Back Pain - Assessment, Diagnosis &Treatment
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Lower Back Pain - Assessment, Diagnosis & Treatment


Back Pain particularly lower back pain is a common condition and in the UK, it is one of the largest cause of work-related absence. Lower Back pain is also one off the main reasons of pain presented to our clinics in Manchester and Bolton for Osteopathy, Physiotherapy, Deep Tissue Massage and Rehabilitation, it can be very uncomfortable and painful , Most back pain is not usually serious and is

managable with changes in activities and exercise.

What is Lower Back Pain

How Common is Lower Back Pain

What causes Lower Back Pain

The Need for Lower Back Pain Assessment

Methods for Lower Back Pain Assessment

What is Lower Back Pain


Back pain  is any ache experienced within the back, it can involve various structures of the the back (see Back Anatomy) and usually defined as non  specific lower back pain.

Lower back pain can come on suddenly or gradually, and may from direct trauma or a conitinual repetitive action. The complex structure of your Lower back means that even small injuries to the spine can cause a lot of pain and discomfort.

Generally pain in your lower back is usually a symptom of stress or damage to your ligaments, muscles, tendons or discs. In most cases of back pain your back will heal itself, and staying active and continuing with your usual activities will normally promote healing. Back pain will usually last from a few days to a few weeks. Persistent pain however, in severe and persistent cases of back pain, it is important to seek advice so that a correct diagnosis can be reached and appropriate treatment given. Treatment for back pain can vary and  will depend on the underlying cause of the condition.

How Common is Lower Back Pain

Back Pain is common, very common, it’s the number one reason for days of work and second only to the common cold for presentation to the doctors.

Back pain can affect anyone, regardless of age, but it is more common in people who are between 35 and 55 years of age.

Lower back pain is often known as lumbago, affects seven out of 10 people at some time in their lives.

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What Causes Lower Back Pain

Most cases of lower back pain known as 'non-specific'  are not caused by serious damage or disease, but by sprains, muscle strains, minor injuries or a pinched or irritated nerve.

Back pain can also be triggered by everyday activities at home or work, and by poor posture. For example, back pain may be triggered by:

bending awkwardly, lifting, carrying, pushing or pulling incorrectly,

slouching in chairs, standing or bending down for long periods,

muscle tension, over-stretching,

driving in hunched positions, or driving for long periods without taking a break.

Sometimes, you may wake up with back pain and have no idea what has caused it, this is because it can be so multifactorial, with any activity affecting your strength, flexibility, mobility and posture, even your diet, nutrition and fluid can have an influence on your back.

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Some common causes of back pain include:

pregnancy, gynaecological problems in women, such as pelvic inflammatory disease (PID),

different types of arthritis, such as osteoarthritis,

stress-related tension,

viral infections,

bone disorders,

bladder and kidney infections,

osteoporosis (weak and brittle bones),

a trip or fall,

a trauma or injury, such as a fracture,

lack of exercise,


 this is what you osteopath, physiotherapist will discuss to help you manage and where possible improve you back function, the better you back will be.

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The Need for Lower Back Pain Assessment

Lower back pain is often categorised as:

Acute - where your back pain occurs suddenly and lasts for less than three months, and

Chronic - where your back pain develops gradually, over time, lasts for more than 12 weeks, and causes long-term problems.

Most back pain is not serious and can ease with a simple changes in activities however, occasionally back pain can be serious, such as the bulging or rupture of one or more of the intervertebral discs,  this can cause serious back pain. This results in the inner jelly-like material (nucleus pulposus) pressing on the spinal cord or nerve roots, which run next to the disc. This is commonly known as a 'slipped disc', but is more accurately described as a 'prolapsed' (bulging) or 'herniated' (ruptured) disc.

Intervertebral discs tend to dry out and weaken with age, or following an injury. This results in the discs becoming less flexible, which means they do not cushion the vertebrae as well as they did before. This is a common cause of stiffness and pain, particularly in the elderly. It also tends to be worse early in the morning.

Persistent lower back pain can also be caused by a number of rare conditions, such as:

congenital (inherited) spinal defects, bone diseases, shingles (an infection that affects the nerves), fibromyalgia, or cancer that has spread to the spine.


However, most people with lower back pain experience mild pain and have occasional bouts of pain that are more severe. This can make it difficult to determine whether their back pain is acute or chronic.

When you have a chronic condition of back pain or have a cycle which may follow a pattern such as;

You experience a gradual increase in back pain and general aches which can be sharp on activity, you reduce your activity, maybe time off work which allows the sypmtoms to ease, you then go back to work and resume activities, shortly after a period of time your symtoms return only this time they linger for longer with stronger sensations, initially it may be once a year then it maybecome 2 – 3 times a year.

This is all too common and the reason a full physical assessment is required to understand the underlying conditions or make the decision for additonal investigations.


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Methods for Lower Back Pain Assessment an treatment

There are various methods for assessing muscular skeletal conditions particular lower back pain, our clinics offer:





Deep Tissue Massage


These therapists have a long history of treating the public, athletes and also providing advice and assistance to industry.



Both clinics provide osteopathic treatment with all our osteopaths registered with the General Osteopathic. Back pain and its treatment is something osteopaths have built a strong reputation in treating and work with various health professional for its management.



Physiotherapy is availalble at both clinics with each physiotherapist (physio’s) registered with the Health Professional Council and the Chartered Society of Physiotherapists.  All our physiotherapists are experienced practitioners



One of the main important issues with lower back pain is the management and recovery, this is one of the strenghts of a rehabilitation therapist who can put in place a excellent programme working along physiotherapists and osteopaths for optimum response to treatment.

Deep Tissue Massage

This is an excellent way to help maintain health and complements treatment, improving function and recovery by relaxing muscles taking the pressure of the joints allowing rehabilitation , massage is recommended by most health professional to assist treatment.

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