Symptoms
Does this sound like you
- A dull ache or sharp pain low in the back
- Stiffness, often worse first thing in the morning or after sitting
- Muscle spasm that makes it hard to stand up straight
- Pain when bending, lifting, twisting or getting out of a car
- Pain that spreads into the buttock or down the leg
- Pins and needles in the leg or foot
- Trouble sitting, standing or driving for long
Assessment
We start with your story: when the pain began, what you were doing, and what eases it or makes it worse. Then we examine how your back and hips move, and how strong your trunk, hips and legs are. We also test the nerves that run from your lower back into your legs, by checking feeling, strength and reflexes.
This tells us whether the pain is mainly coming from the joints and muscles of the back, or whether a nerve is involved. If the exam points to a nerve problem, or to another cause that needs a closer look, we explain what we found. We then advise you to see a doctor or nurse practitioner.
Treatment
Early on, the goal is to calm the pain and keep you moving. Long bed rest is no longer advised. We find positions and gentle movements that ease the pain, and help you plan work and daily tasks around it.
Hands-on treatment can ease pain and help your back move more freely. It may include gentle joint movements (mobilization), manipulation and soft-tissue work. See manual therapy.
We also offer IMS (intramuscular stimulation), which uses fine needles in tight, sensitive bands of muscle and aims to help them release. See IMS and dry needling. Massage therapy can help with muscle tension and spasm alongside physiotherapy.
Exercise is the main treatment. Your plan starts with easy movement and builds to strength work for the trunk, hips and legs. Step by step, it adds the bending, lifting and twisting your work and sport ask of your back.
Getting back to sport
Your back is ready for sport when the movements your sport asks for make the pain no more than a little worse. Skiing and snowboarding ask your back to twist, absorb bumps and land. We build up to each in stages.
Our Back Fundamentals series suits this stage. It teaches safe ways to load the spine, built around a protective stance it calls the power position. Both sports need a full range of postures, but the series trains the power position as your default for impact and twisting. It has three levels, from beginner up, plus a set of abdominal exercises. Keeping it up once you are back is one way to help protect your back.
When to come in
Book an assessment if back pain stops you working, sleeping or doing your sport, keeps coming back, or spreads into your leg. If you hurt your back at work and have a WorkSafeBC claim, have your claim number ready when you book. Our Active Rehab Program page explains how WorkSafeBC claims work with us.
Go to the emergency department right away, or call 911, if any of these happen:
- new loss of control of your bladder or bowels, or new trouble passing urine
- numbness around the groin or buttocks
- weakness or numbness in both legs
- back pain with a fever and feeling very unwell
- back pain after a hard fall or crash
The people
Who treats it
Partner · PhysiotherapistSport physiotherapy and return to sport · Movement analysis and exercise programming · Complex orthopaedic and post-surgical rehabilitationVillage North · Whistler Athlete Centre
Partner · PhysiotherapistHand and upper-limb rehabilitation · Concussion and vestibular rehabilitation · Sports and spinal injuriesVillage North
Partner · PhysiotherapistComplex neck and back problems · Sports injuries · Concussion and vestibular rehabilitationVillage North
PhysiotherapistPelvic health and pelvic floor physiotherapy · Pre- and post-natal rehabilitation · Sports injuries and post-surgical rehabilitationVillage North · Whistler Athlete Centre
PhysiotherapistRunning injuries · Post-surgical rehabilitation, including ACL and rotator cuff · Concussion and vestibular rehabilitationVillage North
PhysiotherapistACL rehabilitation, with or without surgery · Concussion and vestibular rehabilitation · Running injuriesVillage North
PhysiotherapistSnow sports injuries · Acute sporting knee injuries · Strength and conditioningVillage North · Whistler Athlete Centre
PhysiotherapistPelvic health for men and women · Antenatal physiotherapy · Hip, pelvis and spinal injuriesVillage North · Whistler Athlete Centre
- By referral
Care
How we help
Physiotherapy
Assessment, hands-on treatment and a plan built around your sport, from physiotherapists whose patients compete on the World Cup with Canada's ski and snowboard teams.
Read more ServiceManual Therapy
Joint and soft-tissue mobilization and manipulation from physiotherapists with post-graduate manual therapy training, also called musculoskeletal or manipulative physiotherapy: easing pain by treating the underlying problem, without drugs.
Read more ServiceIMS and Dry Needling
Fine, solid needles placed into tight, tender bands of muscle to help them release, practised here as Gunn IMS or as functional dry needling, depending on each physiotherapist's training.
Read more ServiceRegistered Massage Therapy (RMT)
Manual soft-tissue treatment for pain, muscle tension, spasm and trigger points: restoring mobility and promoting recovery.
Read moreFAQ
The questions we hear most
Do I need an X-ray or MRI for back pain?
Usually not. Most low back pain is not a sign of serious damage, even when it hurts a lot. Scans often show disc and joint changes that many people without pain also have, so they seldom change the plan. A doctor or nurse practitioner may order one if there are signs of a nerve problem, a broken bone or another cause.
Should I rest until my back pain settles?
Not for long. A short break from heavy tasks can help, but staying in bed tends to leave the back stiffer and weaker. Gentle walking and changing position often feel better than lying still. Aim for activity that makes the pain no more than a little worse, and keep doing what you can at work and at home.
Is pain down my leg sciatica?
Sometimes. Sciatica is pain from an irritated nerve in the lower back. It often runs below the knee and can bring tingling or numbness in the leg or foot. Back joints and muscles can also send pain into the buttock and thigh without any nerve problem. Our nerve tests help tell them apart. Leg weakness that is getting worse needs a prompt check by a doctor or nurse practitioner.
Can I ski or snowboard with low back pain?
Often, in time. It depends on how your back moves and what brings the pain on. Bumps, jumps and twisting falls load the lower back hard, so a back that is still flaring may not cope with a full day. Start with easier terrain and shorter days. Before you push harder, we can check how your back and hips handle twisting and landing.
This page is general information, not a diagnosis or a substitute for an assessment. If you are unsure, see a health professional.