Low back pain is one of the most common reasons people seek musculoskeletal care. For most people it is not caused by a serious problem and improves with the right approach to movement, load and pain management.

Low back pain is extremely common and, in most cases, is not a sign of serious disease. The lower back is a complex structure of joints, discs, ligaments and muscles, and pain can arise from several of these without there being a single, clearly identifiable “cause” on a scan.

The most important early steps for most people are staying active within reasonable limits, avoiding prolonged bed rest, and using simple measures to manage pain while the back settles. Physiotherapy and a graded return to normal activity are central to recovery.

Our role is to assess your back carefully, identify any features that need further investigation, and give you an honest plan. Where pain is persistent and has not responded to first-line measures, we can discuss whether additional treatments are reasonable in your situation — always alongside, not instead of, good rehabilitation.

Common symptoms

  • Pain across the lower back, sometimes radiating to the buttock or thigh
  • Stiffness, especially after rest or in the morning
  • Pain aggravated by certain postures, bending or lifting
  • Difficulty with prolonged sitting or standing
Evidence-informed treatment summary

How our treatment options may fit for Low Back Pain

The options below include the treatments offered at The Back Pain Doctor. Listing a treatment does not mean it is recommended for this condition. The evidence, likely benefit and role of each option are considered against the diagnosis, examination findings, imaging where appropriate, patient goals, risks, cost and alternatives.

Foundation

Diagnosis, education and progressive rehabilitation

This is the starting point for most musculoskeletal conditions.

The priority is to identify the likely pain generator, explain the condition clearly, modify aggravating load and build a realistic plan to restore strength, movement and confidence.

Evidence is condition-specific; it is not a universal pain treatment.

Shockwave is best framed as an adjunct where the diagnosis fits. It is generally more established for selected tendon and plantar heel pain presentations than for many joint or nerve conditions.

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Evidence varies substantially by condition, tissue and preparation method.

PRP may be discussed in selected tendon or joint presentations. It should not be presented as a guaranteed regenerative treatment, and uncertainty, cost and alternatives should be discussed.

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Best used for specific inflammatory or irritable pain generators, usually for short-term relief.

An injection may help when a joint, bursa, tendon sheath or other defined structure is driving symptoms. It is not a cure and needs to be weighed against risks, recurrence and the need for rehabilitation.

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Clinical evidence is still developing and guideline support is limited.

EMTT may be discussed as an adjunct in selected presentations, but should be presented with clear uncertainty and never as a replacement for diagnosis, load management or rehabilitation.

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Selected cases

Prolotherapy

Evidence is condition-specific and generally less established than exercise-based care.

Prolotherapy may be considered in carefully selected chronic ligament, tendon or joint-related pain presentations, but it is not a first-line treatment.

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Most relevant when focal myofascial pain is a clear contributor.

Trigger point treatment may reduce pain from focal muscle spasm or myofascial tenderness. It should be paired with movement restoration, strength work and recurrence prevention.

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Relevant only when the history and examination support nerve irritation or entrapment.

Nerve-focused treatment may be discussed when there is a plausible peripheral nerve pain generator. Progressive weakness, major neurological deficit or red flags require a different pathway.

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This is general information only. Suitability is assessed individually. Treatments with limited or condition-dependent evidence may still be discussed, but only with clear explanation of uncertainty, expected benefit, risks, cost and alternatives. Red flags, progressive neurological symptoms or suspected serious pathology require a different pathway.

Frequently asked questions

Do I need an MRI for my back pain?
Often not. For most acute low back pain without warning features, imaging does not change early management and can sometimes lead to unnecessary worry or treatment. We assess whether imaging is genuinely needed based on your history and examination.
When should I be concerned about back pain?
Features such as significant trauma, unexplained weight loss, fever, progressive leg weakness, or problems with bladder or bowel control warrant prompt assessment. If you have these, seek medical care without delay.
Will I need surgery?
Most low back pain is managed without surgery. Surgery is reserved for specific situations and is not the first option for the majority of people.

Ready for a clearer plan for your back or musculoskeletal pain?

Book an assessment with Dr Joshua Hatch.

Your assessment focuses on understanding the likely source of your pain and the most appropriate non-surgical options for your diagnosis, with the aim of reducing pain and improving function.

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Book an appointment with the Back Pain Doctor