ConditionSpine
Low back pain
Low back pain is the most common reason people are referred here, and the most commonly mistreated. The work is to identify which structure is generating the pain — disc, facet joint, sacroiliac joint or muscle — because each responds to something different.
Also calledLumbar painLumbagoDisc pain
What it is
The lower back carries load through several structures at once: the discs between the vertebrae, the small facet joints at the back of the spine, the sacroiliac joints at the pelvis, and the muscles and ligaments that hold it all in position. Pain can come from any of them, and often from more than one.
The label "non-specific back pain" is used widely, and sometimes correctly. But in a specialist setting a more precise answer is usually available, and precision changes the treatment.
What it feels like
- A deep, band-like ache across the lower back
- Worse after sitting, driving, or standing in one place
- Sharp catches when twisting, bending or getting out of a chair
- Morning stiffness that eases with movement, or the reverse
- Pain that spreads into the buttock or upper thigh but not past the knee
How we assess it
A full history first: how it began, what provokes it, what has already been tried and what happened. Then a focused examination of movement, load tolerance and neurological signs.
Existing scans are reviewed on screen with you. Imaging findings are common in people with no pain at all, so a scan is read alongside the examination rather than instead of it. Where the source is genuinely unclear, a diagnostic block can confirm or exclude a single structure before any longer-lasting treatment is considered.
Treatment options
Treatment is matched to the structure identified, and is almost always staged rather than delivered all at once.
- Medication review — simplifying, not adding
- Image-guided facet joint or sacroiliac injection where a joint is implicated
- Radiofrequency neurotomy when injections confirm the joint but relief is short-lived
- A graded exercise programme, supervised, with a defined progression
- Pain psychology where sleep, mood or fear of movement is driving the cycle
What recovery looks like
Most plans run over six to twelve weeks with scheduled review points rather than an open-ended arrangement. Injections buy a window of reduced pain; the rehabilitation done inside that window is what makes the change hold.
If a treatment does not do what it was expected to do, that is information — the plan changes rather than repeats.
Risks and honest limits
Not all back pain has a single treatable source, and some people improve in function without a large change in pain score. We say so at the outset rather than after the third procedure.
Injection risks are small but real, and are set out on each procedure page. Red-flag features — unexplained weight loss, fever, bladder or bowel change, progressive weakness — are urgent and are assessed the same day.
A note on this page
This is general information, written to help you prepare for a conversation. It is not a substitute for an individual assessment — what is right for you depends on your history, your examination and your own goals.
Common questions
Asked before, answered here
No. Bring any scans you already have, but a new scan is only arranged when the result would change the plan.
Almost never. Prolonged rest reliably makes back pain worse. The plan is about restoring load tolerance safely.
For most people, no. Surgery is appropriate for a specific minority, and we say plainly when a surgical opinion is the right next step.
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Have this assessed properly
Send a few lines about your pain and how long it has been going on. We will reply with a time and what to bring.
Visit
Level 2, 48 Macquarie StreetSydney, NSW 2000Response
Enquiries are answered within one to two business days. Urgent clinical matters are triaged the same day by the practice team.