Types of back pain we treat

Back pain is not one thing. It presents differently depending on the structure involved, how it developed and how long it has been there. Understanding which type you have is the starting point for treating it effectively.

Lower back pain

The most common presentation we see. Whether it came on suddenly from a lift or a movement, or has been building gradually over months of desk work and poor sleep posture, lower back pain affects your capacity to work, exercise and rest. Acute episodes tend to resolve well with the right treatment. Chronic lower back pain requires a more thorough approach that addresses both the pain and the contributing factors.

Mid-back pain

Typically linked to posture, prolonged sitting, driving or repetitive movements. The persistent ache between the shoulder blades that loosens temporarily with movement but keeps returning is a pattern we see regularly in office workers and people who spend significant time behind a wheel.

Sciatica and nerve pain

Sciatica is not a diagnosis in itself. It is a symptom, specifically pain, pins and needles, numbness or weakness that travels down the leg along the path of the sciatic nerve. Common causes include disc herniation pressing on a nerve root, piriformis syndrome where the buttock muscle compresses the nerve, spinal stenosis and spondylolisthesis. The presentation varies considerably between patients and treatment depends heavily on identifying the underlying cause accurately.

Disc-related pain

Bulging or herniated discs can produce both localised lower back pain and referred pain down into the legs. Disc presentations respond well to specific manual therapy and a carefully progressed rehabilitation program. Most resolve without surgery when managed conservatively and consistently.

Sacroiliac joint dysfunction

Pain localised to one side of the lower back or into the buttock, often aggravated by sustained standing, walking, climbing stairs or rolling over in bed. The SIJ is frequently overlooked as a source of lower back and pelvic pain and responds well to targeted mobilisation and stability work.

Postural back pain

The accumulated load of hours spent at a poorly set up workstation, sustained driving, or repetitive movements that were never varied or recovered from adequately. This is one of the most preventable presentations we see, and one of the most responsive to treatment when the contributing habits are addressed alongside the pain.

Arthritis-related back pain

Stiffness and aching from age-related spinal changes including facet joint osteoarthritis and degenerative disc disease. Conservative management including joint mobilisation, core strengthening and load management produces meaningful improvement in function and pain even when structural changes are well established.

A closer look at sciatica

Sciatica deserves specific attention because it is both extremely common and frequently misunderstood. The sciatic nerve is the largest nerve in the body, originating from multiple nerve roots in the lumbar spine and running through the buttock and down each leg. When any part of that pathway is compressed or irritated, the result is pain, numbness, tingling or weakness along the course of the nerve.

Common symptoms include a burning or electric shock sensation down one leg, pins and needles in the buttock, hamstring, calf or foot, weakness in the affected leg and pain that worsens with sitting, sneezing or prolonged standing.

Most cases of sciatica respond very well to conservative osteopathic care. Accurate diagnosis of where the nerve is being affected and why is what determines whether treatment works. That is why assessment at Nudge spends as much time on the why as on the where.

Our three-phase approach

Phase 1: Assessment

Your first appointment runs 60 minutes. We take a detailed history of your pain, your lifestyle and your goals, observe how you move, perform orthopaedic and neurological testing to identify the source of the problem, and assess the spine, pelvis and surrounding joints. You leave knowing what is causing your pain, whether osteopathy is the right approach, and what your treatment plan looks like. If we think you need imaging, we will tell you and refer you to your GP with specific recommendations.

Phase 2: Treatment

Your treatment plan is built around your specific presentation. Manual therapy includes spinal mobilisation, soft tissue release, muscle energy technique, counterstrain and articulation, selected based on what your assessment revealed and adjusted as you progress. Where appropriate, dry needling addresses deep muscular trigger points around the lower back and hip that are contributing to pain and movement restriction. Exercise rehabilitation addresses the muscular deficits maintaining the problem, including core stabilisation, hip and glute strengthening, targeted stretching and nerve flossing for sciatic presentations. Lifestyle and ergonomic guidance covers workstation setup, sleep posture, lifting technique and activity modification throughout recovery.

Phase 3: Long-term management

Getting out of pain is the first goal. Staying out of it is the more important one. We give you a home exercise program specific to your condition, teach you to recognise your body's early warning signs, and put together a prevention strategy that fits your work and lifestyle. For patients with recurring or chronic presentations, maintenance care prevents minor episodes from becoming significant setbacks.

When to book

Book an appointment if your pain has not improved after a few days of rest, you are taking pain relief regularly, sleep is affected, pain is limiting work or daily activities, or you have had recurrent episodes and want to properly address what keeps bringing it back.

Seek immediate medical attention rather than booking with us if you experience loss of bladder or bowel control, numbness in the saddle area, rapidly worsening leg weakness, or back pain following significant trauma. These are rare but require urgent medical review.