5 Things Your Physio Wants You to Know About Back Pain

Back pain is one of the most common reasons people walk through our doors at Laura Franklin Rehab. It affects around 80% of people at some point in their lives, and for many it can feel frightening, confusing, and isolating.

After years of treating back pain across every age group and activity level, there are a handful of things we find ourselves saying again and again. So here are the five things we genuinely wish every patient knew.

1. Most back pain is not caused by serious damage

This is probably the single most important thing we can tell you. When your back hurts, it is completely natural to worry that something is seriously wrong. You might assume a disc has slipped, something has torn, or your spine is damaged.

The reality is that the vast majority of back pain is not caused by structural damage. It is usually driven by a combination of things: changes in activity levels, muscle deconditioning, stress, poor sleep, and the way your nervous system processes pain signals.

Understanding this is not about dismissing your pain. Your pain is absolutely real. But knowing that it does not usually mean structural damage can be incredibly liberating, because it means recovery is almost always possible.

2. Scans often tell you less than you think

Many people assume that an MRI or X-ray will reveal exactly what is causing their pain. The truth is more nuanced than that. Research consistently shows that many of the findings on spinal imaging, things like disc bulges, degeneration, and facet joint changes, are extremely common in people with no pain at all. One well-known study found disc bulges in over 50% of people in their 30s who had absolutely no symptoms.

This does not mean scans are useless. In specific clinical situations they are essential. But in most cases of back pain, a thorough physical assessment by an experienced physiotherapist will tell you far more about what is actually driving your symptoms than an image ever could.

At LFR, our assessments look at how you move, where your strength and control deficits are, and what factors in your life are contributing to the problem.

3. Movement is medicine, not something to fear

When your back is painful, it is tempting to stop moving. Rest feels like the safe option. But in most cases, avoiding movement actually makes things worse. Your muscles weaken, your joints stiffen, and your nervous system becomes more sensitised to pain, not less.

The key is finding the right type and amount of movement for where you are right now. That is exactly what physiotherapy-guided rehabilitation does.

At LFR, we start with gentle, targeted exercises and progressively build your capacity. For many of our clients, the next stage involves clinical Pilates in our dedicated Pilates gym, where they work on personalised programmes in small groups of no more than four, under the close supervision of an instructor trained through Polestar or APPI. It is a controlled, safe environment designed to rebuild your confidence in your body.

4. Your back pain is not just about your back

Pain science has moved on enormously in the last decade. We now understand that back pain is influenced by a whole range of factors beyond just the physical. How well you are sleeping, your stress levels, your general fitness, your beliefs about your pain, and even how much you understand about what is happening in your body. All of these play a significant role in how much pain you experience and how quickly you recover.

This is why our approach at LFR is never just about hands-on treatment. We take time to understand you as a whole person. We educate you on what is driving your pain, help you develop strategies for managing flare-ups, and build a rehabilitation plan that accounts for your life, your goals, and your daily routine.

5. Long-term recovery means building strength, not just reducing pain

Here is where most back pain treatment falls short. Many clinics focus purely on short-term pain relief. A massage, some stretches, a few exercises on a sheet of paper, and off you go. The pain settles for a while, then it comes back. Sound familiar?

Lasting recovery from back pain requires building genuine strength and resilience in your body. That means progressive, challenging exercise that goes beyond the treatment room.

This is exactly why LFR exists as an integrated clinic. Your journey does not end when the pain settles. Our physiotherapists work alongside our Pilates instructors and personal trainers to take you from pain management, through movement rehabilitation, and into strength and performance. All under one roof, with one team who communicate about your care.

It is the difference between getting out of pain and staying out of pain.

What to do next

If you are currently dealing with back pain and want to understand more about what is really going on, we have put together a free guide that covers the most common myths, what the research actually says about recovery, and practical strategies you can start using today.

Download our free Back Pain Guide at laurafranklinrehab.co.uk/backpainguide

We also run a regular online workshop called Your Back Pain, Explained, where one of our specialist therapists walks you through the latest evidence on back pain in a clear, jargon-free way. You can find upcoming dates on our events page.

And if your back pain is affecting your daily life and you want to get it properly assessed, you can book a physiotherapy assessment directly through our website. We will listen, we will assess thoroughly, and we will give you a clear plan for getting better.

Laura Franklin, Physiotherapist and Director, Laura Franklin Rehab, Guiseley, Leeds