How Do Physios Treat Lower Back Pain?

How Do Physios Treat Lower Back Pain, Leg pain from back

The goal of physios is to restore the function and movement of your body when it’s affected by injuries or illness. They observe how nerves, bones, and muscles are affected, plus how manual therapy and exercise therapy can help. But how do physios treat lower back pain? 

Generally, physiotherapy is one of the most efficient ways to treat lower back pain. There is numerous research present to support the techniques physios use. And most issues of lower back pain ideally respond to manual therapy and graded exercises.

Here we’ll take a close look at the different types of back pain and how a physio can help. Let’s get started!

Lower Back Pain


Lower back pain is among the leading reasons for physical disability, especially in the workplace. Studies show that about 80% of people suffer from lower back pain at one point in their lifetime. 

Physiotherapy is a widely used form of treatment for relieving lower back pain. It is utilized as both one line of treatment and together with other remedies. Other treatments include massage, traction, heat, short wave diathermy, or ultrasound.

The human back is generally a highly complex system of interlocking elements, including discs, vertebrae, facet joints, muscles, and ligaments. Because of its complex form and structure, episodes of lower back pain require a good physiotherapy-based rehab program.

It’s a necessary course to take after a basic medication procedure has been undertaken. Though it’s best to note that lower back pains can be caused by serious conditions. It’s a must to seek immediate medical attention if you feel/experience any of the following: 

  • Tingling in the lower body
  • Unusual weakness in the lower body
  • Vomiting and nausea
  • Dizziness or confusion
  • Shortness of breath
  • Fever or chills
  • Painful urination or blood in your urine
  • Incontinence

Lower Back Pain Categories


There are different descriptions of LBP (lower back pain) depending on the source. Based on the European Guidelines to prevent LBP, it’s defined as discomfort and pain. It’s localized above the inferior gluteal folds and below the costal margin, with/without leg pains. Another definition is pain occurring posteriorly in the area between the proximal thighs and lower rib margin. 

The common type of LBP is called non-specific lower back pain. It is pain unassociated with recognized and known pathology.  

Lower back pain is often categorized into subtypes: acute, sub-acute, and chronic. These are based on how long the pain lasts. 

Acute pain is when aching lasts for less than six weeks, while sub-acute pain lasts between six and 12 weeks. Chronic pain, on the other hand, goes on for 12 weeks or more. 

Lower Left Back Pain

Lower back pain isn’t always the entire lower area. Sometimes, the pain occurs in just your lower left area. 

Here are the most usual causes of pain in your lower left back: 

  • Soft tissue damage in muscles/ligaments supporting your spine
  • Spinal column injuries like facet or disc joints of the spine
  • A condition connected to your internal organs like kidneys, intestines, or reproductive organs

Lower Right Back Pain

Lower right back pains are usually caused by mechanical issues with the tendons, spine, muscles, and ligaments. Other causes of it may include kidney stones, infections, or appendicitis. 

The treatment for such concerns varies depending on the cause. However, these may still involve surgery or physical therapy. 

Other Causes of Lower Back Pain

It’s important to know the other causes of lower back pain, and here are the main culprits:

Sciatica (Herniated Disc) – It refers to pain radiating along your sciatic nerve. It then branches out from your lower back throughout your buttocks and hips, then down to each of your legs. Often sciatica affects only one side of the body. 

Spine Fracture (Compression Fracture) – A spinal fracture is the fracture or dislocation of your backbone that can happen anywhere along your spine. Most of these are caused by injuries or trauma from falls, car accidents, sports, or high-velocity impacts. 

Spondylolysis – It’s a stress fracture occurring through the pars interarticularis of your lumbar vertebrae. The pars interarticularis is a slim bone segment that joins two vertebrae. This is the most prominent area to get affected by repetitive stress. Generally, spondylolysis is a common condition found in one out of 20 individuals. 

Malignant Disease (Multiple Myeloma Metastatic Disease) – It’s a term for diseases where abnormal cells split without any control and can attack nearby tissues. These can also spread to other areas of your body via the lymph and blood systems. 

Studies show that spinal metastases occur in 3 to 5% of patients with malignant diseases. Its development can cause pain, the development of MSCC (a complication of cancer), and collapse at single/multiple vertebral levels. 

Abdominal Aortic Aneurysm – An abdominal aortic aneurysm (AAA) is swelling or a bulge in your aorta. The latter is the primary blood vessel running from your heart through the tummy and chest. AAA can become dangerous if it isn’t spotted during its earlier stages.

When it balloons and gets bigger, AAA can lead to significant abdominal pain and back pains. It can lead to an artery rupture or leak which ends up becoming a life-threatening emergency. 

Cauda Equina Syndrome (Spinal Stenosis) – It’s the narrowing of spaces in your spine that can add pressure to the nerves traveling through your spine. This condition usually happens in the lower back and neck, and people with spinal stenosis may sometimes not feel symptoms. 

Nephrolithiasis – Nephrolithiasis, more commonly known as kidney stones, are hard deposits of minerals and salt that form within your kidneys. The wrong diet, excess weight, certain supplements or medications, plus some medical conditions are some of the causes of kidney stones. 

Additional Causes of Lower Back Pain – Aside from those mentioned, lower back pain is also caused by connective tissue diseases, infections, morning stiffness, and hyperparathyroidism.

Types of Physical Therapies


Patients who suffer from lower back pain are usually referred for physiotherapy. These often last for four weeks as the initial conservative and non-surgical treatment option before looking into more aggressive treatments. One of these is back surgery.

The goal of physical therapy is to lessen back pain and increase function. Physios in turn teach you how to maintain a program to prevent future pains and lower back problems. 

There are two types of physical therapies involved in providing relief for lower back pain. To give you a better idea of these, we’ll explain each of them. 

Active Physiotherapy

This is an important form of physical therapy for rehabilitating your spine. To get effective results, you’ll need a generalized back exercise program that has the following: 

  • Stretching which includes simple and easy hamstring stretches
  • Back pain strengthening that involves dynamic lumbar stabilization/other prescribed exercises that last for 15-20 minutes
  • Low-impact aerobic conditioning

Passive Physiotherapy

When exercise is too painful for your lower back and is otherwise impossible, your therapist will likely consider passive therapies. These include heat/ice packs, TENS units, Ionophoresis, ultrasounds, and specific exercises. 

There is also a set of weight training, stretching, and other exercises to help relieve lower back pains. The primary ones include the following: 

  • Ankle pumps
  • Wall squats
  • Heel slides
  • Straight leg raises
  • Single-knee to chest stretches
  • Piriformis stretches
  • Hip flexor stretch
  • Lumbar stabilization exercise

What Does a Physiotherapist Do for Lower Back Pain?

What Does a Physiotherapist Do for Lower Back Pain

Physiotherapists are well-trained to determine the conditions, diagnose your lower back issues, and help you understand the problem. They will provide you with a treatment plan that considers your lifestyle, general health, and activities. 

They have a set of treatment methods used for lower back pains. Some of these include exercise programs for strengthening muscles, improving mobility, and muscle re-education for control improvement. 

Physiotherapists also include treatments like joint manipulation and mobilization for decreasing stiffness and pain, as well as airway clearance techniques. They also have breathing exercises, massages (soft tissue mobilization), acupuncture, and hydrotherapy. 

These professionals provide assistance with the use of various aids like splints, walking sticks, crutches, or even wheelchairs when necessary. 

Lower Back Pain Examination

When caring for people with lower back pain, neurologic exams can be narrowed down to just a couple of tests. These are tests of dorsiflexion strength of the toe and ankle, ankle reflexes, and light touches over the foot. A straight leg raising test is also included. 

Management Strategies  

There are a few non-complicated management strategies to handle lower back pain. We’ve provided you with a list you can refer to. 

Lessen the Bed Rest – It may sound strange but it’s best to avoid too much bed rest. Studies show that laying down too much or too long can slow down your recovery. Doing so can also increase the lower back pain you’re experiencing. 

Smart Sleeping – You need to sleep smart and make sure your bed is high-quality. For your sleeping posture, the best position is on your back or sides. These are better and easier than sleeping on your tummy. 

If you sleep on your belly, pressing your face on the pillow isn’t possible. You’ll need to breathe so your head will be turned the whole time. However, this position can lead to intense neck pain when you wake up. 

Always Keep a Good Posture – Always pay attention to how you hold your posture whenever you stand, sit, walk, and do your daily activities. Having good posture is when all the bones in your spine are aligned correctly. Remember, poor posture can leave your back tense and stiff, and it often leads to lower back pains. 

Take Some Time to Relax – Back pain can also be linked to tension, stress, and other non-physical issues. Acupuncture and massages can help relieve and loosen muscles to lessen lower back pain. 

Meditation, yoga, and other similar practices can help lift your mood to avoid stress. Plus, stretching your muscles to relax helps better manage your lower back pain. 

Back Pain Physiotherapy Exercises

If you have an inactive lifestyle, you’re likely suffering from a couple of problems, including lower back pain. It can get extremely painful, but luckily, some physiotherapy exercises can offer relief. 

When you regularly practice these exercises, they can provide long-term relief from chronic pains in your lower back. 

If you’re wondering what type of exercises your physio may suggest, here are some of the best: 

The Cat and Cow Pose – Lay on all fours and make sure to keep your back straight. Then after, bend your spine outward and upward, making sure it’s directed toward the ceiling. 

Hold the position until you feel a slight stretch in your neck. Make sure it isn’t painful in any way. 

After, bend your back inward, then downward until you feel another stretch. But this time, the stretch will be in your lower back. 

Repeat the exercise about ten times. 

Prone Leg Lifts – This is like the cobra stretch but instead of raising your upper body, it’s kept planted firmly down. 

For prone leg lifts, keep your legs stretched out and close together. Then, raise them in a single, continuous motion. 

Do the motion as much as you can. Hold the pose then lower your legs back to the surface. 

Cobra Stretch – For the cobra stretch, lay in the same position as the prone leg lifts. Keep your hands on each side of your chest when doing so. 

Keep your feet planted on the floor, then press on your hands while pushing your upper body. This is from your chest to head, upwards. 

Again, hold the pose for a couple of seconds before gently lowering yourself. 

Bridges – This is a very helpful physiotherapy exercise if you want to strengthen and improve your lower back. To perform this correctly, lay down on your back then rest your stretched-out arms by your sides. 

Lift your hips off the floor, keeping your body in a straight line from head to toe, to the knees. 

Leg Stretches – Lay on your back and raise your knees while keeping your feet flat on the ground. Elevate your right foot, then loop a towel or band around it. 

From there, gently pull your foot towards your chest. Keep your right leg straight, don’t bend until you feel the stretch in your hamstrings. 

Side Twists – A side twist is another good stretch when you have lower and side back pains. To do this, lay on your back while stretching your arms by your sides. 

Slowly bend your knees to one side while shifting/turning your body in the opposite direction. Do this on the opposite side as well. 

What to Expect After Physiotherapy?

After the assessment, you might feel a bit sore and after any treatment, you’ll likely feel slightly tender.  But generally speaking, you’ll leave feeling a lot better.

After your first appointment, your physio will construct a treatment plan. They’ll begin with a quick chat to know how you’ve been feeling since the previous appointment. 

Then, your physio will fulfill a condensed assessment to keep track of your progress. The remaining sessions will focus on your ongoing treatment.


How Does Physiotherapy Relieve Back Pain?

The best way to avoid lower back pain from recurring is to go for early treatment. Physiotherapy can help treat lower back pain. During your session, the physio will guide you through the entire process of treatment and recovery. It includes specific exercises put together, especially for your needs. The examination results will determine the right kind of physiotherapy for your lower back. 

What is the Best Physiotherapy for Back Pain?

Active physical therapy is the best for lower back pain since it focuses on specific stretching and exercises. For most treatments of lower back pain, active exercise is the primary focus.

Why Would I Need Physiotherapy for Back Pain?

Physiotherapy for treating back pain is essential since it helps improve the function and movement of your joint and muscles. It can help lessen pain while simultaneously allowing you to move normally without problems. Physios utilize many techniques and treatments to help relieve and cure your back pain.



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