Lower back pain: what actually helps, according to physiotherapy

Almost every adult gets a bout of lower back pain at some point, and almost every one of them gets told something different about what to do about it — rest, don't rest, stretch, don't bend, see a surgeon. Here is what we actually see work, session after session, for the kind of everyday back pain that isn't caused by a serious injury.

First: keep moving

The single biggest mistake people make is going to bed for a week. Prolonged bed rest weakens the muscles that support your spine and tends to make pain last longer, not shorter. Gentle movement — walking, easy stretching, normal daily activity within your pain tolerance — keeps blood flowing to the area and speeds recovery for the vast majority of cases.

What we check for in the first session

• Where exactly it hurts and whether the pain travels down a leg (a sign the sciatic nerve may be involved).
• What movements make it worse or better — sitting, standing, bending forward, arching backward.
• Posture and movement patterns at work and at home that may be loading the spine unevenly.
• Core and hip strength, since a weak core forces the lower back to do work it isn't built for.

Exercises we give most patients in week one

1. Cat-cow stretch — on hands and knees, alternate arching and rounding the back slowly, 10 reps, to restore gentle mobility.
2. Glute bridges — lying on your back, knees bent, lift the hips using the glutes, not the lower back. Builds the support your spine is missing.
3. Bird-dog — on hands and knees, extend opposite arm and leg while keeping the back still. Trains core stability without spinal load.
4. Walking, 15–20 minutes daily, at a pace that doesn't aggravate the pain.

Manual therapy and dry needling

Alongside exercise, hands-on techniques — joint mobilisation, soft-tissue release, and dry needling for tight, overactive muscles — can bring faster relief in the first few visits, making it easier to do the exercises that build lasting strength. We always explain a technique before using it.

The part people skip: the plan after the pain is gone

Pain going away doesn't mean the underlying weakness or movement habit that caused it is fixed. Most of our back-pain patients recover fully in 6 to 10 sessions, but we build in a simple home programme afterward specifically so the same flare-up doesn't come back in three months.