By Craig Wakefield, Physiotherapist | Holistic Physio Fitness
Lower back pain is one of the most common reasons people visit a physiotherapist. In fact, around 8 out of 10 Australians will experience lower back pain at some point during their lives. Whether it starts after lifting something heavy, spending hours sitting at a desk, gardening on the weekend or seemingly appearing for no obvious reason, back pain can have a significant impact on work, exercise and everyday life.
One of the biggest myths I hear as a physiotherapist is:
“I think I just need to rest until my back gets better.”
While this advice was once common, we now know from decades of research that prolonged rest is usually one of the worst things you can do for most episodes of lower back pain.
The key is understanding why your back hurts and then following an evidence-based rehabilitation program designed specifically for you.
Why Does Lower Back Pain Occur?
Your lower back is an incredibly strong and resilient part of your body.
It is made up of bones, discs, joints, muscles, ligaments, tendons and nerves that all work together to support movement.
Pain can develop for many reasons, including:
- Muscle strains
- Ligament sprains
- Joint irritation
- Disc-related pain
- Poor lifting technique
- Sudden increases in activity
- Long periods of sitting
- Reduced strength
- Previous injuries
- Stress and poor sleep
Often, it isn’t just one factor that causes pain. Instead, it is usually several contributing factors occurring at the same time.
That’s why every patient requires an individual assessment rather than a one-size-fits-all treatment approach.
Pain Doesn’t Always Mean Something Is Seriously Wrong
Many people worry that severe pain automatically means they have badly damaged their back.
Fortunately, this is rarely the case.
Research shows that many people have disc bulges, arthritis and degenerative changes on MRI scans without experiencing any pain whatsoever.
Likewise, someone with significant back pain may have very little structural damage.
Pain is influenced by many factors, including:
- Tissue health
- Nervous system sensitivity
- Previous pain experiences
- Sleep quality
- Physical activity
- Stress
- General health
This is why physiotherapists don’t simply treat MRI scans—we treat people.
Should You Have a Scan?
Many patients believe they need an MRI before seeing a physiotherapist.
In reality, most episodes of lower back pain do not require imaging.
Clinical guidelines recommend that scans are generally reserved for situations where there are signs of serious underlying pathology or where symptoms persist despite appropriate management.
Unnecessary imaging can sometimes create more anxiety by identifying age-related changes that are completely normal and unrelated to the pain.
A physiotherapist can determine whether further investigations are appropriate based on your assessment.
Why Rest Often Slows Recovery
Years ago, people were advised to spend days lying in bed after hurting their back.
We now know this approach usually delays recovery.
When you stop moving:
- Muscles become weaker.
- Joints become stiffer.
- Confidence decreases.
- The nervous system can become more sensitive.
- Returning to activity becomes harder.
Instead, current evidence recommends remaining as active as your symptoms reasonably allow.
This doesn’t mean pushing through severe pain.
It means gradually keeping your body moving while allowing tissues to recover.
Exercise Is One of the Best Treatments
Exercise is considered one of the most effective treatments for both acute and persistent lower back pain.
The right exercises help:
- Improve spinal mobility
- Increase core and hip strength
- Improve flexibility
- Improve balance
- Reduce stiffness
- Improve confidence
- Reduce future injury risk
Importantly, the “best” exercises differ from person to person.
Your rehabilitation program should match your injury, goals, lifestyle and current physical abilities.
There Is No Magic Exercise
Patients often ask me,
“What’s the one exercise that fixes back pain?”
Unfortunately, there isn’t one.
Successful rehabilitation usually involves:
- Improving movement quality
- Strengthening weak muscles
- Increasing tolerance to activity
- Building confidence
- Gradually progressing exercise
As your body adapts, your program should change as well.
That’s why ongoing review with your physiotherapist is so important.
Hands-On Treatment Can Help
At Holistic Physio Fitness we may use a combination of treatments depending on your condition.
These can include:
- Joint mobilisation
- Soft tissue massage
- Dry needling
- Stretching
- Movement retraining
- Exercise prescription
- Education
Hands-on treatment often provides short-term symptom relief, allowing you to move more comfortably.
However, lasting improvement usually comes from combining these treatments with an appropriate exercise program.
When Should You See a Physiotherapist?
Although many episodes of back pain improve over several weeks, you should consider seeing a physiotherapist if:
- Your pain is limiting everyday activities.
- The pain is returning regularly.
- You’re unsure what caused it.
- You’re avoiding exercise because of pain.
- You want to prevent future episodes.
- Your recovery seems slower than expected.
Early assessment often helps prevent minor problems becoming persistent ones.
Our Approach at Holistic Physio Fitness
At Holistic Physio Fitness, we don’t just focus on where your pain is—we look at why it developed.
Your assessment includes looking at:
- Your movement patterns
- Muscle strength
- Joint mobility
- Previous injuries
- Lifestyle
- Work demands
- Sporting activities
- Long-term goals
We then create an individual rehabilitation program that evolves as you improve.
Our aim isn’t simply to reduce pain today.
Our goal is to improve how your body functions so you can confidently return to work, sport and everyday life while reducing the likelihood of future injuries.
Preventing Future Back Pain
Although no one can completely eliminate the risk of back pain, there are several things that significantly reduce your chances of recurrence:
- Stay physically active.
- Perform regular strength training.
- Avoid long periods of sitting without movement.
- Maintain flexibility.
- Progress activities gradually.
- Get adequate sleep.
- Maintain a healthy body weight.
- Seek treatment early if symptoms develop.
Small, consistent habits usually have a much bigger impact than searching for a quick fix.
Final Thoughts
Lower back pain can be frustrating, but it doesn’t have to control your life.
Modern physiotherapy is about understanding the cause of your symptoms, restoring confidence in movement and helping your body become stronger and more resilient.
If you’re experiencing lower back pain, remember that complete rest is rarely the answer. With the right advice, the right exercises and a personalised treatment plan, most people can make significant improvements and get back to doing the activities they enjoy.
Looking for a Physiotherapist on Sydney’s Northern Beaches?
If you’re experiencing lower back pain, neck pain, sports injuries or ongoing musculoskeletal pain, our experienced physiotherapy team at Holistic Physio Fitness in Mona Vale is here to help.
We provide comprehensive assessments, hands-on treatment and personalised exercise programs designed to get you moving with confidence again.
Book an appointment today and take the first step towards moving better, feeling stronger and staying active.
References
- Foster NE, Anema JR, Cherkin D, et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet. 2018;391(10137):2368–2383.
- Hartvigsen J, Hancock MJ, Kongsted A, et al. What low back pain is and why we need to pay attention. The Lancet. 2018;391(10137):2356–2367.
- Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. American Journal of Neuroradiology. 2015;36(4):811–816.
- Qaseem A, Wilt TJ, McLean RM, Forciea MA. Non-invasive treatments for acute, subacute and chronic low back pain: a clinical practice guideline. Annals of Internal Medicine. 2017;166(7):514–530.
- Maher C, Underwood M, Buchbinder R. Non-specific low back pain. The Lancet. 2017;389(10070):736–747.
- Australian Commission on Safety and Quality in Health Care. Low Back Pain Clinical Care Standard. Sydney, Australia.
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