How physiotherapy can help relieve your back pain

Physiotherapy can help restore the movement and function of your joints and muscles after an injury or due to disease or deformity. It is, consequently, often recommended to treat back pain as it can help restore your mobility and reduce your risk of recurring back pain. 

The four stages of physiotherapy

If you’re experiencing persistent back pain, it’s helpful to see a physiotherapist for a diagnosis of the cause of your back pain and for a tailored treatment programme. Treatment usually follows four stages.  

The first stage of physiotherapy focuses on controlling your pain and reducing any inflammation and swelling. Once your pain eases, stage two involves improving the range of movement of your muscles to prevent long-term stiffness and to encourage blood flow to the damaged tissue, which helps recovery. 

Stage three focuses on building strength in your muscles. With back pain, muscle strengthening shifts the strain off your spine and onto your muscles, which in the long term, reduces your risk of further back pain. 

Finally, stage four involves resistance training ie further strengthening your muscles by making them work against a force or weight. This will allow you to get back to your regular exercise levels and/or sporting activities. 

Passive versus active physiotherapy

When you see a physiotherapist about your back pain, they will provide you with advice on exercises, how far to push yourself, when to rest and how to adapt your daily life. They will also offer encouragement and reassurance to help you stay motivated during your recovery process. They usually offer both passive and active physiotherapy. 

Passive manoeuvres are where you do not need to move your body yourself. Instead, your physiotherapist will massage your body, or use a TENS machine, laser or other devices to encourage blood flow. In the case of a trapped nerve, they may also manually ‘stretch’ your spine using traction — this helps reduce pressure on the cushions that sit between the bones making up your spine (vertebral discs). 

Active manoeuvres are where you move your muscles to perform specific exercises. This is a key part of muscle strengthening, resistance training and rehabilitation. 

How long is physiotherapy for back pain needed?

How long you need physiotherapy to resolve your back pain will depend on the underlying cause. In cases of acute or sudden onset back pain, often two to three sessions, alongside exercises at home, is enough to help relieve back pain. 

Chronic (long-term) back pain usually needs more sessions; how many more depends on how your rehabilitation progresses and how motivated you are to continue practising your exercises at home.  
If you have chronic back pain and physiotherapy isn’t improving your condition, despite regularly performing your exercises, your physiotherapist will usually refer you to a doctor and/or to have imaging tests.