Back Pain can range from muscular stiffness, bony/mechanical spine pain, deep muscle spasm where any laughing or coughing is very painful or intolerable.

Some times on waking up, the back is incredibly stiff, conversely it may feel rested and pain-free. Back Pain can ease or worsen throughout the day. It may be better or worse for activity. Your back may only hurt when standing or it may be pain-free when standing.

There are different causes and different treatments for a Sore Back.

Different back tissues will be affected in each individual case. It is important to identify the affected tissues, so the correct treatment can be given.

The idea that Spinal Manipulation is a “Cure All” for back pain is incorrect, and on some occasions it can actually make the pain or condition worse.  

The area that the back pain is experienced is not always where the problem lies. For example, low back pain may have its source in the thoracic area.

It is vital that all areas are examined when you have a sore back, and the affected and related back tissues identified, and correctly treated.

Once the likely factors behind the back pain are found, Osteopathic treatment may help ease the pain, then good advice on exercise, diet, seating, posture, beds and lifting can go a long way in helping prevent its recurrence.

Sciatica refers to pain affecting the lower back and legs, often caused by pressure on the sciatic nerve. In genuine sciatica, a prolapsed disc in the lower back presses on the nerve, causing severe pain, leg pain, numbness, and weakness, sometimes leading to foot drop when walking. This condition requires medical attention, accurate diagnosis, and prescribed medication for pain relief.

However, most cases of "sciatica" are less severe, originating from the lower back or buttock. Often, people injure their back by moving improperly, such as during bending or lifting, leading them to mistakenly think they've "slipped a disc." In reality, the issue may involve minor displacement of a vertebra or overstretched ligaments, which trigger protective muscle spasms in the low back and legs, causing pain.

Additionally, the piriformis muscle, located in the buttock, can spasm and compress the sciatic nerve, resulting in "Piriformis Syndrome," which mimics sciatica symptoms. Fortunately, conditions causing sciatica-like pain are typically less severe and can be treated effectively with therapies such as osteopathy and acupuncture.

This condition normally responds very well to Osteopathic Treatment.

Read more about Sciatica

The majority of lower back pain is of mechanical origin, caused by overloaded vertebral joints, ligaments, and muscles that fail to function properly. Around 60% of people will experience back pain at some point in their lives, leading to 350 million lost working days annually in the UK. The cause of lower back pain can vary, often stemming from injury, poor posture, or inadequate workstation setups. In 75% of cases, no clear underlying medical cause is identified.


Osteopaths typically find painful muscles and stiff joints, which can improve with osteopathic treatment. Osteopaths not only provide immediate relief but also offer advice on exercise, posture, and ergonomics to prevent future issues. Long-term management focuses on understanding personal triggers for back pain, such as specific chairs, activities, or habits.

Exercises that involve movement, strengthening, and stretching—like weight training, Pilates, Tai Chi, and yoga—are especially beneficial for managing back pain. Additionally, stress can contribute to back pain, so learning relaxation techniques can significantly reduce symptoms and improve overall health.

Mindfulness and Trauma Release Exercises are great tools that have been proven to work for relaxation.

Read More about Low Back Pain

Facet joints, located between the vertebrae, can cause back pain when they become misaligned or move incorrectly. One common cause of facet joint pain occurs when bending forward and twisting, such as when lifting something from the floor. This movement can force the facet joints to move beyond their normal range, overstretching the joint capsule and resulting in sudden back pain, muscle spasms, and limited mobility. Although the exact mechanics of facet joint dysfunction are still debated, the condition typically responds well to spinal manipulation.

As we age, the intervertebral discs, which act as shock absorbers between the vertebrae, begin to narrow. This increases the load on the facet joints, leading to wear and tear of the cartilage covering them, often associated with degenerative disc disease. While this condition is usually painless, it can flare up when the facet joints are exposed to excessive stress, such as lifting heavy objects or performing unfamiliar activities. These flare-ups can cause significant discomfort but can often be managed with appropriate treatment.

This condition normally responds very well to Osteopathic Treatment.


Read more about Facet Joint Syndrome

A herniated or prolapsed disc can cause severe back pain and sciatica.

The intervertebral discs between the vertebrae are essential for spinal movement, consisting of an outer elastic fibrocartilage and an inner deformable nucleus. When a disc bulges or prolapses, it may press on nerves, leading to pain and potential disability. A prolapsed disc, especially in the lower back, may require surgery in severe cases. However, back extension exercises can often help by creating space for the bulge to reabsorb, though they may initially worsen back pain. Pain radiating to the legs should subside as pressure on the nerve is reduced.

In cases of neck prolapses, similar exercises should be performed. Spinal manipulation is not recommended during the acute stage but may be used once inflammation has subsided. Serious cases, such as Cauda Equina Syndrome (loss of sensation and possible loss of bladder control), require immediate medical attention.

Most disc prolapses heal within three months, as discs have no blood supply and rely on fluid absorption for healing. The process is slower due to the lack of circulation. Disc bulges are most common in individuals aged 30 to 50. Smoking can worsen disc conditions, as it decreases the metabolism within the disc by 50%.

When the Disc Prolapse is in the Neck - the Cervical Spine - there are similar exercises that should also be followed.

Read more about Herniated Discs