If you have lower back pain and you lift, you’ve almost certainly been told one of two things: “stop lifting and rest” or “push through it.” Both are wrong most of the time. Here’s the more useful framework we use at RXN Performance in Uptown Dallas.

The short answer

For the vast majority of active adults with non-traumatic lower back pain, the right answer is to keep training with modifications — not stop, and not push through. Complete rest almost always makes the problem worse. Continuing exactly as you were almost always extends the timeline.

When you should pause and get assessed first

• Pain with bowel or bladder changes, numbness in the saddle region, or progressive weakness in a leg — these warrant medical evaluation, not just training modifications.
• Pain after a clear traumatic event (a missed catch, a known disc injury, a fall).
• Pain that’s getting worse week over week despite reasonable modification.

Anything else — chronic nagging back pain, pain that comes and goes with volume, the familiar tightness that won’t quite resolve — is exactly the kind of thing a sports chiropractor sees every day, and is usually trainable around while we fix the root cause.

What to modify in the meantime

The three highest-leverage modifications for almost anyone:

• Scale, don’t skip, the squat and deadlift. Drop load, slow the eccentric, and shrink the range to whatever’s truly pain-free. Eliminating these patterns entirely tends to deconditon the exact muscles that protect your back.
• Add hip mobility work before every session. Most chronic back pain in lifters is driven by hip restriction the lumbar spine is compensating for. Five focused minutes on internal rotation and flexion does more than half an hour of foam-rolling your back.
• Hammer single-leg work. Split squats, step-ups, single-leg RDLs — these expose and correct the asymmetric loading patterns that build up under heavy bilateral work and quietly drive most stubborn back pain.

Related resource: Pre-Workout Routine for Back Pain — 10 Minutes That Actually Prevent Flare-Ups. Written by Dr. Ryan Giniel, D.C.

The mistake almost everyone makes

They wait until they “feel ready” to lift heavy again, then reload at full weight in one session. The body interprets that exactly the way you’d expect — as a brand new stressor on tissue that hasn’t been progressively reloaded — and the pain returns. The fix is structured re-progression, not waiting until pain is 0/10 and hoping.

What a real recovery looks like

Ron’s case study is a useful example. He’d had lower back pain for 5–7 years and was considering surgery. We didn’t tell him to stop training — we modified what he was doing, treated his actual driver (left hip internal rotation + an old SI joint pattern), and progressively reloaded. He ended at a 295 lb trap-bar deadlift in 6 months, pain free. The pattern matters more than the protocol.

The next step if this sounds like you

If you’re a lifter dealing with lower back pain, a movement assessment is the right starting point. We’ll figure out what’s actually driving your pain and build a training-friendly plan around it. Discovery calls are free.

Book a Free 15-min Discovery Call →

Written by Dr. Ryan Giniel, D.C., founder of RXN Performance in Uptown Dallas. More about Dr. Ryan →