Lower Back Pain Physiotherapy
Lower back pain is one of the most common reasons people see a physiotherapist. Most episodes settle, but the path back to normal life is easier with a clear assessment, a realistic plan and honest information about what is and is not known.
Individual rehabilitation plan — shaped by the assessment, reviewed as you progress
We assess your situation first, explain what the assessment shows, and agree a suitable rehabilitation direction with you. WhatsApp us to book, or ask first.
When to seek medical or emergency care
Most back pain can be handled safely after a physiotherapy assessment and a graded plan, and we will say so if we think something else should be checked first. Arrange a prompt medical review instead of starting rehabilitation if the pain followed a significant fall or accident, if you feel feverish or generally unwell, if you have unexplained weight loss or a history of cancer or osteoporosis, or if the pain is constant, clearly worse at night and not eased by any position. The signs listed below are uncommon, but they can indicate pressure on the nerves at the base of the spine — if any of them appear, go to an emergency department the same day rather than waiting for a physiotherapy session.
- Weakness in one or both legs that is getting worse
- Numbness or altered sensation in the saddle area — inner thighs, buttocks, genitals or back passage
- New difficulty passing urine, or new loss of bladder or bowel control
- Pain, numbness or weakness affecting both legs at the same time
Back pain usually shows up as difficulty bending, sitting for long periods, standing up from a chair or turning in bed, and it often flares after a busy stretch rather than after one obvious event. Some people also notice pain, numbness or altered sensation spreading into the buttock or leg, which suggests a nerve is being irritated. Other possible causes should stay on the table: hip problems, abdominal or pelvic conditions and inflammatory joint disease can all present as back pain and can look similar at first.
- Pain or stiffness bending forward, sitting or getting out of a chair
- Pain that eases with walking or with a change of position
- Pain, numbness or altered sensation spreading into the buttock or leg
- Flare-ups after a heavier week rather than after one clear injury
- Difficulty turning in bed or getting comfortable at night
The first visit is mainly assessment: how your pain behaves, what matters most to you, how you move, and a screen for anything unusual.
What the physiotherapy assessment covers
The first appointment is mostly assessment. We ask how the pain started and how it behaves through the day, what you can and cannot do at the moment, and what matters most to you — returning to work, sleeping through the night, or lifting your child. We then look at how you move, how your trunk, hip and leg muscles work, and screen for anything suggesting this is not a straightforward mechanical back problem.
- Your symptoms: where the pain sits, what eases or provokes it, and how it has changed
- Daily activities and function: sitting, bending, lifting, walking and self-care
- Work, study or caring duties, including how long you sit or stand and what you carry
- Sleep: your usual position, whether pain wakes you, and how rested you feel
- Load and injury history: recent changes in training or workload, and previous back episodes
- Movement: spinal and hip range of motion, and how you move between positions
- Strength and control of the trunk, hip and leg muscles, and balance where relevant
- Neurological and general screening: sensation, muscle power, reflexes where indicated, plus medical history and medicines
Your plan depends on the assessment, your preferences and how you respond — it may include graded exercise, work advice, and hands-on treatment or acupuncture where appropriate and with your consent.
How your treatment and rehabilitation plan is built
There is no fixed recipe. What we suggest depends on the assessment, on your preferences and health history, and on how you respond as we go. A plan may include graded exercise for the trunk, hips and legs, practical advice on staying mobile at work, and hands-on treatment or acupuncture where the assessment suggests they may help and you consent to them. We explain each option before using it, you can decline any part of it, and not everyone needs passive treatment at all.
Most progress happens between visits: a realistic activity level, a short home programme, a plan for flare-ups, and review at each appointment.
Self-management, activity and how progress is reviewed
Most progress happens between appointments. We agree a realistic activity level rather than complete rest, because long periods of rest usually leave a back feeling stiffer and more fragile. You get a short home programme, a way to pace a heavy day, and a plan for a flare-up so one bad day does not undo a good week. At each visit we review your symptoms, movement and function, and change the plan when your response tells us to.
Understanding lower back pain
Lower back pain is very common and, for most people, it is not caused by serious disease. The joints, discs, muscles and nerves of the lower back work together, so it is rarely possible to blame one single structure. A web page cannot diagnose your back: symptoms alone do not identify which tissues are involved, and very similar pain can have quite different explanations. What we can do is assess you in person, explain what the examination suggests, and be clear about what stays uncertain.