Low Back & Pelvis

What It Is

Acute back pain is common, and usually not serious. It usually improves within a few weeks (NHS, 2026). It is not always obvious what causes it. A common cause is a pulled muscle (strain), and muscle spasm, the small facet joints of the spine and the discs can all be sources of pain.

So what exactly happens? Well, there are a few processes going on that need to be discussed.

Firstly, acute back pain can occur when bending forwards, bending backwards, or coming up from a forward bend. For example, imagine you are picking up a pen from the floor, you bend forwards, and then something "goes" in your back. Your back is in spasm and you are feeling very sharp pain. This is acute back pain. The pain can be so severe you cannot sit comfortably, or stand for long periods. Lying down may feel the most comfortable at first, but try not to stay in bed for long periods; staying as active as you can and carrying on with your daily activities helps you recover (NHS, 2026).

But why does it occur? Often there is no single clear cause, and back pain often gets better on its own (NHS, 2026).

Lower Back Anatomy

Facet joints are nestled in the back on either side of your spinal column, behind the vertebral bodies and the discs. Each vertebra has a bony prominence on either side, forming a facet joint with the vertebra above and below.

Facet joints are surrounded by a joint capsule, and small folds of tissue similar to a mini version of the knee joint's meniscus have been found within the facet joints of the lower back (Bogduk and Engel, 1984). The facet joints help to limit excessive movement, carry some of the load through the spine and give the spine stability (Perolat et al., 2018).

In-between the vertebrae sit discs, which help the spine absorb force and allow movement. If a disc loses height, more load passes through the facet joints, which may contribute to wear in those joints over time (Inoue et al., 2020).

Surrounding the vertebrae are muscles, ligaments and nerves, all of which can be a source of pain.

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat Acute Back Pain

Hands-on treatment (manual therapy), such as massage and gentle mobilisation of the joints, can be helpful, but NICE guidance says it should only be used as part of a treatment plan that includes exercise (National Institute for Health and Care Excellence, 2016). If the pain is not settling, I can combine hands-on work with exercises to improve the mobility of your spine and help you get back to your normal activities. See the My Approach tab for how I work.

1. Anti-Inflammatory Medication

The NHS (2026) advises that anti-inflammatory medicine such as ibuprofen can help ease back pain, although it may not be suitable for everyone, and that paracetamol on its own is not recommended for back pain. Easing the pain can help you keep moving. (This medicine information comes from the NHS, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

2. Keep Active, Ice and Heat

Try to stay active and carry on with your daily activities as much as you can, and do not stay in bed for long periods. An ice pack (or bag of frozen peas) wrapped in a tea towel can help reduce pain and swelling, and a heat pack or hot water bottle wrapped in a tea towel can help relieve stiffness or muscle spasms (NHS, 2026).

3. Exercise

Activities like walking, swimming, yoga and pilates may also help ease back pain (NHS, 2026). Stop any exercise that makes your pain worse and get advice.

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Spinal manipulation: a hands-on technique, used by some physiotherapists, osteopaths and chiropractors, in which a joint is moved with a quick, controlled thrust; NICE says it should only be considered as part of a treatment plan that includes exercise (National Institute for Health and Care Excellence, 2016).
Prescription painkillers: if your back pain is severe or not getting better, a doctor may prescribe painkillers (NHS, 2026).

How I can help (see the My Approach tab)

Massage and gentle joint mobilisation, alongside exercise
Exercises to get your spine moving and build strength
Advice on staying active and getting back to your usual activities

Tips

Keep moving: staying active and continuing with your daily activities helps recovery, while long periods of bed rest do not (NHS, 2026).
Practise exercises to help strengthen the spine and the muscles around it; regular exercise is recommended to help manage back pain (National Institute for Health and Care Excellence, 2016).
Back pain often gets better on its own within a few weeks, but it can sometimes last longer or keep coming back (NHS, 2026). If it does keep coming back, talk to me or your family doctor or nurse practitioner.

Treatment

My Approach

Most back pain isn't caused by serious damage, and the outlook is good: the spine is strong and built to be loaded, and staying active usually helps you recover more than resting does. My aim is to ease the pain and spasm, get you moving with confidence again, and build the strength your back needs for daily life, work and training.

I start by asking how it happened and what eases or aggravates it, then assess how your back and hips move, test your strength, and check the nerves to your legs (sensation, reflexes and strength). I also check for the rare signs of something more serious. Numbness around the genitals or anus, new bladder or bowel problems, or weakness in both legs mean calling 911 or going to the emergency room. Pain that wakes you at night and isn't eased by changing position, or a history of cancer, means seeing your family doctor or nurse practitioner first.

When It's New

Massage and gentle joint mobilisation to ease guarding muscles, always alongside exercise rather than on their own
Warm applications in the clinic to help spasm settle before we move
Easing positions: knees bent and supported when lying, or a small roll behind your low back when sitting
Practising the basics: rolling, getting up from lying and sit-to-stand
Short walks you build on day by day, rather than bed rest

As It Settles

Gentle trunk work, progressing to bridges, lunges and hip-hinge bending
Strength work with weights, plus regular walking or other aerobic exercise
Learning to relax into bending, lifting and twisting rather than bracing and holding your breath
Bringing back movements you've been avoiding, step by step, and explaining how pain works so worry doesn't hold you back
A home programme to do between visits

Day to Day

Change position often, and get up and move at least every half hour
Keep loads close when you lift, and turn with your feet rather than twisting under load

Back pain can come back, and a flare isn't a failure: it's something to manage with a plan you already know. I use gentle, low-velocity mobilisation of the spine, never quick thrusts or big, fast movements. If you're interested in thrust manipulation, a physiotherapist, chiropractor or osteopath can discuss it with you.

What to Expect

Typical Course

Typical course: Most people come once or twice a week while the pain is new, then weekly as we build strength, spacing visits out as you manage on your own, with a reassessment at about 4 to 6 weeks. Acute back pain usually improves within a few weeks, and after that the focus is building strength and a plan you can use if it flares again.

What I Focus On

Reassurance & Education

Early Movement

Hands-On Relief With Exercise

Hip Hinge & Strength

Daily Habits

Please read

When to See a Doctor First

When to Get Urgent Help

If you have back pain and any of the following, call 911 or go to the emergency room at your nearest hospital (NHS, 2026):

Pain, tingling, weakness or numbness in both legs
Loss of feeling around your genitals or anus
Changes in your bladder or bowels, such as difficulty peeing, or peeing or pooing yourself
Changes in feeling or function during sex, such as not being able to get or keep an erection
Chest pain
Your pain started after a serious accident, such as a car accident

Get medical advice promptly if you feel hot, cold, shivery or generally unwell, or if the pain is severe, starts suddenly or is getting worse quickly. See your family doctor or nurse practitioner if the pain does not improve after a few weeks, stops you doing day-to-day activities, is worse at night, is worse when sneezing, coughing or pooing, or comes with weight loss you cannot explain or a lump or change in the shape of your back (NHS, 2026).

Sources

References

NHS (2026) Back pain. Available at: https://www.nhs.uk/conditions/back-pain/ (Accessed: 7 October 2026).
National Institute for Health and Care Excellence (2016, updated 2026) Low back pain and sciatica in over 16s: assessment and management (NICE guideline NG59). Available at: https://www.nice.org.uk/guidance/ng59/chapter/Recommendations (Accessed: 7 October 2026).
Perolat, R., Kastler, A., Nicot, B., Pellat, J.-M., Tahon, F., Attye, A., Heck, O., Boubagra, K., Grand, S. and Krainik, A. (2018) 'Facet joint syndrome: from diagnosis to interventional management', Insights into Imaging, 9(5), pp. 773–789. doi: 10.1007/s13244-018-0638-x
Inoue, N., Espinoza Orías, A.A. and Segami, K. (2020) 'Biomechanics of the lumbar facet joint', Spine Surgery and Related Research, 4(1), pp. 1–7. doi: 10.22603/ssrr.2019-0017
Bogduk, N. and Engel, R. (1984) 'The menisci of the lumbar zygapophyseal joints: a review of their anatomy and clinical significance', Spine, 9(5), pp. 454–460. doi: 10.1097/00007632-198407000-00006

Massage therapy · Kitchener–WaterlooAcute Back Pain

What It Is

Lower Back Anatomy

Self-Care & Treatment

How to Treat Acute Back Pain

1. Anti-Inflammatory Medication

2. Keep Active, Ice and Heat

3. Exercise

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

When It's New

As It Settles

Day to Day

Typical Course

When to See a Doctor First

When to Get Urgent Help

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooAcute Back Pain

What It Is

Lower Back Anatomy

Self-Care & Treatment

How to Treat Acute Back Pain

1. Anti-Inflammatory Medication

2. Keep Active, Ice and Heat

3. Exercise

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

When It's New

As It Settles

Day to Day

Typical Course

When to See a Doctor First

When to Get Urgent Help

References

Related Conditions

Lower Back Pain

Hyperlordosis

Posture

Workplace Ergonomics

Book a session