Low Back Pain and how to fix it.

What Is Low Back Pain?

Low back pain is one of the most common reasons people seek physiotherapy. 1 in 4 people suffer from pain at some point in their life. If you are an active person, such as dancers, performers, athletes, etc, it can have a significant impact on your quality of life.

There are many reasons why pain happens; it may arise from joints, discs, nerves, or muscular imbalances, especially around the pelvis and core. Repetitive overuse, change in activity level, our stress level, poor sleep, and being hypermobile can influence our pain experience as well.

The structure of the lower back?

Low back pain typically affects the lumbar spine, the lower part of your back just above the pelvis. This area supports much of your body weight and absorbs force with every step, jump, or movement. Key surrounding structures include the lumbar vertebrae and discs, the facet, core muscles. pelvic floor and gluteal muscles.

Symptoms of low back pain

Pain can also refer to nearby areas like the buttocks, hips (Feeling Hip Pain or Stiffness? Start Here to Improve Hip Mobility), or legs, especially if nerves are involved. Symptoms vary depending on the cause, but may include:

• Dull, aching, or sharp pain in the lower back

• Stiffness or limited movement, especially when bending or twisting

• A sense of instability or “catching” during movement

• Pain that worsens with prolonged standing or sitting

• Tightness in the hips, hamstrings, or surrounding muscles

Common Causes of Back Pain

• Sport injury related www.fmphysio.com/post/dear-cheerleaders-here-s-what-you-need-to-know-about-your-back-pain

• Lumbar facet joint strain: from repetitive arching or backbending

• Disc irritation or herniation: often worsened by spinal flexion (bending forward), twisting, coughing and sneezing.

• Muscle imbalances, such as tight hip flexors with weak glutes or core Feeling Hip Pain or Stiffness? Start Here to Improve Hip Mobility)

• Pelvic instability – especially common post-injury, postpartum, or during adolescent growth https://www.fmphysio.com/post/overcoming-back-pain-pelvic-stability-and-core-care-for-dancers

• Sacroiliac joint (SIJ) dysfunction – most commonly felt in the lower back and buttocks, but can also radiate to the hip, groin, and even the legs or feet

• Overuse or load mismanagement Dear Cheerleaders: What You Need to Know About Your Back Pain – from too much, too soon, without recovery

• Stress-related tension – where pain is linked to emotional load, trauma or anxiety

Medical Treatment Options for Back Pain

The first line of treatment for back pain typically involves conservative care with physiotherapy, activity modification, and self-management strategies. However, in some cases, medical intervention may be necessary to support your recovery, especially if pain persists, worsens, or is linked to structural issues like disc herniation or nerve involvement.

Medications, such as anti-inflammatories or muscle relaxants, may be prescribed to help manage acute symptoms, allowing you to engage more comfortably in rehabilitation. For more targeted relief, corticosteroid injections or denervation treatments may be recommended to reduce inflammation and pain sensitivities around irritated joints or nerves, particularly in cases of facet joint pain or sciatica-related pain.

In rare situations where conservative treatment isn’t effective, such as severe disc prolapse with nerve compression, surgical options like microdiscectomy or spinal fusion may be considered. These decisions are made collaboratively with your healthcare team, and physiotherapy plays a key role both before and after any surgical intervention to support recovery and long-term function.

Holistic and Biopsychosocial Treatment for Low Back Pain

Low back pain isn’t just physical treatment; it also involves your nervous system, stress levels, beliefs, and environment. The NICE guidelines https://www.nice.org.uk/guidance/ng59 for managing chronic pain in the UK recommend a multidisciplinary, biopsychosocial approach, which includes:

• Active exercise-based therapies

• Cognitive behavioural therapy (CBT) Psychological Approach: CBT for Pain Treatment

• Acupunture

• Education and goal setting

• Avoiding over-medicalisation and opioid

  
  

Alongside physiotherapy, there are other holistic treatment options that some might find helpful. Breathwork and mindfulness are powerful tools for calming the nervous system and reducing pain sensitivity, especially in those who are dealing with high stress or persistent discomfort. Massage and soft tissue therapy (link to serivce page) can help release tight muscles, though it's most effective when combined with active rehabilitation and exercise therapy. For targeted muscular relief, dry needling or acupuncture may be used short-term to address trigger points. These strategies can be integrated with a rehabilitation plan, not used in isolation, to improve function and quality of life over temporary symptom relief with pain medication.

Physiotherapy treatment goals

Physiotherapy rehabilitation for back strength and mobility typically follows a staged approach. In the acute phase (weeks 0–2), the focus is on reducing pain, restoring gentle movement, and activating deep core muscles. The sub-acute or mid-stage (weeks 3–6) shifts toward building endurance in the core, glutes, and pelvic stabilisers, and correcting postural habits. In the late stage (6–12 weeks and beyond), progress to dynamic control exercises, such as single-leg loading, back extension strength, and movement-specific drills that reflect the demands of daily life.

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