# Low back pain

Low back pain is pain, stiffness or muscle spasm in the lower back, sometimes spreading into the buttock or leg. It can start with a twisting fall or a hard landing on skis, lifting at work or a long drive, or with no clear cause at all. We check your back and the nerves to your legs, ease the pain, and rebuild strength for work, study and sport.

## Symptoms

- 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](https://backinactionphysiotherapy.com/services/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](https://backinactionphysiotherapy.com/services/dry-needling). [Massage therapy](https://backinactionphysiotherapy.com/services/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](https://backinactionphysiotherapy.com/resources/rad-exercise-programs/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](https://backinactionphysiotherapy.com/resources/occupational-rehab) 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

## Who treats it

- [Therese Leigh, Physiotherapist, BSc Physiotherapy, MHA, Dip Sport Physio, FCAMPT, GunnIMS](https://backinactionphysiotherapy.com/team/therese-leigh)
- [Mike Conway, Physiotherapist, M. PT Sports, M. PT Manips, M. PT Studies, BSc Kin, CHT, GunnIMS, FCAMPT, CSCS](https://backinactionphysiotherapy.com/team/mike-conway)
- [Bianca Matheson, Physiotherapist, BSc PT, Grad Dip PT Manips, Dip Sports Physio, FCAMPT, GunnIMS](https://backinactionphysiotherapy.com/team/bianca-matheson)
- [Jian Soares, Physiotherapist, M ClinPhys, BSc PT, FCAMPT](https://backinactionphysiotherapy.com/team/jian-soares)
- [Dana Elliott, Physiotherapist, MScPT, BSc](https://backinactionphysiotherapy.com/team/dana-elliot)
- [Julie Charette, Physiotherapist, BSc PT, Cert. MDT](https://backinactionphysiotherapy.com/team/julie-charette)
- [Emilie Noble, Physiotherapist, MSc PT, BSc Kines, AN-IMS](https://backinactionphysiotherapy.com/team/emilie-noble)
- [Cameron Gant, Physiotherapist, BSc Physiotherapy, PG Cert Sports Physio](https://backinactionphysiotherapy.com/team/cameron-gant)
- [Nicole Klopfer, Physiotherapist, B Physiotherapy (Hons) (UMelb), M Physiotherapy (Manips) (UWA), PGrad Cert Cont & PF Rehab (UMelb), GunnIMS](https://backinactionphysiotherapy.com/team/nicole-klopfer)
- [Michael Pearce, Physiotherapist, BSc PT](https://backinactionphysiotherapy.com/team/michael-pearce)
- [Kelsey Rey, Physiotherapist, MPT, BHK](https://backinactionphysiotherapy.com/team/kelsey-rey)
- [Keeley Wentzel, Physiotherapist, BSc Physiotherapy (Hons)](https://backinactionphysiotherapy.com/team/keeley-wentzel)

## Services

- [Physiotherapy](https://backinactionphysiotherapy.com/services/physiotherapy)
- [Manual Therapy](https://backinactionphysiotherapy.com/services/manual-therapy)
- [IMS and Dry Needling](https://backinactionphysiotherapy.com/services/dry-needling)
- [Registered Massage Therapy (RMT)](https://backinactionphysiotherapy.com/services/massage-therapy)

## Programs

- [Back Fundamentals](https://backinactionphysiotherapy.com/resources/rad-exercise-programs/back-fundamentals)

## Frequently asked questions

### 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.

## Massage for recovery

Massage therapists do not diagnose, so start with a physiotherapist. Once you have a diagnosis and a plan, our registered massage therapists can help with the recovery. [About massage therapy](https://backinactionphysiotherapy.com/services/massage-therapy)

*This page is general information, not a diagnosis or a substitute for an assessment. If you are unsure, see a health professional.*