11/09/2026
π¦ LOW BACK PAIN: ARE WE STILL TREATING THE PATIENT β OR JUST THE SPINE?
Low back pain is one of the most common musculoskeletal presentations in clinical practice. But current evidence continues to support a more person-centred, biopsychosocial approach rather than focusing solely on spinal structures or imaging.
π§ What does the evidence tell us?
πΉ Exercise remains a key component of management. Recent evidence suggests that exercise therapy and physical activity can provide benefits for pain, disability and recurrence, although effects are generally modest and exercise should be individualised. (PubMed Central (PMC))
πΉ There isnβt one βbestβ exercise. Pilates, motor-control exercise, strengthening, walking and other active approaches can all have a role. The important question is: What is appropriate for this patient, their goals and their presentation? (Frontiers)
πΉ Education matters. WHO recommends person-centred, holistic care that considers physical, psychological and social factors influencing chronic primary low back pain. (World Health Organization)
πΉ Clinical reasoning is essential. Rather than automatically attributing pain to a disc, facet, posture or βweak coreβ, physiotherapists should consider the patientβs history, functional limitations, psychosocial factors, neurological findings and potential red flags.
π For physiotherapists, ask:
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Have I screened for serious pathology?
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Have I assessed neurological signs where indicated?
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Have I identified the patientβs functional goals?
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Have I addressed fear, beliefs and avoidance?
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Is my exercise prescription specific and progressive?
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Am I using manual therapy as an adjunct rather than the entire treatment?
π WANT TO STRENGTHEN YOUR LOW BACK PAIN CLINICAL SKILLS?
SmartPT Academy has dedicated CPD courses on:
π Evidence-Based Low Back Pain Rehabilitation & Management
π Evidence-Based Assessment of Low Back Pain
π Lumbar Spine Pathologies
π Lumbar Spine Anatomy & Biomechanics
β¦and a growing library of MSK, orthopaedic, neurological and rehabilitation CPD courses. (SmartPT Academy)
Our low back pain rehabilitation course covers pain science, exercise selection, fear-avoidance, graded exposure, clinical reasoning and appropriate use of manual therapy. (SmartPT Academy)
π Self-paced learning
π CPD certificate
π₯ Downloadable resources
π± Learn on mobile or desktop
π Access from anywhere
π Visit smartptacademy.com and explore the courses today.
Invest in your clinical knowledge. Improve your reasoning. Improve your practice.