Why does the back hurt, and why does it linger?
Back pain is rarely a sign of serious damage. In more than 85% of cases, it is "non-specific" low back pain: no fracture, no tumour, no serious pathology. Yet it can be debilitating, last for weeks, and keep coming back.
What makes pain persist is usually the absence of understanding about what triggers it — and therefore the inability to act on it. A wrong movement, a prolonged posture, a muscle that has been compensating for years. The goal of the first appointment is to put a finger precisely on that.
What research says clearly: adapted movement is superior to rest. Staying immobile makes low back pain worse in the vast majority of cases. The right treatment is to move — but in the right direction.
What I treat
Not all back pain is the same. Each situation requires a distinct assessment.
Acute low back pain
Recent back pain, often after a wrong movement or effort. Responds well to prompt management.
Sciatica
Pain radiating down the leg, tingling, numbness. Usually sciatic nerve compression — treatable without surgery in the majority of cases.
Herniated disc
A spinal disc that protrudes and compresses adjacent structures. 80% of herniated discs are treated without surgery.
Chronic low back pain
Pain lasting more than 3 months. Requires an approach that goes beyond symptom management.
Neck pain
Neck pain, tension, stiffness. Often linked to desk posture or whiplash.
Post-operative pain
Rehabilitation after spinal surgery (disc replacement, discectomy, spinal fusion). Programme adapted to your stage of recovery.
How I approach back pain
At the first appointment, I start with a full history: how long you have had pain, what triggers it, what relieves it, what you would like to be able to do again.
Then I assess your movements systematically. What I am looking for is your directional preference — the direction in which your pain decreases or centralises (moves toward the centre). This is the core principle of the McKenzie Method (MDT), which I use for the vast majority of back pain presentations.
Once that direction is identified, I give you precise exercises to do several times per day. Not a generic handout — exercises matched to what your back is doing that day.
What makes this different from a standard appointment: you leave the first session understanding what is happening in your back and what you can do about it yourself. The goal is to make you independent, not to create reliance on ongoing sessions.
What the research says about back pain
You should rest and wait for it to pass.
Adapted movement accelerates recovery. Prolonged rest makes low back pain worse.
I need an MRI before I can start treatment.
An MRI is not needed to start. A clinical assessment is often more useful than imaging.
My herniated disc can only be treated surgically.
80% of herniated discs resolve without surgery with the right treatment.
Chronic pain cannot improve.
Even pain present for months or years often responds well to targeted treatment.