Treating Chronic Lower Back Pain With Physiotherapy

By Lakeview Physio
Neck & Back Pain
February 27, 2017

Back pain is a challenging experience for those living with it. Due to the nature of the symptoms, many Canadians seek relief through a myriad of remedies- physiotherapy being one of them.

In September 1998, a study published by the Department of Physical Medicine and Rehabilitation at the University of Saskatchewan found that approximately 11% of Canadian adults had been significantly impacted by back pain.

There are a lot of factors that influence that statistic, though we need to be clear that the number published by the University of Saskatchewan is not an anomaly- the same study found that 85% of working people can expect to experience some level of back pain in their lifetimes, and other studies (referenced here) reinforce these numbers.

Suffice to say, a lot of Canadians experience lower back pain. This correlates with other studies that show that nearly 20% of Canadians live with some type of chronic pain.

Article Contents

As experienced physiotherapists, we’re here to help. In this article, we’re going to briefly describe the three most common causes of lower back pain and physiotherapy treatments that reduce pain and promote healing.

Common Causes of Lower Back Pain

Back pain can result from any number of different things. Seemingly minor actions can cause serious pain. We get it- and chances are we’ve seen it in our clinic, too!

Common causes of back pain include muscle/ligament strain, disc herniations, and osteoarthritis.

Muscle or Ligament Strain


In younger people the most common injury – by far – is a strain of a muscle or ligament. Strain is usually caused by lifting a heavy object, lifting an object improperly, a sudden twist, or another sudden movement.

These activities can cause the muscle or ligament to develop micro-tears, and these tears can be painful.

These types of injuries are common in sport.

Symptoms of Muscle/Ligament Strain

  • Pain when moving, especially when standing and walking
  • A dull, achy, throbbing sensation in the lower back
  • Soreness when touched or physically manipulated
  • Muscle spasms of varying degrees (can be anywhere from mild to severe)
  • Sharp spike in pain when trying to activate the affected muscle group
  • Stiffness and soreness tends to be worse in the morning and eases somewhat with light movement during the day.

Disc Herniation


Commonly referred to as a “slipped disc”, a spinal disc herniation is a major cause of chronic back pain among Canadians. A disc herniation may seem to happen as a result of a physical event (sporting accident, workplace injury, etc.), a motor vehicle accident, or by bending over to tie your shoes!  In fact, we believe that many factors, including degenerative disc disease, contribute slowly over time until an event or movement takes the vulnerable disc to a point of herniation and subsequent pain.

A herniated disc is often accompanied by inflammation of the affected area and developing arthritis, which can compound the perceived pain from the herniation itself.

See more information on how physiotherapy helps arthritis.

Symptoms of Disc Herniation in the Lower Back

  • A marked increase in pain when bending forwards and sideways, but often bending backwards relieves the pain(in any direction)
  • Chronic, ongoing pain in the lower back which is typically one sided
  • Pain often radiates to the buttock and that radiates down the leg (called sciatica)
  • Pain that is made worse by inactivity, especially sitting, but often relieved by lying down
  • Pain that appears to improve when active, particularly when walking or running
  • Stretching the affected buttock may feel good temporarily, but often leg pain worsens several hours after stretching exercises



Many older Canadians are very familiar with osteoarthritis. One of the most common causes of chronic back pain in middle age and older adults, osteoarthritis is generally a degenerative condition (meaning that it develops slowly over prolonged periods of time).

Osteoarthritis is caused by a gradual breakdown of the articular cartilage – which is the covering over the end of any bone.  In the lower back the facet joints (joints between 2 vertebrae) are weight bearing joints.  They are prone to osteoarthritis and symptoms appear as their articular cartilage breaks down with gradual changes of osteoarthritis.

Symptoms of Spinal Osteoarthritis

  • Tenderness of the area when touched or physically manipulated
  • Chronic pain that is achy, throbbing, often coming and going in waves of different levels of severity
  • Substantial changes in back flexibility.  Bending in any direction can be painful and progressively stiffer as time goes on.
  • Muscle tightness and tenderness on both sides of the lower back
  • Pain that is more significant in the morning and evening, seemingly improving during the day
  • Pain and stiffness noticeable moving from sitting to standing and with sustained standing.
  • Walking tends to feel better, but running often painful.
  • The changes of osteoarthritis can irritate adjacent nerves, resulting in neuropathic pain (nerve pain).  Neuropathic pain can refer into the buttock, leg and foot and can be throbbing, burning, achy and seem to come and go in waves of different levels of severity.

Effective Physiotherapy Treatments for Back Pain

Back pain is a challenging experience for those living with it. Due to the nature of the symptoms, many Canadians seek relief through a myriad of remedies- physiotherapy being one of them.

Physiotherapy for back pain is a varied practice that requires the appropriate training, education, and experience in order to be effective. At Lakeview Physiotherapy & Acupuncture, we take a patient-centric approach and create an individualized treatment program designed to address your specific symptoms.

We Start by Developing a Preliminary Understanding of Your Pain

Our physiotherapists start by conducting a comprehensive assessment of your symptoms. This assessment begins with a conversation, where we learn when your pain began and its cause (if known); we review your medical history, any formalized diagnosis, and any other information you may have to provide a jump-off point.

We also conduct a detailed movement examination of your spine, and of the problem areas in particular. During this exam we also look at other body systems to ensure that they aren’t influencing the pain.

Back pain can be difficult to solve, and results do not always happen overnight. A thorough preliminary assessment of your injury and body is important in ensuring we properly address the problem.

Manual/Manipulative Therapy

If appropriate, manual therapy is used to encourage a stuck or frozen joint to get moving again. This process centres around helping your body move in the ways it was meant to. This process is especially beneficial for improving range of motion.

Acupuncture & Gunn IMS

Using needles to stimulate fibres deep in the low back muscles is a centuries-old practice that helps relieve pain. Intramuscular stimulation (IMS), like acupuncture, promotes blood flow and improved nerve communication in the affected area.

At Lakeview, we leverage both acupuncture and Gunn IMS to help our patients. Learn more about acupuncture and IMS.

Habit Training

In most people, improved posture would help improve pain symptoms. Physiotherapists assist by teaching the correct posture for specific tasks, helping you improve control of your core muscles, while also working to promote healing and relieve pain.

Strength-Building Exercises

Guided by an experienced (and knowledgeable) physiotherapist, specific exercises aimed at improving core strength are proven to help alleviate chronic pain. This process can seem daunting, especially if the catalyst for the pain (injury, accident, etc.) was fairly recent. This is one area where working with a physiotherapist is very beneficial.

Physiotherapists, after assessing your flexibility, range of motion, and causes of symptom flare ups, will create an exercise program designed to strengthen core muscle groups, improve stability, and promote good posture.


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