About back pain
Lower back pain is one of the most common reasons people come to the practice. It can start suddenly after lifting, gardening or a long drive, or build slowly from sitting, stress and habits that load the spine the same way every day. Most episodes are not caused by serious damage, and most respond well to treatment that restores movement and builds tolerance.
Physiotherapy starts by finding out which structures are sensitive and why. That is what the first assessment is for: how you move, where the pain sits, what makes it better or worse, and what your day asks of your back.
What we assess and treat
Back pain we commonly assess and treat at the practice:
- Muscle and joint strain after lifting, twisting or a sudden movement
- Pain and stiffness linked to prolonged sitting and desk work
- Disc-related pain, sometimes with pain, pins and needles or numbness into the leg
- Facet joint irritation and stiffness in the lower or mid back
- Sacroiliac joint pain, including during and after pregnancy
- Age-related changes such as spondylosis and spinal stenosis
- Flare-ups of a long-standing back problem
How physiotherapy helps
Treatment is decided by the assessment, not before it. Depending on what we find, your plan may include:
- 01
Assessment
A movement and hands-on assessment to identify what is driving your pain and what your back can tolerate right now.
- 02
Hands-on treatment
Joint mobilisation and soft-tissue techniques to ease pain and restore movement, where the assessment shows they are appropriate.
- 03
Targeted exercise
A short, specific programme for mobility, control and strength that progresses as you improve.
- 04
Everyday advice
Practical guidance on sitting, lifting, sleeping positions and pacing, so treatment gains hold between sessions.
- 05
A plan you understand
You leave knowing what we are treating, what to do at home and when to expect change.
When to see your doctor first
Some symptoms need a medical assessment before physiotherapy
- Numbness, weakness or heaviness in both legs
- Any change in bladder or bowel control, or numbness around the groin or buttocks
- Back pain with fever, unexplained weight loss or feeling generally unwell
- Pain that started with a fall or accident, particularly in older adults or if you have osteoporosis
- Pain that consistently wakes you at night and does not ease when you change position
These are uncommon. If you are unsure, call the practice and we will guide you on the right first step.
Your first visit
- 1
Assessment
We talk through your history and symptoms, then assess how you move to find the cause.
- 2
Treatment
Hands-on treatment starts in the same session, matched to what the assessment shows.
- 3
Your plan
You leave knowing what we are treating, what to do at home, and what comes next.
Common questions
How many physiotherapy sessions will I need for back pain?
It depends on what the assessment finds, how long you have had the pain and what you need to get back to. We discuss a plan at the first visit and review it as you progress, rather than committing you to a fixed number of sessions.
Should I rest or keep moving?
For most back pain, staying gently active is better than bed rest, and returning to normal activity in stages helps recovery. How much and how soon is individual, which is what your assessment and plan are for.
Do I need an X-ray or scan before physiotherapy?
Usually not. Most back pain can be assessed and treated without imaging. If your assessment suggests a scan or a medical opinion is needed, we will say so and refer you to your doctor.
Related conditions
This page is general information about physiotherapy for this condition. It is not a diagnosis and does not replace an individual assessment. If you are worried about your symptoms, please contact the practice or see your doctor. Reviewed 2026-09-10. Physiotherapy services are provided by Candice Paulse, BSc Physiotherapy (UCT), registered with the HPCSA (PT 0091502).