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Back (& Sciatica)

Back symptoms include different types of pain including sharp, shooting pains, burning, throbbing or stabbing pains and can be constant or intermittent – i.e. come and go. You may also be getting pins and needles, tingling, weakness, numbness, other strange sensations or pain in one or both of your legs and feet. Pain along the pathway of the sciatic nerve which runs down the back of your leg is called ‘sciatica’ and has a number of causes.

Pain cause by issues in the lower back can move around which is confusing for the person experiencing it, but very common.

The cause of your back symptoms will range from a muscle strain to a facet joint, or disc injury like a disc prolapse or disc bulge, or problems with the joint between the pelvis and the spine called the sacroiliac joint or SIJ. The causes of sciatic pain or sciatica is explained in this article written by one of our specialist Physiotherapists. 

We will assess your back and advise you on which structures are causing your pain, as well as how to treat the cause of the problem, like training your deep stability muscles or mobilising your stiff thoracic spine.

Please scroll down to learn more about certain types of back pain and injury and what treatment will involve. If you have had surgery you can find out more here about your post-operative back.

If you fell, had an accident or the pain came on suddenly then you may have torn a ligament, cartilage, disc or even suffered a fracture, so you need to get assessed by a Physiotherapist or Osteopath immediately.

Even if you have not had a traumatic injury, it is essential that you get pain and other symptoms assessed by a Physiotherapist or Osteopath so that you do not do further damage, and can find the quickest way to recover. 

Please scroll down for further advice on back pain and injury including discs, facet joints, core stability and thoracic mobility.

How the Back (& Sciatica) Works

The back is the foundation from which all movements of the body occur.

 

It is made up of vertebral bones stacked on top of each other like building blocks with discs in between each of them. In children these are gel-like but as the years go by they lose water and become more solid, which can contribute to stiffening of the spine with age.

 

The vertebral bones have little prominences that stick out either side that form joints called “facets”. Vertebral shape varies along the spine which means different movements are favoured in different regions between your pelvis and your neck. The spinal cord runs from the head down, through the middle of the vertebrae, to the base of the spine with nerves exiting through small holes between the vertebrae. From here, the nerves carry sensory and motor information to the fingertips and toes. Alongside this there is a network of blood vessels, a complex system of soft tissues, fascia (the body’s inside skin), cartilage and ligaments along with layers of muscles of different shapes and sizes. These muscles can be divided broadly into the deep stability muscles like transversus abdominus and multifidus, and the big movement muscles like rectus abdominus and quadratus lumborum. The nerves that come out of the spine provide the arms and legs with the ability to feel and move.

 

Certain back conditions can damage these structures if left untreated, so if you have back pain you MUST see a Physiotherapist or Doctor to ensure that you do not do anything to aggravate your condition before following any of the advice or exercises on this website. The complexity of the spine, the amount we use it for day to day activities like lifting, the degree of strain we put through it during training and sports and the fact that we often use it inefficiently through poor posture and insufficiently strong deep stability muscles means that almost all of us will have back pain at some point in our lives.

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    Common Injuries

  • Post-Operative Back

    The unfortunate, but sometimes necessary stage for certain back conditions is surgery. We work with the top spine surgeons, so we know exactly who to guide you to, so be reassured that you will be in good hands. We will work closely with your Orthopaedic Consultant to ensure that you...

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  • Facet Joint Problems

    Facet joint pain is normally localized: centrally over your spine or to one side. It may feel like a "catching pain" during certain movements like bending backwards, or turning. It is associated with poor posture, repetitive strain (e.g. horse riding) or injury (e.g. snowboarding falls)The common factors that contribute to...

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  • Stiff Thoracic Spine

    The thoracic spine – middle and upper part of the back - is the stiffest part of the spine due to the ribs attaching here, but it commonly becomes too stiff as a result of poor postures. Please click here to learn correct sitting posture. Thoracic spine stiffness puts more...

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  • Sacroiliac Joint ‘SIJ’

    Problems in the joint that joins your spine to your pelvis are still hotly debated in the physio, osteo and medical worlds. Strains can occur when the ligaments supporting the joint are loose (e.g. during pregnancy or with hypermobility) and we have seen many patients with SIJ pain following a...

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  • Disc Problems

    Disc injuries cover a whole spectrum of problems including disc degeneration, disc prolapse and a disc bulge, all in varying levels of severity. Minor injuries will feel like a localized ache over the spine; more severe injuries cause intense pain and immobility, with pain, pins and needles, numbness and/or weakness...

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  • Stretching

      A note on static stretching v dynamic stretching I bet you can't remember the last time you saw elite athletes doing a static stretches pitch-, track- or court side pre-performance. That is because research now shows that static stretching is not advisable before exercise. This is because it slows...

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  • Breathing and relaxation training

    Many spinal, hip and shoulder problems can be helped by retraining breathing habits and releasing the structures involved in breathing, such as the diaphragm and thoracic spine.

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  • Deep back stability muscles

    Please read how the back works before reading the following. These are the muscles that are supposed to be worked in Pilates; however we have seen plenty of people who have been to lots of Pilates classes and have not been using these muscles at all! You really need an...

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  • Release the thoracic spine

  • Glut/ VMO/ leg alignment exercise

    Please click here to read 'how the knee works' before reading the following. This exercise trains the lateral glute muscle fibres, lower limb alignment, VMO (the inside part of the quads muscle) and stretches the calf so is a big hitter – if you can get it right! You will...

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  • How to find pelvic neutral

    Please click here to learn how the back works before reading the following. Do not do the following if you have any back pain- you must see a Physiotherapist or Osteopath for a full assessment, diagnosis and guidance through the exercise. Please click on the link to learn how to...

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About Your Injury

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