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How to Manage Your Low Back Pain

Often patients arrive at physiotherapy with the notion that the massage or the ‘hands-on’ treatment that the practitioner provides within the sessions will result in the low back pain resolving. Now that statement is true to some degree. back pain

The start of your journey to resolving your back will happen when you make that appointment as you are initiating the start of ‘change’. Have you ever noticed that when you book in to see a dentist or hygienist you will automatically start taking more care of your teeth?

Well, this will happen before you see a clinician - you will start to think about your back, you will know that I will be asking questions, and this will lead you to think more about your back. This process is important not only for me but for you, because the key to success is to start being aware of what the problem is and then together we will be able to find the solution.

Hands-on treatment

 back pain

Now, the other myth buster is that the ‘hands-on’ treatment (be it massage, manipulation, adjustment, mobilisation, acupuncture or Voodoo dolls) DOES NOT CURE YOUR BACK. What it does is help to reduce your pain to allow you to get moving and get strong.

This is not to say that there is no place for it; I use deep massage and joint mobilisations to help reduce painful muscles and it is very effective, but we provide these treatments to get you moving and my emphasis is about what YOU can do to keep the pain at bay.

This is also true for more medical treatment such as pain killers, anti-inflammatories, epidurals and facet injections. These are all available to help reduce your symptoms but if they are not combined with effective exercises and looking at your triggers then you will find the problem may not completely resolve.

The Partnership


As a physiotherapist, I am looking for a partnership with my patients. This partnership requires both parties to be actively involved, as the more you bring to the table the better the results. I do see people (mainly when I worked in London) that would come in with a ‘just fix me’ attitude, I can picture them now walking in to the session still on their phones and I’m sure I once had someone on his phone whilst I was treating him! This will not work. You need to be engaged in the process as most of the change will be coming from you.

A Chance is gonna come


Load management and back pain is really important and what we are not very good at is putting our bodies first. I often have active discussions with people that go like this:

YOU: ‘ I have to walk 20 minutes a day to get to work and I am really struggling with pain in my back after that walk’.
ME (amazing physio): ‘Can you get to work without walking?’
YOU: ‘No’.

Sometimes we feel we have no choice in matters, but we always have a choice. I used to work in Weybridge a couple of years ago and I noticed that I was spending hours in my car listening to LBC and radio 4 and generally getting grumpy about the world or perhaps about the journey. It began to take its toll on my back and neck as well as I didn’t have any time to exercise. As time went on things got worse so I made the decision to change this. Not only did it help with my back and reduced my time listening to the radio, it also allowed me more time to do what I loved and have time to fit exercise into my life.

Change can be drastic (giving up my Weybridge commute) or can be smaller - walking to the train station instead or getting the bus or going for a walk at lunchtime. Joining a lunchtime Pilates class or setting one up in your office.

There are many options, but you must be committed for change.

A week of putting your back first


This is what I will always prescribe to people who come and see me. Have a week where you think about your back, control how much you are sitting, how much you are bending and listen to what your back is telling you. If we are limiting how much we are using our back, we then need to make sure it keeps moving. I will always advise on 4 basic mobilising exercises for the back that keep you moving (more on getting the back moving next!).

Magic Mix


To summarise, when starting to manage your back:

1)    Look at your triggers and make a change
2)    Get a thorough assessment to rule out any other causes and start you on your journey
3)    Get hands-on treatment to help with pain
4)    Have a week of putting your back first
5)    KEEP THE BACK MOVING (Episode 3)
6)    Then start the journey to get yourself stronger and more mobile

Have a look at our page about how to manage your back when it’s going through a flare up. Interested in our other blogs?

Jehan is an experienced physiotherapist based in Kingston and Surbiton. Her blogs are a mix of her personal and professional experience.