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Key points
- Exercise in general helps long-term back pain. Stretching is one part of that picture, not the whole of it.
- On its own, stretching has weaker evidence than strengthening, Pilates or core exercise, and studies disagree about how much it helps.
- For neck pain, stretching combined with strengthening seems to work better than stretching alone.
- Stretches should feel like a gentle pull, never sharp pain. Pins and needles or numbness are a signal to stop.
- Pick exercises you enjoy and can keep up. Regular practice matters more than any single stretch.
Why people stretch for back and neck pain
When your back or neck hurts, the muscles around it often feel tight and guarded. Stretching feels like the natural thing to do, and for many people it gives a pleasant sense of release. It is also free, needs no equipment and can be done at a desk or before bed.
The question is whether stretching actually changes pain and function over weeks and months, and how it compares with other types of exercise.
What the evidence says for low back pain
There is good reason to keep moving. A Cochrane review of 249 trials found moderate-certainty evidence that exercise reduces pain in chronic low back pain compared with no treatment or usual care, although the improvement in day-to-day function was small.[1] NICE recommends considering a group exercise programme (which can be biomechanical, aerobic, mind-body or a mix) for people with low back pain, with or without sciatica, taking into account their needs and preferences.[2]
Stretching specifically is less clear-cut. A 2022 network meta-analysis of 118 trials found that most types of exercise improved pain and disability, but stretching on its own did not significantly reduce pain compared with control groups. Pilates, strength and core-based exercises came out best.[3] On the other hand, a large analysis of 217 trials by the Cochrane exercise review team found that flexibility exercises did improve function compared with minimal treatment. The same authors concluded that people should be encouraged to do the exercise they enjoy, because sticking with it matters.[4]
A US trial randomised 228 adults with chronic low back pain to 12 weekly classes of yoga, conventional stretching classes or a self-care book. Yoga was better than the book, but it was not better than the stretching classes at any time point.[5] In other words, a well-run stretching class held its own against yoga, so structured stretching can be a genuinely useful option, even if stretching alone is unlikely to be the most powerful treatment.
What the evidence says for neck pain
The Cochrane review of exercises for neck disorders found no high-quality evidence for any exercise approach. For chronic neck pain, strengthening and endurance exercises for the neck, shoulders and upper back were the most promising, and combined strengthening and stretching programmes also helped pain and function. Stretching alone, however, may not improve pain or function (low-quality evidence).[6]
There are some encouraging individual trials. In a study of 96 office workers with chronic neck and shoulder pain, everyone was given ergonomic advice and half were also taught neck and shoulder stretches to do twice a day, five days a week, for four weeks. The stretching group had greater improvements in pain, neck function and quality of life, and people who stretched at least three times a week did better than those who did less.[7]
Stretching or strengthening?
You do not have to choose. A sensible routine for most people combines some stretching for comfort and movement with exercises that build strength and endurance, plus general activity such as walking. If you are only going to do one thing, the evidence leans towards strengthening or a structured programme such as Pilates. Stretching is a good way to start the day, warm down after activity, or ease stiffness after long periods of sitting.
Simple, safe stretches
These are gentle starting points. Move slowly, breathe normally and hold each stretch for around 20 to 30 seconds, repeating two or three times. You should feel a mild, comfortable pull.
For the lower back
- Knee to chest: lie on your back with knees bent. Bring one knee towards your chest, holding behind the thigh. Lower it and swap sides. Later you can try both knees together.
- Lower back rotation: lie on your back with knees bent and feet flat. Keeping your shoulders on the floor, let both knees fall slowly to one side as far as is comfortable, then return through the middle and go to the other side.
- Cat and camel: on your hands and knees, slowly round your back towards the ceiling, letting your head drop, then gently let your back sag into a slight arch while lifting your head. Keep the movement small and smooth.
- Hamstring stretch: lie on your back and loop a towel or belt around one foot. Straighten that leg towards the ceiling until you feel a stretch behind the thigh. Keep the other knee bent.
For the neck and shoulders
- Chin tuck: sit tall and gently draw your chin straight back, as if making a double chin, without tipping your head down. Hold for a few seconds and relax.
- Side bend: sit tall and slowly tilt one ear towards the same shoulder, keeping the other shoulder relaxed and down. Return to the middle and repeat on the other side.
- Turning: slowly turn your head to look over one shoulder, then the other, staying within a comfortable range.
- Chest opener: stand in a doorway with forearms on the frame at shoulder height, then step gently forward until you feel a stretch across the front of your chest.
When to stop. Stop a stretch if it causes sharp or stabbing pain, pain that spreads down an arm or leg, pins and needles, numbness or dizziness. Avoid bouncing, forcing a stretch or pushing into the end of a painful movement. If symptoms carry on after you stop, or your pain is getting steadily worse, see your GP or physiotherapist. If you have had recent spinal surgery, check with your surgical team before starting.
Making it stick
- Little and often works well. Five minutes once or twice a day is easier to keep up than a long weekly session.
- Link stretches to an existing habit, such as after brushing your teeth or during a work break.
- Add some strengthening and walking over time rather than relying on stretching alone.
- A physiotherapist can tailor a programme if you are unsure where to start, especially if you have sciatica or lumbar spinal stenosis.
Seek urgent medical help (A&E or 999) if you have:
- Numbness around your bottom, genitals or inner thighs, or new problems controlling your bladder or bowels.
- Weakness in your legs or arms that is getting worse.
- New clumsiness of the hands or problems with balance and walking alongside neck pain.
- Back or neck pain with fever, unexplained weight loss, or a history of cancer.
- Pain after a significant fall or injury.
Numbness in the saddle area or bladder changes can be signs of cauda equina syndrome, which needs same-day assessment.
References
- Hayden JA, Ellis J, Ogilvie R, Malmivaara A, van Tulder MW. Exercise therapy for chronic low back pain. Cochrane Database Syst Rev. 2021;9(9):CD009790. Link
- National Institute for Health and Care Excellence. Low back pain and sciatica in over 16s: assessment and management (NG59). London: NICE; 2016 (last updated 2026). Link
- Fernández-Rodríguez R, Álvarez-Bueno C, Cavero-Redondo I, et al. Best exercise options for reducing pain and disability in adults with chronic low back pain: Pilates, strength, core-based, and mind-body. A network meta-analysis. J Orthop Sports Phys Ther. 2022;52(8):505-521. Link
- Hayden JA, Ellis J, Ogilvie R, et al. Some types of exercise are more effective than others in people with chronic low back pain: a network meta-analysis. J Physiother. 2021;67(4):252-262. Link
- Sherman KJ, Cherkin DC, Wellman RD, et al. A randomized trial comparing yoga, stretching, and a self-care book for chronic low back pain. Arch Intern Med. 2011;171(22):2019-26. Link
- Gross A, Kay TM, Paquin JP, et al. Exercises for mechanical neck disorders. Cochrane Database Syst Rev. 2015;1(1):CD004250. Link
- Tunwattanapong P, Kongkasuwan R, Kuptniratsaikul V. The effectiveness of a neck and shoulder stretching exercise program among office workers with neck pain: a randomized controlled trial. Clin Rehabil. 2016;30(1):64-72. Link
This guide is general information and is not a substitute for advice about your own situation. Please speak to your GP, physiotherapist or specialist before starting a new treatment.
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