They are three words uttered far too often: “I can’t exercise.”

For some, it’s a convenient excuse to remain on the couch or committed to things other than good health. Others really do struggle, suggested Neel Anand, M.D., clinical professor of surgery and director of spine trauma at Cedars-Sinai Spine Center in Los Angeles. Millions of Americans suffer from chronic and acute back pain. It not only keeps them from the gym but from simple everyday activities.

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To fix back pain, he suggests people need to be willing to get to the root of the problem, do a little work, and want to be on their way to better health.

“Chronic back pain should never be allowed to happen and that’s one of the excuses we are dealing with every day [when it comes to exercise],” Anand told LifeZette — especially if people are taking medication to manage the pain.

Those medications, he said, often lead to a cycle of depression, more pain, and less fitness or even obesity — which only compounds back problems. “It’s a vicious cycle. You never want to get there,” he said.

Related: Question All Those Lower Back Pain Tests

A strong core is critical to protect the spine. He suggests isometric exercises such as pilates, yoga, straight leg and double leg lifts, wall slides, and squats. Rowing, bicycling, and swimming are also great exercises to strengthen one’s core.

Here are a few other good ways to take better care of the back, according to Anand:

Posture
Poor posture and back pain go hand-in-hand, but it doesn’t take a lot to dissolve their union. Stand in front of a mirror, he said, and check that your head is straight and stacked over your body with your chin parallel to the floor. Your shoulders should be level and not drooping forward or pulled too far back; our shoulders should be in line with your ears.

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You knees should also be straight and not bent or hyper-extended; same with the feet. This is your “perfect posture state” and should be a goal in everyday activities. A bonus for achieving it? Better posture makes you look thinner and younger, said Anand.

If you’re not overweight and don’t think you need to exercise, “you’re wrong,” said Anand.

Weight Loss
For those who are overweight and experiencing back pain, losing some of the excess can have almost immediate benefits. “If you’re like the millions of Americans who’ve included weight loss on their list of resolutions for the new year, your spine will likely respond well to your efforts,” he added.

Exercise
If you’re not overweight and don’t think you need to exercise, “you’re wrong,” said Anand. “I’ve seen plenty of slender patients who come to me with horrific spine issues and they’ve never really exercised. Exercise is critically important for maintaining muscle mass and a strong core — major supporters of a healthy, pain-free spine.”

Stress Relief
While it’s impossible to completely eliminate stress from daily living, yoga, meditation, a good book, a warm bath — any of it will help your back breathe a sigh of relief along with your mind and the rest of your body.

Expert Advice
If you’ve been suffering from back pain that keeps you up at night, prevents you from doing things you enjoy, or generally has you feeling less than “you” — get help. Stop explaining it away or ignoring it altogether. The sooner you get an expert opinion about your pain, the more options you’ll have in treating it and the faster you’ll feel relief.