In addition to regular cardiovascular exercise, the American Academy of Orthopedic Surgeons has also recommended a series of exercises that have been specifically chosen in order to help strengthen and condition the muscles that support the spinal column. These exercises can be done at home, and they do not require any special exercise equipment.

The primary goals of an exercise program for your spine are to make the muscles of your back, stomach, hips and thighs strong and flexible. These exercises should be incorporated into an overall program of aerobic conditioning such as walking, bike riding, swimming, or jogging. Before beginning any exercise program, check with your doctor to make sure that there are no other medical considerations that would change your approach to the exercise program. If exercise is new to you, then consider working with a certified personal trainer who can help you develop an exercise program that will meet your goals.

Swimming is often recommended as a good exercise for back sufferers as it strengthens the muscles while your body is supported by water. Swim crawl with side breathing rather than breaststroke, because breaststroke can put strain on the neck and back (and on your knees too). Aqua-aerobics is probably an especially good start. Your local leisure or community center may run exercise classes.

Here are some starter exercises to strengthen your muscles - they are too boring to keep up for long, but they enable you to exert close control over back stress and pain, while you build up some initial muscle tone.

Don't persevere with anything that makes your back pain worse.Do a little every day, not a lot every few days.

• Wall slides to strengthen back, hip, and leg muscles Stand with your back against a wall and feet shoulder-width apart. Slide down into a crouch with knees bent. Count to five and slide back up the wall. Repeat 5 times.
• Leg raises to strengthen back and hip muscles Lie on your stomach. Tighten the muscles in one leg and raise it from the floor. Hold your leg up for a count of 10 and return it to the floor. Do the same with the other leg. Repeat five times with each leg.
• Leg raises to strengthen stomach and hip muscles Lie on your back with your arms at your sides. Lift one leg off the floor. Hold your leg up for a count of 10 and return it to the floor. Do the same with the other leg. Repeat five times with each leg. If that is too difficult, keep one knee bent and the foot flat on the ground while raising the leg.
• Back leg swing to strengthen hip and back muscles Stand behind a chair with your hands on the back of the chair. Lift one leg back and up while keeping the knee straight. Return slowly. Raise other leg and return. Repeat five times with each leg.
• Curl
  Lie on your back with your knees bent and feet flat on your bed or floor. Raise your knees toward your chest. Place both hands under your knees and gently pull your knees as close to your chest as possible. Do not raise your head. Do not straighten your legs as you lower them. Start with five repetitions, several times a day.
• Back bend Stand with your feet slightly apart. Place your hands in the small of your back. Keep your knees straight. Bend backwards at the waist as far as is comfortable, and hold the position for one or two seconds.
• Single/double Knee to chest
  Lie on back with both knees bent. Bring one knee to chest, grasp knee with both hands, pull as close to the chest as you can. Lower knee back to starting position. Repeat with other leg.
• Prone Press-ups
  Lie on stomach with palms by shoulders as if to do a push-up. Slowly push shoulders up while keeping pelvis in contact with the surface; back and buttocks relaxed. Slowly lower shoulders. Move cautiously for several repetitions and then move more vigorously as tolerated. Lock elbows, exhale, and let the lower back sag while sustaining the up position for several seconds during last few repetitions.

The best type and intensity of exercise is different according to your condition, your fitness and the state of your back. You need some exercise, but not too much. That's why you may be given conflicting advice by different experts. If that happens, learn the broad principles and then go your own way - it's your body and only you can feel it. The key is to start gently, choose your sports carefully, and gradually develop into a more strenuous regime. Getting fit is a stress/recovery process, while most bad backs result from too much or too prolonged stress with incomplete recovery. Your exercise "sweet spot" will be unique to you, and will change as you get fitter and your back heals.

Low Back Exercise Guide: Regular exercises to restore the strength of your back and a gradual return to everyday activities are important for your full recovery. Your orthopedic surgeon and physical therapist may recommend that you exercise 10 to 30 minutes a day one to three times a day during your early recovery. They may suggest some of the following exercises. This guide can help you better understand your exercise and activity program, supervised by your therapist and orthopedic surgeon.