Back Pain: Causes, Treatment and Physiotherapy Exercises
Most back pain is mechanical, meaning it comes from the joints, discs and muscles of the spine rather than a serious disease. Gentle movement, gradual strengthening and a return to normal activity usually help more than rest. If pain lasts longer than two weeks, keeps returning or travels down the leg, a physiotherapy assessment can identify the cause and guide the right exercises.
Back pain is the single most common reason people book a physiotherapy assessment at our Centurion clinic. The good news is that the large majority of episodes settle well when you understand what is driving the pain and load the spine sensibly. This guide explains the usual causes, what physiotherapy treatment involves and which exercises are a reasonable starting point.
What actually causes most back pain
In clinical practice the majority of back pain is described as non specific mechanical back pain. That sounds vague, but it simply means the pain comes from irritated structures in the spine: the small facet joints, the discs, the ligaments or the muscles that control them. Common triggers include a sudden awkward lift, long hours seated with little movement, a rapid increase in gym or running load, and periods of poor sleep or high stress, both of which lower your pain threshold. Less commonly, pain is linked to a disc bulge irritating a nerve root, which usually produces leg symptoms as well.
What physiotherapy treatment involves
A first session starts with a detailed interview, then a physical assessment of your movement, strength and nerve function. From there treatment is typically a combination of hands on techniques to reduce pain and restore movement, education about load and activity, and a graded exercise programme you continue at home. Dry needling, soft tissue work and joint mobilisation may reduce symptoms in the short term, but the lasting change comes from exercise and better daily loading habits.
Why rest is rarely the answer
Extended bed rest tends to make back pain worse. Muscles deconditioned quickly, joints stiffen and confidence in movement drops. Current guidance across most health systems is to stay as active as your symptoms allow, modify rather than stop activity, and return to normal routines progressively. Walking is often the easiest starting point because it loads the spine gently and rhythmically.
Physiotherapy for back pain in Centurion
If you are dealing with persistent back pain in Centurion, an assessment can separate a simple mechanical problem from one that needs imaging or a medical opinion. Our clinic is in Eco Park, Centurion, and we also do home visits across Rooihuiskraal, Irene, Lyttelton, Midstream, Wierdapark, Highveld and surrounding areas when travelling is difficult.
Exercise programme
Work within a comfortable range. Mild discomfort is common, sharp or increasing pain is not.
1. Cat Cow Stretch
BeginnerStarting position: On your hands and knees, hands under shoulders and knees under hips.
- 1Breathe out and gently round your spine towards the ceiling.
- 2Breathe in and slowly let your spine sag towards the floor.
- 3Move slowly and stay inside a comfortable range.
- 4Keep your neck relaxed and in line with your spine.
Suitable for: Most people with stiff, achy backs that ease with movement.
Stop if the movement produces sharp pain or pins and needles into the legs.
2. Glute Bridge
BeginnerStarting position: Lying on your back, knees bent, feet flat and hip width apart.
- 1Breathe out and press through your heels to lift your hips.
- 2Lift only as far as you can without arching your lower back.
- 3Hold briefly at the top and squeeze your glutes.
- 4Lower slowly and reset before the next repetition.
Suitable for: Building hip and trunk strength to support the lower back.
Keep the effort in your buttocks, not your lower back or hamstrings cramping.
3. Dead Bug
IntermediateStarting position: Lying on your back, knees and hips bent to ninety degrees, arms towards the ceiling.
- 1Gently brace your trunk so your lower back stays steady.
- 2Slowly lower one arm overhead and the opposite leg towards the floor.
- 3Only go as far as you can without your back arching away from the floor.
- 4Return to the start and repeat on the other side.
Suitable for: People ready to progress from basic mobility to control work.
Reduce the range if you feel your back lifting or pain increasing.
When to stop and get assessed
- Sharp, sudden or increasing pain during the movement.
- New or worsening pins and needles, numbness or weakness in a leg.
- Pain that stays noticeably worse for more than 24 hours afterwards.
When to see a physiotherapist
Book an assessment if pain lasts more than two weeks, keeps returning, wakes you at night, travels below the knee, or is limiting work, sleep or exercise. Seek urgent medical care for loss of bladder or bowel control, saddle numbness, unexplained weight loss or fever with back pain.
Related physiotherapy services
Frequently asked questions
Can exercise help lower back pain?+
For most mechanical back pain, yes. Graded movement and strengthening may reduce symptoms and lower the chance of recurrence, although the right exercises depend on what is driving your pain.
Should I rest if my back is sore?+
Short term relative rest is fine, but prolonged rest usually delays recovery. Staying gently active within comfort is generally better.
Do I need an X ray or MRI for back pain?+
Usually not. Imaging is reserved for cases with specific warning signs or symptoms that do not respond to treatment, because scan findings often do not match the pain.
How many physiotherapy sessions will I need?+
Many mechanical back pain episodes improve within four to six sessions alongside a home programme, but this varies with how long the problem has been present.
Medical disclaimer: this article is general education and does not replace a personal assessment. If your pain is severe, worsening, or accompanied by numbness, weakness or loss of bladder or bowel control, seek care promptly.
Book with N S Physiotherapy
In clinic in Eco Park, Centurion, or home visits across Centurion and Midrand.
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