Getting help for low back pain
Whai āwhina mō te mamae ā-tuarā o raro
You may want treatment from a chiropractor, osteopath or physiotherapist to help you recover from your back pain. All give similar treatment and can be effective – choose the one that suits you best.
You can expect whichever health professional you choose to thoroughly assess you, advise you on how you can help yourself and give you an individual treatment plan. This plan will include exercises and manual therapy.
If you do not get significantly better after five to six treatments, talk to your therapist or GP about what other options you have.
Structured exercise programme
Your exercise programme might include flexion (bending forward) and extension (bending backward), strengthening, aerobic exercise (like walking, swimming or cycling), general fitness or a combination of these. It might include supervised exercise sessions or exercises you can do at home.
Manual therapy
Manual therapy includes spinal mobilisation and spinal manipulation.
Manipulation involves moving a joint in your spine more than it would normally move. Mobilisation involves moving a joint in your spine within the range it would normally move. Once they have examined you and talked about the options, the therapist may use one or both techniques.
Manual therapy may also include massage, techniques to reduce tension and checking how well the joints in your spine are working.
Next steps
If after five or six treatments, your back pain is not starting to get better, talk to your health professional about other treatment options.
If your pain lasts for more than three months, the information in the chronic (persistent) pain section may be helpful.
Written by HealthInfo clinical advisers. Last reviewed May 2022.
Sources
The information in this section comes from the following sources, some of which may be clinically complex or not available to the general public
ACC – Non-specific acute low back pain, part 3 – return to work (http://www.acc.co.nz/PRD_EXT_CSMP/groups/external_providers/documents/guide/prd_ctrb113162.pdf), retrieved March 2017
Bell J.A., & Burnett A. (2009). Exercise for the primary, secondary, and tertiary prevention of low back pain in the workplace: a systematic review. Journal of Occupational Rehabilitation. 19:8-24. DOI: 10.1007/s10926-009-9164-5
Choi B.K.L., Verbeek J.H., Tam Wai-San, Jiang J.Y. (2010) Exercises for prevention of recurrences of low-back pain. Cochrane Database of Systematic Reviews 2010, Issue 1. Art. No.: CD006555. DOI: 10.1002/14651858.CD006555.pub2
Christiansen D., Larsen K., Kudsk J.O., Vinther N.C. Pain responses in repeated end-range spinal movements and psychological factors in sick-listed patients with low back pain: is there an association? J Rehabil Med 2009; 41: 545-49.
Wong J.J., Coté P., Sutton D.A. et al. Clinical practice guidelines for the noninvasive management of low back pain: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Eur J Pain 2016; 21: 201-16.
Hides J., Jull G., Richardson C. Long-term effects of specific stabilizing exercises for first-episode low back pain. Spine 2001; 11: e243-e248
Larsen K., Weidick F., & Leboeuf-Yde C. (2002) Can passive prone extensions of the back prevent back problems? Spine. 27(24):2747-52
Martimo et al (2008) Effect of training and lifting equipment for preventing back pain in lifting and handling: systematic review. British Medical Journal published online 31 Jan 2008; doi:10.1136/bmj.39463.418380.BE
Muller et al (1999) The influence of previous low back trouble, general health, and working conditions on future sick-listing because of low back trouble. Spine. 24(15):1562-1570
Roffey D.M., Wai E.K., Bishop P., Kwon B.K., Dagenais S. Causal assessment of occupational sitting and low back pain: results of a systematic review. Spine J 2010; 10: 252-261
Stanton T.R. et al (2008). After an episode of acute low back pain, recurrence is unpredictable and not as common as previously thought. Spine . 33(26):2923-2928
Williams M.M. & Grant R.N. A comparison of low back and referred pain responses to end range lumbar movement and position. 1992
Image and embedded video sources
Arching back image – From iStock (image ID 20844690). January 2016.
Manual therapy image – From Shutterstock (image ID 1202838715). May 2022.
Modified push-up, back bend lying, back bend standing, sitting, lifting images – Provided by Richard Hopkins physiotherapist. January 2017.
Normal spine image – From Shutterstock (image ID 65496961). Image labels added. July 2014.
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Review key: HILBP-103167
