Spinal Pain

What helps?

Spinal pain is one of the most common problems seen by physiotherapists. In most cases, physiotherapy can help, but as in all problems, early assessment and treatment is vital.


The longer you have the problem, the more recurrent it is, the further down your arm or leg the pain travels and the more severe your symptoms, the worse your prognosis. If you have signs of nerve involvement (weakness in the arm/leg, numbness/ pins and needles in your hands or feet) this may indicate a longer recovery or a worse outcome.


In about 80% of spinal pain the exact diagnosis is not apparent. This means that no-one can tell exactly what structure is injured. Physiotherapists usually use a biomechanical diagnosis. This identifies areas of the spine and surrounding structures, that have dysfunctional movement. Treatment is aimed at restoring pain free movement and function in the spine. This helps in the majority of patients.

Is your back out?

A common 'diagnosis' offered to some patients is that their 'back or neck is out'. This is a false and outdated representation of the true nature of one's spinal pain. Acceptance of this diagnosis should be taken very cautiously.


Physiotherapy management in most cases seems to be beneficial in helping overcome spinal pain. Using a biomechanical model, modalities such as joint mobilisation/ manipulation, exercises, soft tissue therapy, traction and patient education can lead to a good outcome. Self treatment strategies are very important.

Medical treatment

Unfortunately, not all patients respond to physical therapy. Though knowledge about back problems is not a core part of medical training, your doctor has access to advanced diagnostic options such as blood tests and advanced radiology (such as CT and MRI scans). If there are no serious underlying medical problems (such as infection or cancer), the basic medical tools would be medication, injection or surgery. There is no guarantee these will work in all cases. A combination of physiotherapy plus medical treatment can be helpful in more difficult cases.