Common symptoms
- Aching or sharp pain in the lower back, sometimes spreading into the buttock
- Stiffness, especially in the morning or after sitting
- Muscle spasm that makes bending or turning difficult
- Pain that changes with position, such as sitting, standing or lying down
What causes back pain
In most cases there is no single damaged structure to point to. Doctors call this “non-specific” back pain, and it usually involves a mix of sensitive muscles, joints and discs, influenced by how much you move, sleep, stress and your general fitness.
Less often, back pain is linked to a disc pressing on a nerve, which can cause leg symptoms (see slip disc and sciatica), or to age-related changes such as spinal stenosis. Scans often show disc bulges and “wear and tear” in people with no pain at all, so findings are always interpreted alongside your symptoms.
How we assess it
We take a detailed history: how it started, what makes it better or worse, your work and activity, and any leg symptoms. Then we examine your movement, strength, nerve function and posture, and check for warning signs that need a doctor. Bring any scans or reports you already have.
How we treat it
- Clear explanation of what is going on, and what is safe to do
- Exercise therapy: progressive movement, core and hip strength, and conditioning
- Hands-on treatment to ease pain and stiffness in the short term
- Spinal decompression for suitable disc-related or long-standing pain
- Advice on sitting, lifting, sleep and returning to work or sport
The plan is built around what you want to get back to, whether that is a full day at the desk, picking up your child, or running again.
How many sessions will I need?
Many people with recent back pain need around 6 to 12 sessions over 3 to 6 weeks. Long-standing back pain often takes longer, with sessions spaced out as you take over your exercise programme.
When to see a doctor first
Please see a doctor or go to an emergency department, rather than booking physiotherapy, if you have:
- Numbness around the groin, buttocks or inner thighs (saddle area)
- New difficulty passing urine, or loss of bladder or bowel control: seek emergency care
- Weakness in one or both legs that is getting worse
- Back pain after a significant fall or accident
- Fever, unexplained weight loss, a history of cancer, or severe pain at night that rest does not ease
Frequently asked questions
Should I rest in bed with lower back pain?
No, long bed rest usually slows recovery. Short rests when pain is severe are fine, but gentle walking and normal activity within comfort help most people recover sooner.
Do I need an X-ray or MRI for back pain?
Most people do not. Scans are recommended when there are warning signs or when symptoms are not improving and the result would change treatment. We will tell you if we think you need one.
Can physiotherapy help long-standing back pain?
Yes, exercise-based physiotherapy is one of the most recommended treatments for back pain lasting more than three months. Progress can be slower, so the plan focuses on building strength, confidence and activity over time.
Which exercises are best for lower back pain?
There is no single best exercise. What matters most is doing exercise that suits you, regularly, and progressing it. We choose exercises based on your assessment and what you enjoy.
Is it safe to go to the gym with back pain?
Often yes, with modifications. We can adjust your training so you stay active while your back settles, then rebuild to your usual loads.