Massage therapy · Kitchener–WaterlooLower Back Pain

Back pain usually improves within a few weeks, but it can sometimes last longer or keep coming back (NHS, 2026). There are many treatments, which are discussed later in this sheet.

The vertebrae connect to form a canal that protects the spinal cord. The spinal column has three sections creating three curves in the back: the neck (cervical), the chest area (thoracic) and the lower back (lumbar). The lowest part of the spine (the sacrum and coccyx) is made up of vertebrae that are fused together.

The nerves and spinal cord act like electrical cables. They travel through the canal and carry messages between the muscles and the brain. Nerves branch out from the cord through openings between the vertebrae. The most famous of these is the sciatic nerve, which causes sciatica when it is trapped or pinched. Sciatica pain tends to travel into the buttock, down the back of the leg and sometimes into the foot and toes, and it can cause tingling, numbness and weakness in the leg (NHS, 2024). The other main nerve that comes from the lower back is the femoral nerve, which tends to cause pain down the front of the thigh to the knee.

The ligaments and muscles provide the stability and support your spine and upper body need. Strong ligaments connect the vertebrae to one another.

1. Stay 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).

2. Physiotherapy and Group Exercise

If your pain does not get better after a few weeks, group exercise sessions and physiotherapy may be recommended (NHS, 2026).

3. Osteopathy and Chiropractic

In the US, osteopaths are medical doctors as well as therapists. In the UK and Europe, osteopaths are therapists who use massage, stretching and movement of the joints to improve mobility, and they tend to look at the whole body. Chiropractic is provided in a number of forms; some are gentler and do not use manipulation, such as McTimoney chiropractic.

4. Fitness Training/Personal Training

Active therapy involves weight training, stretching and cardiovascular exercise, which can all be done in the gym (American Academy of Orthopaedic Surgeons, n.d.a). Activities like walking, swimming, yoga and pilates may also help ease back pain (NHS, 2026).

The best thing is to come and see me early on. Scans such as MRI and X-rays are not routinely needed for low back pain (National Institute for Health and Care Excellence, 2016).

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).
• Cognitive behavioural therapy (CBT): a talking therapy that can help you cope with the pain (NHS, 2026).
• Scans: NICE advises against routine imaging for low back pain outside specialist settings; a specialist may arrange a scan if it is likely to change your treatment (National Institute for Health and Care Excellence, 2016).
• Surgery: if your back pain is caused by a medical condition like a slipped disc and other treatments have not helped, surgery may be an option (NHS, 2026).

How I can help (see the My Approach tab)

• Hands-on treatment and gentle, low-velocity joint mobilisation, alongside exercise
• A home exercise programme, building to gym-based strength work
• Advice on staying active, lifting and daily habits

Day to day, change position often, get up and move about 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.