intensity resistance and impact training improves bone mineral density and physical function in postmenopausal women with osteopenia and osteoporosis: the LIFTMOR randomized controlled trial. Journal of Bone and Mineral Research. 2018;33(2):211–220.
5. Saraceni N, Kent P, Ng L, Campbell A, Straker L, O’Sullivan P. To flex or not to flex? Is there a relationship between lumbar spine flexion during lifting and low back pain? A systematic review with meta-analysis. Journal of Orthopaedic & Sports Physical Therapy. 2020;50(3):121–130.
6. Aasa B, Berglund L, Michaelson P, Aasa U. Individualized low-load motor control exercises and education versus a high-load lifting exercise and education to improve activity, pain intensity, and physical performance in patients with low back pain: a randomized controlled trial. Journal of Orthopaedic & Sports Physical Therapy. 2015;45(2):77–85.
7. Saragiotto BT, Maher CG, Yamato TP, et al. Motor control exercise for chronic non-specific low-back pain. Cochrane Database of Systematic Reviews. 2016;(1):CD012004.
8. Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. British Journal of Sports Medicine. 2020;54(24):1451–1462.
This article is general information only and is not a substitute for individual professional advice, diagnosis or treatment. Chiropractic care at CCS Health focuses on the assessment and management of musculoskeletal conditions. Outcomes vary between individuals. Always seek guidance before beginning a new exercise program, particularly if you have existing pain or health concerns.
Dr. Dan Tomassi
Dan works with patients who want more than short-term symptom relief. He focuses on understanding the underlying factors contributing to pain, reduced movement, or performance limitations, then develops practical, individualised plans that support recovery, resilience, and long-term physical wellbeing.
He has a particular interest in working with active individuals, gym-goers, athletes, and people who want to improve the way their body moves and performs. Whether someone is dealing with back pain, neck pain, headaches, sports injuries, training-related issues, or everyday musculoskeletal discomfort, Dan aims to provide clear guidance, evidence-informed care, and a pathway back to confident movement.
