Low Back & Pelvis

What It Is

Lower back pain is incredibly common: around 60–85% of adults have low back pain at some point in their lives (Middleton and Fish, 2009). If back pain occurs in older age, it is often put down to lumbar spondylosis, or degenerative (wear-and-tear) changes in the lower back.

It is very normal to have degenerative changes in the body. Changes in the discs are a normal part of ageing. Signs of disc change can be seen as early as the teenage years (Urban and Roberts, 2003), and almost everyone has some disc degeneration after the age of 40, even if it causes no symptoms (Cleveland Clinic, 2025). The soft centre of each disc (the nucleus) is around 80% water, and it is surrounded by a tough outer ring of fibrocartilage known as the annulus (Urban and Roberts, 2003). As we get older, the centre of the disc naturally loses some water, so the disc becomes thinner and does not absorb shock as well (Cleveland Clinic, 2025). This drying out is an early part of degeneration. Small cracks can appear in the outer ring, and the disc may bulge outwards. If the outer wall cracks open, disc material can push out (a herniated, slipped or prolapsed disc), which may press on a nerve (Cleveland Clinic, 2025; Urban and Roberts, 2003). Despite its name, degenerative disc disease is not really a disease but a condition in which the discs wear down; when more than one disc is affected it is called multilevel degenerative disc disease (Cleveland Clinic, 2025).

Lumbar spondylosis is a broad term for these degenerative changes in the lower back. It includes disc degeneration (degenerative disc disease), and can also involve the small joints at the back of the spine (facet joints) and bony outgrowths (osteophytes); the term is used in slightly different ways by different experts (Middleton and Fish, 2009).

Causes of Lumbar Spondylosis

Hereditary/Genetic: disc disease can run in families, so if a parent, brother or sister has it, you are more likely to get it too (MedlinePlus Genetics, 2016).
Ageing (wear and tear): disc changes become more common as we get older (Urban and Roberts, 2003; Cleveland Clinic, 2025).
Smoking and excess weight: both are linked to a higher risk of disc degeneration (Urban and Roberts, 2003; MedlinePlus Genetics, 2016).
Heavy physical work and injuries: a physically demanding job, heavy work, and acute injuries such as falls can increase the risk (Cleveland Clinic, 2025; Urban and Roberts, 2003).

Lumbar Spine Anatomy

Your spine is made up of many bones (vertebrae) stacked on top of each other. Ligaments, muscles, intervertebral discs and nerves are also part of your spine. The vertebrae connect to create a canal that protects the spinal cord. The spine has three main sections: the neck (cervical), the chest (thoracic) and the lower back (lumbar). Below the lower back, the base of the spine is made of vertebrae fused together.

In between each vertebra is a disc. It is made up of a soft inner part called the nucleus, and a tougher outer part called the annulus. The inner part is mostly water. When the disc starts to degenerate, the inner part dries out and the disc loses water. Small cracks can appear in the outer part of the disc, and the disc material can push out through these cracks; this is known as a slipped disc (or disc prolapse) (Cleveland Clinic, 2025).

The nerves (electrical cables) travel through the spinal canal and carry messages between the brain and the muscles. They branch away from the spinal cord through openings between the vertebrae. Ligaments and muscles give stability and support to the spine, and strong ligaments connect the vertebrae and help keep the spinal column in its proper position.

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

Treatment

Self-Care & Treatment

How to Treat Lumbar Spondylosis

Exercise, including strengthening, stretching and aerobic exercise, helps to restore strength and movement to the lower back and relieve pain (Middleton and Fish, 2009), and hands-on treatment such as massage and mobilisation should be used alongside exercise rather than on its own (NICE, 2026). I can guide you through an exercise programme and combine it with hands-on treatment. See the My Approach tab for how I work.

1. Stay Active

Try to stay active and continue with your daily activities. Do not stay in bed for long periods of time (NHS, 2026).

2. Pain Relief, Heat and Ice

NHS (2026) advice for back pain includes taking an anti-inflammatory medicine such as ibuprofen, although these may not be suitable for everyone. Paracetamol on its own is not recommended for back pain (NHS, 2026; NICE, 2026). (This medicine information comes from NHS, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.) A heat pack (or hot water bottle) wrapped in a tea towel can help relieve stiffness or muscle spasms, and an ice pack (or bag of frozen peas) wrapped in a tea towel can help reduce pain and swelling (NHS, 2026). Ask me how long to use the heat pack for.

3. Exercise

Activities like walking, swimming, yoga and pilates may also help (NHS, 2026).

4. Accept It and Manage Your Condition

Lumbar spondylosis is part of normal ageing of the spine. It is important to realise that almost everyone will have some degree of wear and tear as they get older (Cleveland Clinic, 2025), and that many people with these changes have no symptoms at all. Be realistic and expect some stiffness in your back at times. Staying active and carrying on with your normal daily activities helps back pain recover (NHS, 2026). Keep active, eat well, stay positive in mind and live a well-balanced life to help minimise the pain.

Tips

Combining aerobic exercise with specific strengthening and stretching exercises will help to keep your back muscles flexible and strong.
Make sure to lift heavy objects using your legs and not your back, and avoid frequent heavy lifting where you can (Cleveland Clinic, 2025).
Maintaining a healthy weight helps reduce strain on the lower back (Cleveland Clinic, 2025).
Smoking is linked to disc degeneration and can make back pain worse (Urban and Roberts, 2003; Cleveland Clinic, 2025).
Avoid sitting for long periods – get up and move around regularly (Cleveland Clinic, 2025).
Be realistic – most people get some degree of lumbar spondylosis, and it is something you can manage and keep active with.

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

Options outside my scope

Spinal manipulation: hands-on treatment from a chiropractor, osteopath or physiotherapist, which NICE says should only be used alongside exercise (NICE, 2026).
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)

An exercise programme for strength, movement and fitness
Hands-on treatment and gentle spinal mobilisation, alongside exercise
Advice on staying active, lifting and daily habits

Treatment

My Approach

Changes in the discs and joints of the lower back are a normal part of getting older, and they don't mean your back is fragile. My aim is to ease the pain and stiffness, keep your spine moving, and build strength so your back copes with daily life, lifting and the things you enjoy.

I start by assessing how your back and hips move, which positions ease or bring on your pain, and the strength and flexibility of your trunk, hips and legs. I also check the sensation, reflexes and strength in your legs. Some people feel better bending slightly forward, others leaning back, so this shapes your plan.

Easing Pain and Stiffness

Slow breathing and a comfortable position, often on your side or with your knees supported, to help tight muscles relax
Massage, myofascial and trigger point work through the low back, hips and hamstrings
Gentle, low-velocity mobilisation of stiff parts of your spine, never quick thrusts, and assisted stretches for tight muscles
Warm or cool applications in the clinic, and I'll show you how to use heat and ice safely at home

Building Strength and Confidence

Exercises guided by what eases your symptoms, starting with pain-free movement and gentle stretching
Trunk and hip strength, progressing to bridges, squats, lunges and learning to hip hinge for bending and lifting
When you're ready, gym-based strength work, drawing on my years working with powerlifters
A home programme to do between visits, alongside walking, swimming or other aerobic exercise
Advice on breaking up long spells of sitting, and lifting with your legs with the load kept close

Work on the buttock and hip muscles is only with your informed consent and a written consent form. If you have pain, tingling, weakness or numbness in both legs, numbness around your genitals or bottom, or changes in your bladder or bowels, call 911 or go to the emergency room (see Get Emergency Help).

What to Expect

Typical Course

Typical course: Most people come once or twice a week for the first few weeks, then weekly, with a reassessment at about 4 to 6 weeks, then less often as you manage more on your own. Flare-ups often settle over a few weeks; because the changes are long term, the aim after that is keeping your back strong and moving, with a check-in if it flares.

What I Focus On

Assessment

Pain & Stiffness Relief

Gentle Spinal Mobilisation

Progressive Strength

Staying Active

Please read

When to See a Doctor First

Get Emergency Help

Call 911 or go to the emergency room at your nearest hospital if you have back pain and (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 how your penis or vagina feels during sex, or not being able to get or keep an erection
chest pain
pain that started after a serious accident, such as a car accident

See your family doctor or nurse practitioner if your back pain does not improve after a few weeks of self-care, is stopping you doing your day-to-day activities, does not improve with rest or is worse at night, or if you have lost weight without trying (NHS, 2026).

Sources

References

Middleton, K. and Fish, D.E. (2009) 'Lumbar spondylosis: clinical presentation and treatment approaches', Current Reviews in Musculoskeletal Medicine, 2(2), pp. 94–104. doi: 10.1007/s12178-009-9051-x
Urban, J.P.G. and Roberts, S. (2003) 'Degeneration of the intervertebral disc', Arthritis Research & Therapy, 5(3), pp. 120–130. doi: 10.1186/ar629
Cleveland Clinic (2025) Degenerative disk disease. Available at: https://my.clevelandclinic.org/health/diseases/16912-degenerative-disk-disease (Accessed: 7 October 2026).
MedlinePlus Genetics (2016) Intervertebral disc disease. Available at: https://medlineplus.gov/genetics/condition/intervertebral-disc-disease/ (Accessed: 7 October 2026).
National Institute for Health and Care Excellence (NICE) (2016, updated 2026) Low back pain and sciatica in over 16s: assessment and management (NICE guideline NG59) – Recommendations. Available at: https://www.nice.org.uk/guidance/ng59/chapter/Recommendations (Accessed: 7 October 2026).
NHS (2026) Back pain. Available at: https://www.nhs.uk/conditions/back-pain/ (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooLumbar Spondylosis

What It Is

Causes of Lumbar Spondylosis

Lumbar Spine Anatomy

Self-Care & Treatment

How to Treat Lumbar Spondylosis

1. Stay Active

2. Pain Relief, Heat and Ice

3. Exercise

4. Accept It and Manage Your Condition

Tips

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

My Approach

Easing Pain and Stiffness

Building Strength and Confidence

Typical Course

When to See a Doctor First

Get Emergency Help

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooLumbar Spondylosis

What It Is

Causes of Lumbar Spondylosis

Lumbar Spine Anatomy

Self-Care & Treatment

How to Treat Lumbar Spondylosis

1. Stay Active

2. Pain Relief, Heat and Ice

3. Exercise

4. Accept It and Manage Your Condition

Tips

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

My Approach

Easing Pain and Stiffness

Building Strength and Confidence

Typical Course

When to See a Doctor First

Get Emergency Help

References

Related Conditions

Degenerative Disc Disease (DDD)

Cervical Spondylosis

Facet Joint Osteoarthritis

Leg Length Discrepancy

Book a session