Find the Right Exercise for You

Why Different Pain Types Need Different Exercises

The Concept of "Directional Preference"

In back pain management, there is an important concept called Directional Preference.

In simple terms:

For most people with low back pain, there is a specific direction of movement that reduces symptoms — and it differs from person to person.

Research has shown that a directional preference can be identified in a majority of patients with chronic low back pain (Werneke 2011, Yarznbowicz 2018).

Studies report that patients whose directional preference was identified and used to guide treatment experienced greater improvements in both pain and function compared to those who received non-matched exercises.

The "Wrong Direction" Can Make Things Worse

Moving in the opposite direction of your preference can cause your pain to peripheralize — meaning it spreads further from your back toward your legs. This is a sign that the exercise is aggravating your condition.

Centralization means pain retreats from the legs or buttocks back toward the center of the low back — this is a good sign. Peripheralization is the opposite — pain spreading toward the legs — and is a warning sign.