Does Lifting Heavy Actually Help Your Back? What 13 Trials Say About Load

You don’t need to lift weights to improve your back pain, but you can if you want to.

Resistance training for lower back pain works. The argument is settled. What is not settled is whether you need to add external load (barbells, dumbbells, machines, weighted vests) to get the benefit, or whether bodyweight resistance is enough to get you out of pain and back to daily life. A 2025 study looked at this exact question and gave us the clear states we have so far.

The short version is this. After seven weeks of training, people who used external loads reported pain scores about half a point lower on a 0 to 10 scale than people doing the same exercises without weight [1]. That is statistically significant. It is also, in practical terms, very small. This is actually good news: bodyweight exercises are sufficient for back pain rehab, and resistance training is safe and offers a slight benefit over bodyweight training. Everybody wins.

What this means if you have been avoiding the gym

Don’t. The analysis determined that resistance training is safe for people with back pain. Exercises included in studies that qualified for the review included everything from barbell deadlifts and squats to pilates and resistance bands. All were deemed safe. We know how beneficial exercise and resistance training are to health and longevity, so try your best to continue despite your back pain.

A simple rule of thumb, and this is just my personal recommendation, is to decrease your weights at the gym by 50% on exercises that challenge your back and its stability. The intention behind this is to refocus on proper technique before slowly progressing back up to the normal weights you use. I would add back 5-10% of the weight each week (depending on the exercise) and continue to do so as long as you’re feeling good. This gives your body a chance to shed some fatigue while you also add in targeted exercises to address your back pain.

What this means if you have no intention to go to the gym as part of your back pain rehab

Good news! This review shows that comparable back pain rehab can be achieved without access to gym equipment. Like I said earlier, everybody wins. There’s a whole host of exercises to strengthen the musculature surrounding the hips, legs, and spine (core and spinal erectors) that does not require a gym membership. You can complete them at home, anytime. A few of my favourites are:

• seated good mornings
• bodyweight hip hinges
• glute bridges/hip thrusts (double or single leg)
• Dead bugs
• planks (front and side)

All of these are scalable to easier and harder variations for all fitness levels. All of them (and more) appear in my programs available here.

Where resistance training matters

Guess what?! Back muscle endurance and maximal strength both improved from training with weights, big surprise [1]. This gets at my main point on the utility of resistance training. If you’re an athlete, someone chasing improved physical performance, or even someone that simply enjoys going to the gym, there’s no apparent downside to lifting weights with back pain. There may even be minor upsides in pain reduction according to this study.

To put it plainly: lifting weights isn’t required to improve back pain, but lifting weights may improve pain slightly more than bodyweight exercises.

Take-home message

You don’t need to lift weight to improve your back pain. And that’s a beautiful finding. Many people do not have access to gym equipment because of time, money, or physical location. The findings of this review study remove that barrier - at least for back pain rehab. For those of you that like to lift weights, don’t let your back pain stop you from being active.

If you’d like to take all of the guesswork out of what to do, how to do it, and when to do it, come grab one of my evidence-based programs at backagainassessments.com. Get started with my free 2-minute quiz and find out which pain pattern describes you.

Take the 2-minute back pain quiz

Best,

Mitch

This newsletter is educational and does not replace individual medical advice. If you have new or worsening neurological symptoms (numbness, weakness, loss of bladder or bowel control), see a clinician promptly.

References

[1] Ranzani et al., 2025 — 10.33393/aop.2025.3533. Is resistance training with external loads superior to unloaded exercise in the management of chronic low back pain? A systematic review and meta-analysis. Archives of Physiotherapy, 15, 297-313.