Back Pain Q&A

What causes back pain?

Sometimes there’s a clear cause, such as heavy lifting, sudden movements, or sportsrelated injuries. The trigger can be surprisingly innocuous, though. For example, it’s not uncommon for people to report back pain after reaching into a cot or drying their legs with a towel.

The trickier situations are when the pain develops gradually over time. Generally, there’s something the person is doing, often without thinking, to perpetuate the symptoms. It could be a musician spending a lot of time hunched over a guitar, an electrician working in awkward postures, or something more subtle.

Contributing factors are important to uncover. These may be physical, such as loss of joint mobility, muscle weakness, poor biomechanics, or excessive loading. They can also be psychological, including stress, anxiety, and poor sleep quality. Collectively, these can foster an environment for back pain to emerge. Which treatments are beneficial?

We talk about back pain as a single entity, but it’s a symptom with myriad causes, so treatment varies. As physios, we typically combine manual therapy (hands-on treatment) with tailored exercises. Depending on the stage of recovery, this may involve mobility work, strengthening core muscles, improving coordination, or restoring functional movement.

Does back pain require ongoing treatment?

No. The goal is to help people recover and then equip them with the tools to prevent recurrence. Maintenance treatments can be beneficial, but in most cases should be optional.

Do I need scans?

Imaging can be helpful to rule out severe conditions, but in many cases, it’s not required.

People without pain often have changes in the spine, so x-rays and MRIs can produce incidental findings. For anyone over 30, it’s normal to see mild bulging discs and varying degrees of degeneration. These don’t necessarily require invasive procedures and may be unrelated to your symptoms.

We may refer for imaging in cases of:

1.Persistent or severe nerve symptoms

2.Major trauma (e.g., a fall or car accident)

3.When conventional treatment is not working

Of course, if you’re concerned, it’s fine to have scans done. Just speak to an experienced clinician who can put the results in context.

What about surgery?

Surgery is rarely needed. In a specific cohort, it’s appropriate and effective, but for others, it could exacerbate the situation. We work closely with some excellent local surgeons, and they’re careful to avoid unnecessary operations.

Most back pain, when appropriately managed, will resolve within a few months. This is true even in cases of nerve compression. It can be a very unpleasant period, but the body is sophisticated in the way it heals. The main thing is facilitating the right conditions for that to occur.

Expert guidance is valuable to understand what’s normal and what isn’t. The way we perceive pain is influenced strongly by context. Thinking it will worsen or last forever can produce a lot of anxiety, which amplifies our perception of pain.

What advice would you give to someone experiencing their first episode of back pain?

Complete rest is almost never the answer, so keep moving, within reason. Avoid things that are obviously aggravating, but not forever. Start reintroducing those activities or movements gradually and allow your body time to adjust.

Importantly, seek support early. Back pain is treatable, and it’s much easier to address when it first presents. That said, if you’ve put it off, it’s not too late. Find a trusted physio or other health professional, and they’ll help you on the path to recovery.