Bicycling is an excellent exercise for people of all ages. It’s low impact. It gets you outside. And on a hot day, you can create your own breeze as you roll along.
But if you have a spine-related condition—whether it’s chronic low back pain, a herniated disc or sciatica — you may need to spend a little more time choosing a bike that doesn’t worsen your pain or other symptoms.
Dr. Ram Mudiyam
, an orthopedic surgeon at the Hoag Orthopedic Institute in Huntington Beach, California, says the type of bike you choose depends on many factors, such as your age, what back condition you have, your symptoms, and whether you are a high-performance athlete or a recreational cyclist.
But there are several things to keep in mind when selecting a bike, setting up the proper fit and starting to ride. These tips apply both to people just getting into bicycling and experienced cyclists with new back problems.
Choosing bikes for back pain
Bicycles come in many shapes and sizes. But they generally fall into two categories—upright bikes and recumbent bikes.
Upright bikes include road and racing bikes, mountain bikes and even the beach cruisers with big handlebars. For some people with back pain or a spine condition, leaning forward to reach the handlebars can make their symptoms worse.
“With standard road or racing bikes, typically you're going to lean more towards the front of the bike,” says Dr. Shea Rogers, PT, DPT
, a physical therapist at Baton Rouge Physical Therapy in Louisiana. “That's going to put a little bit more of a forward flexion on the low back. For someone who’s older or with a back condition, that might be a little bit too intense.”
With mountain bikes, hybrids and cruisers, your torso is more vertical, which reduces the bend that occurs in the back. Sometimes this little shift in position can be enough to eliminate any back pain while riding.
If you have back pain but prefer riding a road bike, an endurance or touring bike might be the best option. Their frames have a different shape than racing bikes. “You sit up a little bit taller,” says Rogers, “but it's still going to be fast like a road bike.”
Recumbent bikes are another option, what Rogers calls “a game changer for people with chronic back pain.” With this type of bike, the pedals are out in front of you instead of below the seat. They also have a back rest to lean against. This takes the pressure off the lower back, buttocks and groin.
“I’ve seen some people switch to a recumbent bike after riding a road bike or even a cruiser-style bike,” says Rogers, “and their back pain during cycling almost completely goes away.”
Setting up the proper bike fit
Choosing a bike for back pain is just the first step. You also want to make sure it fits well. “For people who are really active and spend a lot of time on the bike, proper fitting is extremely important,” says Mudiyam. “If you have an ill-fitting bike, you are definitely going to be more prone to injury.”
If you buy your bicycle at a professional bike shop, they will fit the bike before you leave the store. Rogers, who is also an avid cyclist, says a physical therapist with experience cycling can also help fit the bike for you. This is particularly useful for people with existing back conditions.
Fitting the bike starts with choosing the proper type and size of bike. It also includes adjusting the height of the seat and the reach to the handlebars.
“If you don't have a good fit to your bike—if you have your seat too high or too low, or you're too stretched out forward in front of the handles—that's going unbalance your body,” says Rogers, “which can lead to things like back pain, buttock numbness and knee pain.”
Seat selection is also important, he says. Having the wrong seat can put too much pressure on the groin, which can cause numbness in that area. An ill-fitting seat can even cause you to shift around too much while riding, which can lead to back pain.
Bicycling for a healthy back
“Bicycling is a great exercise, in terms of providing cardio,” says Mudiyam, “but like any other sport, it's not for everybody.”
If you have an existing back condition, such as low back pain or a herniated disc, you need to be extra careful when starting to ride or getting back into it. You might also benefit from a more upright bicycle or a recumbent bike. And from getting a professional bike fitting.
However, Mudiyam says people with spinal stenosis — a narrowing of the spinal canal — may do better with upright bicycling compared to activities like walking or running. “It's therapeutic for older patients with spinal stenosis to ride a bicycle,” he says, “because they’re leaning forward a little bit, so they're actually increasing the space within the spinal canal.”
If you are new to bicycling or coming back to it after a break, start out slowly. This allows your muscles, including those in your back, to adapt to the new movements. Rogers suggests riding just 15 to 30 minutes in the beginning, and then increasing it only 10 percent at a time.
Mudiyam says a minor back strain is not too concerning. This is fairly common in high-performance cyclists, especially in mountain bikers. But it can also occur in new riders.
If you develop back pain while riding, stop. The pain will usually go away with rest and maybe an over-the-counter pain medication. If the pain persists for more than a few days, seek medical care. There could be an underlying spine problem that requires additional treatment.
If you develop other symptoms such as weakness, numbness or tingling in your legs, stop riding and seek medical care as soon as possible. “If there is a pinched nerve, either from a ruptured disc or from a space-occupying lesion like a cyst, then you have to treat that problem,” says Mudiyam.
If you seek medical care, ask your doctor when it is safe to begin bicycling again. You might also want to start a core-strengthening exercise program, which will help keep your back pain-free while riding.
“Leaning too far forward puts a lot of stress on your spine,” says Rogers, “especially if you don't have the core stability that you need in order to take pressure off the back.”
Four of the Best Bikes for Back Pain
When choosing the right bicycle for back pain, you will want to keep in mind the type of cycling that you want to do. Are you interested in long-distance road biking, off-roading or just zipping around town in the summer?
Here are a few bikes that can help minimize symptoms in people with chronic low back pain, sciatica, a herniated disc or other spine problems. As always, if you aren’t sure if you are ready to start biking, check with your doctor first.
- Electra Townie. Like other cruisers, the Townie has long handlebars that allow you to sit upright as you bike along the beachfront or to the coffee shop. But the bike is shaped so you can still easily put your feet flat on the ground. And if you like to ride a little more aggressively, you can fit it with larger tires that are better suited for off-roading.
- Trek Domane. If your idea of bicycling is heading out on the road for hours at a time, Trek’s Domane line of endurance road bikes may be just the thing for your back. These bikes are built for longer rides, but allow you to sit more upright than with other road bikes.
- Performer JC-26X Recumbent Trike. Rogers says if you have moderate to severe back pain or have trouble riding pain-free even for 10 to 30 minutes, a recumbent bicycle or tricycle is a great option. Performer makes a number of recumbents, including the JC-26X, which comes with a suspension seat and shiftable gears.
- Schwinn Meridian. If you have stability or balance issues, Rogers recommends a full adult tricycle. “This is a great alternative to a recumbent bike,” he says, “as most of these have a very upright posture which takes the pressure off the back.” Schwinn’s Meridian is widely available and comes with swept-back handlebars, a comfortable seat and a folding basket in back.
Updated: July 3, 2020