What causes back pain, and how physiotherapy treats it
The most common reason people book. Here is what tends to be behind it, what an assessment looks for, and what treatment involves at this clinic.
Rarely one clean symptom
Most back pain sits in the lower back, somewhere between the bottom of the ribs and the top of the pelvis. It can be a dull ache that never quite leaves, a sharp catch when you turn or bend, or a band of stiffness that takes twenty minutes to loosen after you get out of bed.
Some people describe it as a spasm that grips and lets go. Others notice it mostly by what they have stopped doing: not lifting the shopping the same way, not sitting through a film, taking the stairs sideways. Pain can also spread into a buttock or down a leg, which is usually called sciatica and has its own page.
It is worth saying early that most back pain is not caused by damage to the spine, and that a painful back is not the same as a fragile one. Backs are strong, they are built to bend and load, and they usually respond well to being moved rather than protected.
Usually a change rather than an event
Plenty of back pain has an obvious trigger: a lift done awkwardly, a weekend of digging, a fall, a long motorway drive. Muscles, joints and the discs between the vertebrae can all become sensitive after a sudden load they were not ready for.
More often, though, the trigger is a change rather than an accident. A new desk setup, a busier month at work, a period of much less walking than usual, or a return to the gym after a long gap. The back that was coping fine at one level of demand starts complaining at another.
Age-related changes on a scan, such as wear in the discs or the small joints, are extremely common and are found in plenty of people with no pain at all. That is why a scan result on its own rarely explains a symptom, and why the assessment looks at how you move rather than only at where it hurts.
Where it is usually worth booking
Physiotherapy suits back pain that has settled into a pattern, or that keeps coming back. The aim is to reduce the pain, restore normal movement and leave you with a back that tolerates more than it did.
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Assessment
Questions about when it started, what provokes and settles it, what you have already tried and what you need to get back to. Then a look at how your back and hips move, how they load, and how they behave under a bit of demand.
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Hands-on treatment
Soft tissue work, joint mobilisation and guided movement, used where they help settle symptoms and get range back. Where it is appropriate this starts in the first appointment rather than the second.
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An exercise plan
A short set of exercises pitched at where you are now, progressing as things improve, aimed at the thing driving the problem rather than at the sore spot. Fewer exercises done properly beat a long printed list nobody finishes.
There is no promise of a fix attached to any of that. What treatment offers is a clear explanation, a plan with a realistic timescale, and someone checking whether it is working and changing it when it is not.
Sensible things to do while you wait for an appointment
Keep moving within what feels manageable. Complete rest tends to make backs stiffer and more sensitive, so short walks, gentle movement and changing position often are generally more useful than lying still for days.
Break up long periods of sitting. Getting up every half hour or so, even briefly, usually does more than any particular chair or cushion. If a position eases things, use it, and do not read too much into which one it is.
Heat, cold or over-the-counter pain relief can all take the edge off enough to let you move more normally. A pharmacist can advise on what is suitable for you. Sleep matters too: pain is reliably worse after a broken night, which is not in your head and is worth taking seriously.
General guidance only, and none of it replaces an assessment of your particular back.
Back pain that needs a GP or urgent care, not physiotherapy
- Some symptoms alongside back pain need medical attention rather than a physiotherapy appointment. Call 999 or go to an emergency department if you have numbness around your back passage or genitals, difficulty passing urine or a loss of control of your bladder or bowels, or sudden weakness in both legs. Those can be signs of a problem with the nerves at the base of the spine, and they are treated as an emergency.
- See a GP promptly, or call NHS 111 for advice, if back pain follows a significant fall or accident, comes with a fever or feeling generally unwell, is much worse at night, comes with unexplained weight loss, or if you have a history of cancer or a condition that affects your immune system.
- None of that is meant to alarm you. The great majority of back pain is none of the above. If an assessment here turns up something better handled by a GP or a consultant, you will be told that plainly rather than sold a course of treatment.
Book an assessment for your back
Weekday appointments to 20:00 and Saturday afternoons from 14:00, usually available within days. No GP referral needed. Shop 2, 4-6 Roumelia Ln, Boscombe, Bournemouth BH5 1EU.
Call Deborah WhatsApp Waiting for NHS physio Call, text or WhatsApp 07305 447682