Lower Back Pain

Lower back pain is one of the most common reasons people see a physiotherapist, and one of the most misunderstood. Most cases aren’t caused by anything seriously wrong with the spine, they come from muscle imbalance, joint stiffness, and movement patterns that have quietly built up strain over time.

Common causes

• Muscle strain from lifting, twisting, or sudden movement
• Joint stiffness in the lower spine restricting normal movement
• Poor movement patterns, often from prolonged sitting or desk work
• Disc-related issues, including bulging or herniated discs, sometimes with pain radiating into the leg (sciatica)
• Weak core and hip muscles failing to properly support the spine during daily activity

It’s rarely just “wear and tear,” even persistent, longstanding back pain is usually treatable once the actual contributing factors are identified.

Why lower back pain lingers

Pain that flares up, settles, then returns is often a sign that the underlying cause was never fully addressed, only the acute flare-up was calmed down. Rest alone tends to make lower back pain worse over time, since the muscles supporting the spine weaken further, movement and targeted strengthening are what actually resolve it.

What we assess

We look at how your spine and hips move, which muscles are tight and which are weak, and how daily habits (sitting posture, how you lift, how you sleep) may be feeding the problem. This tells us whether the pain is coming from muscle, joint stiffness, disc involvement, or a combination.

Treatment approach

Depending on what’s found, treatment may include manual therapy to ease stiffness and muscle tension, chiropractic adjustment to restore joint movement, spinal decompression for disc-related pain, and a structured core and back strengthening programme, the part that keeps the improvement lasting rather than temporary.

When to get it assessed

• Pain lasting more than two weeks
• Pain radiating into the hip, leg or foot
• Pain that disturbs sleep
• Numbness, tingling, or weakness in the leg
• Pain that’s gradually worsening rather than settling

What you can do in the meantime

Gentle movement is almost always better than strict bed rest, short walks, and changing position regularly rather than sitting or lying still for long stretches, tend to help more than they hurt in the early days. Applying heat can ease muscle-related tension, while ice is often more useful in the first day or two after a sudden strain. Neither replaces a proper assessment if the pain is persisting, but they’re reasonable first steps while you arrange one.

A note on imaging

Many people assume an X-ray or MRI is needed before back pain can be treated. In most cases it isn’t, imaging often shows age-related changes that are present in people with no pain at all, and can be more misleading than helpful without a clinical assessment to interpret it alongside. We’ll tell you plainly if your presentation suggests imaging is genuinely warranted.

Getting started

Lower back pain responds well to the right assessment and a properly built plan, most people see meaningful improvement well before it becomes a long-term problem. Alpha Physiotherapy is on PWD Road, Media Town, Rawalpindi. If your back pain is holding you back from normal activity, book an assessment and we’ll find out what’s actually driving it.