Is my knee going to get worse if I exercise on it?

No, appropriate exercise does not wear the joint out. In fact, the opposite is true: controlled, progressive loading strengthens the muscles that support the knee, improves joint nutrition, and reduces pain. A lot of knee pain, especially the overuse kind, is a loading problem rather than a structur

Is there any point trying physiotherapy if I have "bone on bone" arthritis?

Yes, absolutely. Even when X-rays show significant cartilage loss, exercise and physiotherapy can reduce pain, improve function and help you stay active. Scans often show things like mild wear or changes that are completely normal for someone's age and activity level, and not actually the cause of t

Can a physiotherapist actually help with jaw problems or is it only a dentist's job?

Physiotherapists can absolutely help with jaw problems, and research shows that manual therapy, exercise and education are effective first-line treatments. Dentists often fit splints to protect the teeth, which is useful, but splints don't stop clenching or address the underlying muscle and joint me

Why does my jaw click and is it going to get worse?

Clicking usually means the disc inside your jaw joint is moving slightly out of position as you open and close your mouth. It's very common and doesn't always mean serious damage. Many people have clicking without pain, and it often stays stable or improves with treatment. Pain, locking or a sudden

How long will this take to settle?

Most people with jaw dysfunction see meaningful improvement within a few weeks to three months with physiotherapy, particularly when they address the underlying causes such as clenching, stress and posture. Some cases settle faster, others take longer, especially if symptoms have been present for a

Is this damage to my jaw joint or just the muscles?

It can be either, or both. Some people have joint problems such as disc displacement or wear and tear, while others have primarily muscle pain from overload, clenching or stress. Often it's a mix. We assess the joint and the muscles separately to work out what's contributing most, and that guides th

What is causing this pain in my shoulder?

Shoulder pain is usually caused by overload or irritation of the rotator cuff tendons, subacromial bursa, or joint capsule, often driven by repetitive overhead movement, poor scapular control, or reduced mid back mobility. At Physio K, we assess not just the painful area but the whole shoulder compl

Do I need a scan to find out what is wrong?

Most of the time, no. A thorough clinical assessment, including your history, how the pain behaves, and how you move, gives us the information we need to diagnose the problem and start treatment. Scans such as MRI can be helpful when we suspect a full thickness rotator cuff tear, significant structu

Will I need surgery, or can physiotherapy fix this?

The majority of shoulder problems respond well to structured physiotherapy and exercise-based rehabilitation, and surgery is rarely the first option. Research shows that outcomes after surgical intervention and conservative management are often very similar, sometimes better in the strength rehabili

Should I just rest until the pain goes away?

Rest, most of the time in recovery, is never the answer. Sometimes we do need periods of relative rest, for example post-operatively, but even here this does not last too long. The longer that we rest for with back pain, the longer the pain will tend to stick around. We need to move the body, someti

Is my back damaged, and will it get worse if I stay active?

This is one of the most common worries I hear. Behind these questions is usually a lot of anxiety because patients are led to believe that their back pain is lifelong and that certain movement patterns will increase levels of damage. The majority of the time, this is not the case. Your back is stron

Do I need a scan to find out what is wrong?

Most people with low back pain do not need a scan. Imaging often shows age-related changes that are normal and not the cause of your pain. The Australian Low Back Pain Clinical Care Standard (2022) recommends avoiding routine imaging unless red flags are present. Your physiotherapist will assess you

What if this is something serious and I need a scan, not physio?

Your clinician will screen for red-flag signs that suggest a more serious problem at your first appointment, and if anything does not fit a benign pattern, you will be referred to your GP or an emergency department urgently. Most headaches are not due to serious disease, but we never ignore worrying

Is the treatment going to make my headaches worse?

It is common to feel a little sore or worked-on for a day or two after hands-on treatment or new exercises, but this usually settles quickly. Your programme is tailored to start at a level your body can tolerate and can be adjusted if symptoms flare. I show patients how to recognise normal post-trea

I've tried so many things already, how is this any different?

This approach does not just chase pain, it looks carefully at the mechanical and lifestyle drivers of your headaches: neck stiffness, posture, jaw tension, sleep position, stress patterns and known triggers. The plan is personalised, progress is monitored, and you are given clear tools to use at hom

How long does vestibular rehabilitation take to work?

BPPV often improves within one to three sessions, with many people feeling significantly better immediately after the repositioning manoeuvre. Other vestibular conditions typically improve over 4 to 12 weeks with daily home exercises and regular clinic reviews. Some residual symptoms may take longer

Will the exercises make me feel worse?

Yes, temporarily. Vestibular exercises are designed to provoke mild to moderate symptoms so your brain can adapt and recalibrate. This is normal, necessary and not harmful. The key is finding the right level of challenge, enough to stimulate adaptation without overwhelming you. Your physiotherapist

Can dizziness come back after treatment?

BPPV can recur, with around 15 to 30% of people experiencing another episode within a year, though it usually responds well to repeat treatment. Other vestibular conditions are less likely to recur if you complete the full rehabilitation programme and address contributing factors such as neck stiffn

Is my neck pain something serious, like a stroke or spinal damage?

Most neck pain is not serious and does not indicate stroke or major structural damage. Red flag symptoms such as sudden severe headache, neurological deficits, gait disturbance or systemic illness are rare but warrant urgent medical assessment. Your physiotherapist or GP will screen for these during

Why does it hurt so much if my scan only shows wear and tear?

Pain intensity does not always match imaging findings. Many people with significant degenerative changes on scans have no pain, and many with severe pain have minimal imaging findings. Pain is influenced by inflammation, muscle tension, movement patterns, stress, sleep and nervous system sensitivity

Should I rest completely or keep moving?

Keep moving. Prolonged rest usually worsens stiffness and delays recovery. Gentle, gradual movement within tolerable limits is encouraged from the start, even in acute pain. Avoid activities that significantly worsen your pain, but stay as active as possible. Your physiotherapist will guide you on a

INJURIES AND CONDITIONS WE CAN TREAT

At Physio K, we treat a wide range of conditions affecting the movement system.

Here are some of the most common injuries or conditions we are qualified to treat:

Back Pain

Creator: Maria Josefina Canepa Bustos
Published: 2026-10-04

Physiotherapist in Sydney with over 6 years of experience

By Maria Josefina Canepa Bustos

Senior Musculoskeletal Physiotherapist · Registered with the AHPRA (PHY0002918524)

Maria Josefina Canepa Bustos is a Senior Musculoskeletal Physiotherapist with eight years of clinical experience spanning private practice, high-performance sport, and academia

What Is Back Pain? Symptoms, Causes and Treatment

Back pain is discomfort or pain felt anywhere along the spine, from the neck down to the lower back and pelvis. It can range from a dull ache to a sharp, stabbing sensation, and may come on suddenly or build gradually over weeks. Most back pain is what clinicians call non-specific, meaning no single structure can be reliably identified as the sole cause. Instead, it usually involves a combination of factors: how you move, how much you sit or stand, your fitness and strength, sleep quality, stress levels, and sometimes your beliefs about what the pain means. The good news is that most episodes of back pain improve within several weeks, and physiotherapy combining education, exercise and hands-on treatment helps people recover, return to what they enjoy, and reduce the chance of it coming back.

What Is Back Pain? Symptoms, Causes and Treatment

What it is: Pain or discomfort anywhere along the spine, most commonly in the lower back, usually involving joints, muscles, discs, ligaments and the nervous system rather than one single structure

Common symptoms: Ache, stiffness, sharp pain with movement, difficulty bending or standing straight, sometimes pain into the buttock or leg, disturbed sleep, reduced confidence in your back

Who it affects: Anyone, at any age, particularly common in working adults, those in physically demanding jobs, people who sit for long periods, and those returning to activity after time off

Typical recovery: Many acute episodes improve substantially within 4 to 6 weeks, persistent pain may take several weeks to months of progressive rehabilitation, with realistic goals focused on function and confidence rather than complete pain elimination

Outlook: Generally favourable, most people return to normal activity, work and sport, recurrence is common but does not mean the back is deteriorating, and understanding your back well reduces flare-up risk

What is back pain?

Back pain describes any pain felt along the spine, from the base of the skull to the tailbone. The spine is divided into three main sections: the neck, the mid or upper back, and the lower back. Each section is made up of bones, joints, discs that sit between the bones, ligaments that hold it all together, muscles that move and support it, and nerves that run through and around it. Any of these structures can become sensitive and contribute to pain.

In most cases, no scan or test can point to one single damaged part. This is why the term non-specific low back pain is used so often: it simply means the pain is real and limiting, but it does not come from one identifiable injury that needs fixing. Instead, it is usually a combination of things. Your back may have been asked to do more than it was ready for, or it may have been held in one position for too long, or small repetitive tasks may have built up over time. Sleep, stress, work demands, previous episodes and how you feel about the pain all play a role.

Pain does not always mean damage. Your nervous system can become more sensitive after an injury or during a stressful period, so movements that used to feel fine may now hurt, even though the tissues themselves are healing or have healed. Understanding this is one of the most important steps in recovery, because it helps reduce fear and allows you to start moving again in a way that rebuilds confidence and strength.

What it feels like: symptoms

Dull, constant ache in the lower back, mid back or across the shoulders
Sharp, stabbing pain when bending, lifting, twisting or standing up from sitting
Stiffness, especially first thing in the morning or after sitting for a long time
Feeling like your back has "locked" or "gone out"
Pain that spreads into your buttock, hip or down your leg
Pins and needles, numbness or weakness in your leg or foot (this needs assessment)
Difficulty standing up straight, walking comfortably or finding a pain-free position in bed
Reduced confidence in your back, worry about making it worse, or avoiding activities you used to do

What causes back pain and who is at risk

Most back pain does not have one clear cause. It builds up over time from a combination of factors, and the movement or moment that finally triggers the pain is rarely the whole story. Your back may have been coping quietly with long hours of sitting, a posture that has drifted, broken sleep, a busy period at work, or repetitive tasks, and then one ordinary movement, a sneeze, picking up something light, or getting out of the car, tips it over the edge.

Think of it like a bucket slowly filling with water. Each small demand adds a little: sitting hunched over a laptop, lifting a toddler, carrying shopping, a few nights of poor sleep, stress at work, or a sudden increase in training. Your back handles it without complaint, so you feel nothing. Then one unremarkable movement adds the last few drops and the bucket overflows. That final movement gets the blame, but it was simply the point where your body ran out of room. This matters because if you only focus on the thing that triggered the pain, the underlying load is still there and the problem tends to return.

Common contributing factors include low physical activity, poor sleep, high stress, smoking, work that involves heavy lifting or awkward postures, long periods of sitting or standing without breaks, returning to sport or the gym too quickly after time off, and previous episodes of back pain. Jobs in healthcare, construction, transport, warehousing and manual handling carry higher risk. Sporting activities that involve repeated bending, lifting, twisting or impact can aggravate symptoms, but sport itself is not harmful and staying active is one of the best things you can do.

Some factors you cannot change, such as age, previous injury, or a family history of back pain, but many of the factors that matter most are within your control. Body weight may be associated with back pain, but it is not a simple cause-and-effect relationship and focusing only on weight misses the bigger picture. What usually helps more is improving strength, movement quality, sleep, and how you manage the demands on your back day to day.

Lower back pain is the most common thing we see at Physio K. Most of our patients with back pain are working professionals who spend long hours sitting, often at a desk, in meetings or in the car. Back pain rarely has one single cause. Injuries tend to come from moving too much, moving too little, or moving in positions your back does not tolerate well. More often, it is a combination. You might sit most of the day with a posture that has slowly drifted, then lift a toddler, carry the groceries or repeat the same task a few times too many, and your back finally lets you know about it.

Some people arrive after a sudden episode, like a sharp twinge when bending to pick something up. Others come in because a dull ache has been building for weeks or months and is starting to affect their sleep, work or training. Either way, the question that usually brings people through the door is the same: "Why is this happening, and how do I stop it coming back?"

How back pain is assessed and treated

Assessment begins with understanding your story: what happened, how the pain behaves, what makes it better or worse, and how it is affecting your day. Before your first session, we send you a short questionnaire so we have a head start. Your first session begins with a conversation. We go over what we already know, fill in the gaps and make sure we understand how your back has been affecting your day.

From there, we assess you in two parts. First, we look at how you stand and hold yourself. Then we look at how you actually move. What your body is capable of and how you choose to move can be very different things, and that gap often tells us a lot. We also look at your whole body, not just the sore spot. A problem in your upper back can be driven by what is happening in your lower back, and the other way around, so we check the full picture.

We also check for red flags, which are signs that the pain might be coming from something more serious, such as a fracture, infection, or nerve damage that needs urgent medical attention. These are rare, but they include new problems with your bladder or bowel, numbness around your groin or backside, progressive weakness in your legs, severe pain that does not ease at all, unexplained weight loss, a history of cancer, fever, or pain that started after a significant fall or accident. If any of these apply, we refer you on immediately.

For most people, the assessment shows that the back is sensitive and stiff, but structurally sound, and treatment can begin straight away. Treatment combines hands-on manual therapy with education, posture correction and a targeted exercise programme. Where it suits you, we may also use dry needling. Throughout, we ask about your goals, whether that is sitting through a work day comfortably, lifting your toddler, getting back to training or simply sleeping better.

Manual therapy may include gentle mobilisation of stiff joints, soft tissue release to ease tight muscles, or manipulation where appropriate. These techniques help reduce pain and stiffness in the short term, but they work best when combined with exercise and movement retraining. Exercise is the foundation of recovery. We start with movements and loads you can tolerate, then gradually build strength, control and confidence. The exercises are specific to you: what your back needs, what your day demands, and what you want to get back to doing.

Education is just as important as the hands-on work. We explain what is happening in your back, why it hurts, what you can safely do, and how to manage flare-ups if they happen. Understanding your pain reduces fear, and reducing fear helps you move better and recover faster. We also look at the things that may have contributed in the first place: your work setup, your training load, your sleep, and the small habits that add up over time.

Getting better usually looks like moving with more ease, doing more of what you enjoy and understanding your back well enough to look after it yourself. We aim to give you the tips and knowledge to help prevent it from flaring up again, so you leave with more than just short-term relief.

Different approaches at Physio K

Physiotherapy and massage therapy both help people with back pain, but they approach the problem in different ways and work well together.

Physiotherapy focuses on understanding why the pain started, how your body moves, and what needs to change so the problem does not keep coming back. Your physiotherapist assesses your movement, strength and posture, checks for any signs that need medical attention, and builds a treatment plan around exercise, hands-on therapy and education. The goal is to help you move better, get stronger, and understand your back well enough to manage it yourself. Treatment may include joint mobilisation, dry needling, soft tissue work, and a progressive exercise programme tailored to your work, sport or daily demands.

Massage therapy focuses on releasing tension in the muscles and tissues around your spine, improving blood flow, and helping your nervous system settle. For people with chronic back pain, this can be particularly helpful because long-standing pain often leaves the muscles tight and the nervous system on high alert. Your massage therapist works closely with your physiotherapist, so the hands-on release from massage complements the strengthening and movement work you are doing in physio. Many people find that massage helps them move more freely in their physio sessions and sleep better between appointments.

The two approaches are not competing, they are working toward the same goal from different angles. Physiotherapy gives you the tools to manage your back long term, while massage therapy helps your body settle and respond better to the rehab work. Together, they give you the best chance of a full recovery and the confidence to stay active without fear of the pain returning.

What the research shows

High-quality clinical guidelines consistently recommend education, staying active, exercise and manual therapy for back pain. A 2023 systematic review in Archives of Physical Medicine and Rehabilitation found that the best evidence supports self-management, maintaining usual activity, exercise, and selected spinal manipulation within multimodal care, with interdisciplinary rehabilitation recommended for persistent pain. The American College of Physicians guideline published in Annals of Internal Medicine in 2017 supports non-drug treatments such as exercise, multidisciplinary rehabilitation, acupuncture and spinal manipulation, selected according to symptom duration and patient preferences.

Guidelines also emphasise what not to do. Routine imaging, such as X-rays or MRI scans, is generally discouraged when serious pathology is not suspected, because common age-related findings such as disc degeneration or small bulges are seen in many people without pain and can increase fear without changing treatment. A 2018 overview in the European Spine Journal found that guidelines recommend history and examination for red flags and neurological findings, discourage routine imaging, and support assessment of psychosocial factors such as sleep, stress, work satisfaction and fear of movement.

More recent guidance continues in the same direction. A 2024 review in BMC Musculoskeletal Disorders found that contemporary guidelines commonly recommend education, exercise and activity-based care, while recommendations for passive modalities and medicines vary in certainty. The North American Spine Society guideline published in 2020 states that diagnosis and management should be guided by clinical assessment, with imaging and invasive treatment reserved for appropriately selected patients.

The message across all of this research is clear: back pain is common, usually improves with time and appropriate care, and the best treatment is a combination of education, staying active, and progressive exercise, with hands-on therapy used to support that process rather than replace it.

When to seek urgent help

Most back pain does not require urgent medical attention, but some symptoms do. Seek help immediately if you experience:

New difficulty controlling your bladder or bowel
Numbness around your groin, backside or inner thighs
Weakness in both legs, or progressive weakness in one leg
Severe pain that does not ease at all, even at rest
Back pain with chest pain, shortness of breath or feeling unwell
Unexplained weight loss, fever, night sweats or feeling generally unwell
Pain that started after a significant fall, accident or trauma
A history of cancer, and new or worsening back pain

If any of these apply, contact your GP, go to an emergency department, or call 000. These symptoms are rare, but they need prompt assessment.

Common questions

Should I rest, or should I keep moving?

Keep moving. Bed rest for more than a day or two usually makes back pain worse, not better. Staying active within your pain limits helps your back recover faster, reduces stiffness, and keeps your confidence up. At Physio K, we use a traffic light system to guide this: pain between 0 and 3 out of 10 is the green zone, you can keep going. Pain between 3 and 5 is the yellow zone, you can continue but pay attention to how long the pain lasts afterward. Pain above 5 or 6 is the red zone, your body is telling you to ease off. We help you find the right balance so you stay active without overdoing it.

What is causing my back pain?

In most cases, there is no single cause. Your back pain is more likely the result of several things building up over time: how much you sit or stand, how you move, your strength and fitness, your sleep, stress levels, and previous episodes. The movement that finally triggered the pain, whether it was bending to pick something up or sneezing, is usually just the last straw, not the whole problem. Part of what we do in your assessment is look at the bigger picture, find the factors that have been loading your back over time, and work on those so you are not one small movement away from another flare-up.

How long will it take to get better?

Many people with acute back pain see significant improvement within four to six weeks. If your pain has been there for longer, or if it keeps coming back, recovery may take several weeks to months of consistent work. The goal is not just to get rid of the pain, it is to help you move better, get stronger, and understand your back well enough to manage it yourself. We measure progress by what you can do, whether that is sitting through a work day, playing with your kids, or getting back to the gym, not just by how much it hurts.

Do I need an MRI or X-ray?

Usually not. Scans are helpful when there are red-flag symptoms, significant neurological signs, or if your pain is not improving with appropriate treatment and we need to rule out something more serious. For most people with back pain, a scan will show age-related changes such as disc degeneration or small bulges that are also seen in people without any pain at all. These findings can increase worry without changing what we do to help you. We focus on how you move, how strong you are, and what is stopping you from doing what you want to do, and that tells us far more than a picture of your spine.

This article is for general information only and is not a substitute for personal medical advice. If you have concerns about your health, please consult a qualified clinician or your GP.