Physiotherapy for Back Pain – A Holistic Approach

Affecting millions of people across the UK, back pain is a pervasive health issue that can significantly disrupt daily life.

Amongst the myriad of treatments, physiotherapy emerges as a non-invasive, holistic and effective method for combating back pain, helping sufferers reclaim their mobility and enhance their quality of life.

Demystifying Back Pain: Unravelling its Causes and Impact

Back pain, a complex and multifaceted problem, can be triggered by an array of issues. Let’s delve into the most common ones:

  1. Herniated Disc: A condition where the soft inner part of the intervertebral disc protrudes through the outer ring, often causing nerve irritation and pain.
  2. Sciatica: Characterised by pain radiating down the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg.
  3. Spondylolisthesis: A condition where a bone in the spine (vertebra) slips out of the proper position onto the bone below it.
  4. Spinal Stenosis: The narrowing of the spaces within your spine, which can put pressure on the nerves that travel through the spine.
  5. Muscle or Ligament Strain: Repeated heavy lifting or a sudden awkward movement can strain back muscles and spinal ligaments.

The Power of Physio

As a holistic and patient-centric health profession, physiotherapy is focused on promoting health and wellbeing through physical rehabilitation, injury prevention, and health and fitness.

Physiotherapy is well-established in the field of back care, providing pain relief, enhancing physical function, and improving quality of life for those suffering from back pain.

Physiotherapy for Back Pain: Techniques and Treatments

A physiotherapist uses a multitude of techniques tailored to the individual’s specific condition and needs:

Manual Therapy for Back Pain:

This technique involves hands-on manipulation and mobilisation of the musculoskeletal system. The physiotherapist uses their hands to apply pressure and movement to the muscles, ligaments, and spine.

  • Spinal Manipulation: Here, the physiotherapist applies a rapid, short thrust to an abnormal vertebra in an attempt to improve functionality, reduce nerve irritability, and restore range of motion in the back. This often results in a popping noise similar to cracking your knuckles.
  • Spinal Mobilisation: For those who require a gentler approach, spinal mobilisation is an option. It involves slow movements, such as stretches and deep pressure, to move the spinal joints within their comfortable range of motion.

Exercise Therapy for Back Pain:

Physiotherapists use exercise therapy to improve the patient’s strength, flexibility, and posture, which can help alleviate and prevent back pain.

  • Strengthening Exercises: Strengthening the core muscles, including the abdominal and back muscles, can provide better support for the spine, reduce the strain on the spinal joints, and promote better posture. Examples include bridges and plank exercises.
  • Flexibility Exercises: These exercises aim to increase flexibility in the muscles that support the back to relieve tension and reduce the risk of muscle strains. Stretches that target the muscles of the hips and legs, such as hamstring stretches, can also alleviate back pain.
  • Aerobic Exercises: Low-impact activities such as walking, cycling, or swimming can help improve overall stamina and muscle endurance in the back, helping to improve function and recovery.
  • Posture Exercises: These exercises aim to improve posture, which is important because poor posture can strain the back and lead to chronic pain. Posture exercises aim to align the spine correctly, reducing stress on the back.

Other Approaches

  1. Pain-Relief Modalities: These include the use of heat, cold, electricity (TENS), and ultrasound to alleviate pain and reduce inflammation.
  2. Acupuncture: An ancient practice involving the insertion of fine needles into specific points on the body to relieve pain and tension.
  3. Hydrotherapy: Use of water in the treatment of different conditions, including back pain. This can be particularly helpful due to the buoyancy and warmth of the water.

Creating Your Customised Physiotherapy Plan

A successful physiotherapy treatment plan is always tailored to the individual.

Your physiotherapist will start with a comprehensive assessment to understand the nature and extent of your back pain, your overall health, lifestyle, and goals for recovery.

Based on this, a bespoke treatment plan will be created that combines various techniques, exercises, and modalities.

Home-Based Physiotherapy Exercises for Back Pain

A crucial part of physiotherapy treatment involves exercises that you can do at home to complement your in-clinic treatment:

  1. Bridges: This exercise strengthens your lower back and hip muscles. Lie on your back with knees bent and feet flat on the floor. Raise your buttocks off the ground until your body forms a straight line from your shoulders to your knees. Hold this position for a few seconds then slowly lower your buttocks back to the ground. Repeat this 10 times for 3 sets.
  2. Knee-to-Chest Stretches: This exercise helps stretch your lower back. Lie on your back and bend your knees while keeping your feet flat on the floor. Bring one knee to your chest, while keeping the other foot on the floor, hold for a few seconds, then switch. Repeat this 10 times for each leg.
  3. Pelvic Tilts: This exercise helps strengthen your abdominal muscles, which support your back. Lie on your back with your knees bent and your feet flat on the floor. Flatten your back against the floor by tightening your abdominal muscles and bending your pelvis up slightly. Hold for up to 10 seconds. Repeat 10 to 20 times.
  4. Cat Stretches: This exercise helps increase flexibility in your back. Begin on your hands and knees in a tabletop position. Arch your back by pulling your belly button up towards your spine and letting your head drop forward. Hold for a few seconds, then relax your stomach and back, keeping your back as flat as possible. Repeat this 10 times.
  5. Bird-Dog Stretch: This exercise strengthens your lower back and abdominal muscles. Start on your hands and knees, then simultaneously extend your left leg behind you and your right arm in front of you. Hold this position for a few seconds, then switch to the opposite leg and arm. Repeat 10 times on each side.
  6. Wall Sits: Stand with your back against a wall. Slide down into a squatting position by moving your feet forward, keep your back in contact with the wall, and hold the position for 10 seconds. Repeat 10 times.
  7. Heel Slides: While lying on your back, slowly bend and straighten your knee while keeping your heel sliding on the floor. Repeat 10 times for each leg.
  8. Partial Crunches: Lie on your back and keep your feet flat on the floor and knees bent. With your hands behind your head, raise your shoulders off the floor and hold for one second. Repeat 10 times.
  9. Hamstring Stretches: While sitting at the edge of a chair, straighten one leg in front of your body while the other one is bent. Stretch forward until a gentle pull on the back of your thigh is felt. Hold for 10 seconds, then switch legs.
  10. Pilates Roll-Ups: Lie on your back with your arms extended over your head and your palms facing up. With your feet flexed, slowly curl your body up to a seated position, and then slowly lower your body back down. Repeat 5 times.

Empowering Yourself: Prevention Strategies for Back Pain

Physiotherapy not only treats but also helps prevent back pain.

This can involve education about healthy postures, ergonomic advice for workstations, guidance on safe lifting techniques, and regular exercise recommendations to keep your back strong and flexible.

Maintaining a healthy weight, staying hydrated, and leading an active lifestyle are also beneficial for overall back health.


Back pain, while common, can be a significant impediment to your everyday life.

However, with the right physiotherapy approach, it’s possible to alleviate the pain, enhance mobility, and significantly improve your quality of life.

Remember, every individual’s experience with back pain is unique, and thus, physiotherapy treatment must be tailored to meet your specific needs and circumstances.

By understanding the root cause of your pain, employing the right physiotherapy techniques, and adhering to a personalised set of exercises, you can navigate your way towards a pain-free life.


How does physiotherapy help alleviate back pain?

Physiotherapy helps address back pain by improving mobility, strengthening muscles, and improving posture and body mechanics. It also helps increase blood flow to the affected areas, which can expedite the healing process.

Can physiotherapy prevent recurring back pain?

Yes, through education on proper body mechanics, ergonomics, exercise, and lifestyle habits, physiotherapy can help prevent the recurrence of back pain. Regularly performing the exercises recommended by your physiotherapist will strengthen your back muscles and improve flexibility, which are key to preventing back pain.

Can I do physiotherapy exercises for back pain at home?

Yes, your physiotherapist will likely provide you with a set of exercises that you can do at home. These exercises are an essential part of your treatment plan and should be performed as directed to achieve the best outcomes.

When should I seek physiotherapy for back pain?

If your back pain is severe, lasts for more than a few weeks, or is associated with other symptoms such as numbness or weakness in your limbs, you should seek medical attention. Physiotherapy is often recommended in these cases and can be beneficial at any stage of back pain. See our physiotherapy services here.

What can I expect in my first physiotherapy session for back pain?

Your physiotherapist will conduct a comprehensive assessment that includes a discussion about your symptoms, medical history, and lifestyle, followed by a physical examination. Based on the findings, they will devise a treatment plan tailored to your specific needs and goals. The first session may also include some initial treatment, such as manual therapy or specific exercises.

Remember, it’s crucial to communicate openly with your physiotherapist about your pain levels, any discomfort during exercises, and your expectations for the therapy. This will help ensure that the treatment program is effective and suitable for you.

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