Back Pain

The problem

Back pain and neck pain are the most common physical problems I am asked to treat. Low back pain affects around 70% of people at least once in their life and research indicates that nearly a quarter of the global population suffer from chronic low back pain (i.e. pain lasting more than three months) at any one time.

Understanding your pain

As with other specific conditions that can be addressed with manual therapy, it is important to first understand the history of your back pain before a diagnosis can be made. This involves asking you: to describe your symptoms; when and how your symptoms started; which activities provoke pain or dysfunction and so on.

This history guides me in making an appropriate physical examination of the affected area and surrounding tissue including joints above and below the affected area especially in the rest of your spine and your hips. The examination might include observation in standing and on the treatment couch, palpation of the area as well as some tests of movement and strength. This phase of the session is conducted in constant dialogue with you so that you are not forced into any movements which make your fearful of exacerbating your pain.


Treatment consists of applying manual therapy techniques such as soft tissue massage, joint mobilisation and stretches to the appropriate tissue. Sometimes this means a focus on the area of pain and sometimes this means relieving surrounding tissue that may have become painful or restricted either because of adaptations you have made to accommodate your back problem or issues that are affecting the back directly.

In most cases it’s possible to make significant improvements to pain levels and range of movement with manual therapy. Manual therapy such as soft tissue massage, helps to reduce excessive tone in muscles which you might feel as either as pain or an area of hardness in the muscle. Sometimes this means using manual therapy around what feels like the affected area but sometimes it’s also effective to treat surrounding tissue where dysfunction you might not have been aware of could be contributing to your pain. Trigger points, or knots in the muscles, can contribute to low back pain.

Massage and acupressure can help release these trigger points, leading to reduced pain and improved muscle function. Manual therapy, such as joint mobilisations, can enhance joint mobility and flexibility and improve the range of motion in the lower back. This can be particularly effective in the treatment of facet joint complaints.

During the treatment we can discuss possible lifestyle adjustments you could make to relieve your symptoms and allow healing to take place these might include discussing your work place habits, your posture or how you lift, including how you lift young children if that’s relevant to you. We can also discuss whether a graded exercise programme is appropriate for you and if so I can take you through the relevant exercises after the manual therapy treatment.