Pam Moore

I'm an award-winning freelance health and fitness journalist and content marketing writer with over ten years of healthcare experience. A re

Mar 29, 2021
Published on: SpineUniverse
2 min read

If you’re one of the millions of Americans who experience back pain, you might be wary of doing anything that could potentially make it worse — including resistance training. But for the typical person with back pain, this is counterproductive, says Disa Hatfeld, PhD, Associate Kinesiology Professor and Kinesiology Department Chair at the University of Rhode Island.

Woman performing free weights exercise for back pain and spine safety

According to Dr. Hatfield, who is a former world-class powerlifter, there’s a strong body of research showing that strength training can reduce chronic pain. Plus, she says the literature shows adding weight training to your routine “also reduces [back pain] to a greater extent than cardiovascular activity, or just being active.”

If you’re putting off strength training because you’re still debating whether to use free weights or machines, that’s a mistake says Dr. Hatfield. The sooner you start a resistance training routine of any kind, the better. Here’s what you need to know to determine which route is right for you.

Free weights, which include dumbbells, barbells, and even household items like gallon jugs of water, offer the greatest potential for reward, but arguably the most risks.

The most compelling case for free weights is their capacity to improve your strength in the gym as well as your functional abilities outside the gym. According to Dr. Hatfield, research shows lifting free weights without pain can improve your quality of life.

She points to studies performed on older adults; while subjects appreciate the ability to lift heavier weights, “they get super excited when they go on vacation and they can put their luggage in the overhead bin, or bring their groceries up the stairs.”

Unlike with machines, the strength you develop from lifting free weights transfers to functional activities because you’re responsible for maintaining your balance and form during the movement. Free weights strengthen your stabilization muscles and require co-contraction of your transverse abdominus. Depending on the cause of your back pain, this can be a huge advantage for people with bad backs.

Additionally, research suggests that free weights elicit greater muscle activation than machines, which means they can help you progress faster.

Free weights offer more opportunities to perform compound exercises, moves that work more than one muscle group at once. And according to Dr. Hatfield, they tend to have a greater effect on back pain than single-joint exercises. (A squat, which requires movement at both your hips and knees, is a compound exercise, whereas a seated leg press only requires movement at your knee joints.)

The main downside of free weights is how they’re perceived; many people find them intimidating. It should come as no surprise that you’ll never experience the benefits of a workout you’re afraid to try.

That said, the fear of free weights isn’t completely unfounded. To use them safely, you need more knowledge of correct form. Free weights present a greater risk of injury, particularly if you’re not being careful or are unaware of the flaws in your form.

Woman using weight machine for back pain spine health

For many, machines offer a more user-friendly entry-point to weight lifting. While they won’t give you the same bang for your buck as lifting free weights, you can generally complete a circuit (a series of different exercises) more quickly using machines because of their relatively easy adjustability. Plus, the machine circuit you consistently do is always better than the free weight session you avoid.

Before you hit the gym or even lace up your sneakers, it’s vital that you consult with your physician. While there’s unequivocal data to support strength training’s effectiveness in back pain management, studies typically include subjects with nonspecific back pain, says Dr. Hatfield. To avoid inadvertently hurting study participants, “researchers don’t want to touch certain conditions.” That includes (but certainly isn’t limited to) a herniated disc, a slipped vertebra, or scoliosis.

Ask your healthcare provider for clear guidelines regarding what, if any, exercises you need to modify or completely avoid. If you hire a personal trainer, which Dr. Hatfield recommends, share your doctor’s recommendations with them. And if your personal trainer doesn’t ask for these details or isn’t attentive to them, find another trainer.

A quality fitness professional will take every precaution to ensure your safety. Dr. Hatfield suggests finding a certified personal trainer with credentials from either the American College of Sports Medicine or the National Strength and Conditioning Association.

Also consider your personal trainer’s experience and the continuing education they’ve completed. Some trainers focus on special populations, including geriatrics and/or those with disabilities. Those with prior experience as a physical therapy assistant or athletic trainer are likely to have worked with people who have back pain in the past.

Engaging with a personal trainer won’t just give you structure and accountability — it can also keep you safe. Whether you use free weights, machines, or both, good form is imperative. As Dr. Hatfield explains, it’s generally not the exercise itself but the act of performing an exercise with incorrect form that causes issues. Adding weight to the equation only increases the chances of injury or a back pain flare.

Formal instruction, including face-to-face demonstration and intermittent verbal and/or physical cueing (e.g. a reminder to keep your back flat or a light touch to the low back), goes a long way toward ensuring proper form.

For example, while performing a deadlift, after obtaining your permission to touch you, your trainer might put their hands on your shoulder blades and say “pinch my hands” to encourage you to keep your shoulder blades back, says Dr. Hatfield. Instructional YouTube videos are an excellent resource but nothing can stand in for real-time feedback from a qualified professional, whether that’s a personal trainer in a one-on-one session, small group session, or a group fitness class.

Whether you go with free weights or machines, there are three key movements to help keep back pain at bay: squats, deadlifts, and core exercises. For best results, work these into your routine at least twice a week and make sure the last few repetitions feel challenging.

While squats get a bad rap for causing knee pain, Dr. Hatfield says this is not grounded in science. “We’ve done the research,” she says. Also, you don’t need a heavy barbell for squats, or any exercise, to be effective.

No matter what exercise you’re doing, as long as you’re challenging your muscles appropriately — whether using bodyweight, resistance bands, dumbbells, or even wearing a backpack — your body will respond by growing stronger, and ultimately keeping your back pain in check.

Strength training is a commitment, but it’s worth the effort. Whether you opt for free weights, machines, or a combination of the two, the keys to success are maintaining a consistent practice and using good form.

View Sources

Millions of Americans experience back pain each day: Centers for Disease Control and Prevention (2020) “Acute Low Back Pain.” https://www.cdc.gov/acute-pain/low-back-pain/

Free weights come with a greater risk of injury, compared to machines: National Strength and Conditioning Association (December 2000) “Roundtable Discussion: Machines Versus Free Weights.” http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.451.9285&rep=rep1&type=pdf

Research suggests free weights elicit greater muscle activation: Journal of Strength and Conditioning Research(March 2010) “A Comparison of Muscle Activation Between a Smith Machine and Free Weight Bench Press.” https://journals.lww.com/nsca-jscr/FullText/2010/03000/A_Comparison_of_Muscle_Activation_Between_a_Smith.26.aspx

Incorporate strength training twice a week: BMC Musculoskeletal Disorders (March 2017) “Effects of yoga, strength training and advice on back pain: a randomized controlled trial.” https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-017-1497-1

Core strength training helps manage back pain: Journal of Physical Therapy Science (March 2015) “Core strength training for patients with chronic low back pain.” https://www.jstage.jst.go.jp/article/jpts/27/3/27_jpts-2014-564/_article/-char/ja/