Low back pain is incredibly common. In fact, it’s the leading cause of disability worldwide—affecting not just athletes and tradies, but also desk workers, teens, and older adults alike.
The good news? Most people recover within a few weeks, and physiotherapy can play a key role in that process. This guide explains what really works when it comes to managing low back pain—and what doesn’t.
What Causes Low Back Pain?
In many cases, back pain is non-specific, meaning it’s not due to a serious injury, fracture, or disc problem. Instead, it’s often the result of tension in muscles, joints or ligaments—and sometimes even stress or postural habits.
That’s why physiotherapists use a biopsychosocial approach: looking not just at the tissues, but also at your stress levels, lifestyle, movement habits, and sleep—all of which can affect your recovery.
Key Messages for Managing Back Pain
1. Stay Active and Keep Moving
Gone are the days of bed rest. Gentle movement helps with healing. Your spine is strong and made to move. Even light walking or simple stretches can reduce stiffness and support recovery.
2. Pain Doesn’t Always Mean Damage
Pain can be intense, but that doesn’t always mean something is seriously wrong. Your back is full of sensitive tissues and nerves, and these can become irritated even without structural damage.
Understanding this can help reduce fear and improve confidence in movement.
3. The Way We Talk About Pain Matters
Terms like “unstable spine” or “weak core” can increase fear and lead to more pain and avoidance of activity. A key part of physiotherapy is providing clear, supportive language that helps build confidence and promote healthy movement habits.
What Helps? Evidence-Based Treatments
- Exercise Therapy
A tailored exercise plan helps build strength, improve mobility, and reduce pain over time. - Education
Understanding your condition reduces anxiety and helps you make informed decisions about your recovery. - Manual Therapy (Hands-On Treatment)
Techniques such as joint mobilisation or soft tissue therapy can reduce symptoms—but they’re most effective when combined with active exercise. - Mindfulness and Stress Management
Stress and emotional factors can heighten pain sensitivity. Breathing, relaxation, and pacing strategies may help.
What Doesn’t Help (According to Research)
- Relying only on passive treatments
Modalities like massage, heat, or spinal manipulation may offer short-term relief, but long-term improvement relies on movement and active rehabilitation. - Overuse of medication
Painkillers like paracetamol or opioids are no longer first-line treatments. Anti-inflammatories may help in some cases but should be used cautiously and under supervision. - Routine imaging
X-rays and MRIs are often unnecessary and may lead to confusion or fear. Unless there are red flags (such as trauma or nerve involvement), imaging is not usually needed.
How Physiotherapy Can Help
A physiotherapist will:
- Rule out serious causes of pain
- Provide a clear explanation of your condition
- Prescribe a personalised exercise program
- Teach safe movement strategies
- Support your mental and emotional well-being during recovery
Final Thoughts
Low back pain is rarely dangerous, and it usually improves with the right combination of movement, education, and reassurance. With the right guidance, you can regain your confidence and return to the things you enjoy.
References
- Almeida, M., Saragiotto, B., Richards, B., & Maher, C. G. (2018). Primary care management of non-specific low back pain: key messages from recent clinical guidelines. Medical Journal of Australia, 208(6), 272-275. https://doi.org/10.5694/mja17.01152
- Brukner, P., Bahr, R., McCrory, P., & Khan, K. (2017). Brukner & Khan’s Clinical Sports Medicine: Injuries (5th ed.). McGraw-Hill Education.
- Foster, N. E., et al. (2018). Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet, 391(10137), 2368–2383. https://doi.org/10.1016/S0140-6736(18)30489-6
