Back and Neck Pain

Back and Neck Pain

Do you have back and neck pain?
Back and neck pain symptoms can vary from mild to physically deforming. Sometimes the symptoms can be relieved quickly via hands-on therapy, or a more long-term exercise solution might be required. Often the critical element is getting the right diagnosis that suits you and your body mechanics.

Lower back pain_MG_7280

Neck pain_MG_7598

Mid back pain_MG_7623



Lower Back Pain

Simple back pain:
Often called mechanical back pain, this is mainly located in the lower back region. The cause may be due to overloading of the bony joints of the spine or soft tissue, causing breakdown and irritation. Mobilising (loosening) the joints can have a dramatic effect on improving this pain. What is important though, is not to miss why the pain was caused. Often a case of simple back pain can lead to bigger issues if the real biomechanical cause of the injury is not addressed.

Sciatica vs referred leg pain
Sciatica is a more severe cause of back pain and occurs when your lumbar disc is ruptured and putting pressure on the sciatic nerve running down the leg. A bad case of sciatica can cause muscle weakness and loss of sensation. Management initially is a combination of manual therapy and traction to unload the disc and reduce muscle spasm. Exercise intervention is critical to help stabilise the damaged disc and regain functional use of the spine and nervous system. Gyrotonic® exercises are effective in alleviating the pressure on the disc and nerve, and helping the area to regenerate.

Not all leg pain is sciatica. Some cases of leg pain may be due to referred pain from the vertebrae, or an entrapment of the sciatic nerve as it passes through muscles down the leg. Manual therapy in these cases is distinctly different to sciatica, and if diagnosed and applied correctly, results can be very quick.

Malalignment Syndrome
If you feel that your back is ‘out’, it probably is – but sometimes the body can be out of alignment without you realising. In this case, malalignment of the spine due to a lumbo-pelvic imbalance or a stuck sacroiliac joint can lead to further damage. A feeling of being ‘out’ can be the body’s way of warning you about a potentially more serious injury. Manual therapy, stretches and targeted exercises can help prevent this progression. Untreated malalignment can lead to the development of hip, knee and shoulder issues.

Scoliosis is classified as either postural or structural. If the diagnosis is postural, manual therapy and exercise can have a great impact on improving the curvature of the spine. Drawing a spine map from observation, and having an X-ray scan will help you to understand why we are delivering specific series and sequencing of exercises. For people with scoliosis and associated back pain, Gyrotonic® exercise intervention is more appropriate than Pilates exercises. However with structural scoliosis, the aim is to optimise the twists in the curvature of the spine, to prevent deterioration. When back pain is also present, a more local solution and minimisation approach is required, to prevent its impact on the existing scoliosis curvatures.

Chronic back pain
If back pain persists for more than six months, it becomes chronic. Firstly don’t panic if it has not been treated well in the past, as key indicators may have been overlooked, inhibiting recovery. However, if pain has been present for a long time, and is not responding to manual treatment and initial corrective exercises, a more clinical and behavioural approach is required. Cognitive behavioural therapy is one way to help deconstruct your pain and learn to manage it and function better. The Physio Gym environment is the ideal controlled setting for you to take control of your pain and learn how to move with confidence again.


A spondylolisthesis is when one vertebrae of the spine slips forwards on the adjacent vertebrae. This often occurs as a result of a sporting injury or overuse. Pain may be constant and gradually gets worse over time. However, there may also be no pain at all. Regardless of the level of pain, it is crucial that patient engages in specific training and exercises to stabilise the spine and prevent further slipping of the vertebrae over time. To return to sports or activities requires a gradual build-up of local control of the spine, to assist in functional or sporting movements. Both Gyrotonic® and Pilates exercise classes can be highly valuable in improving the coordination and stabilisation of your spine.

Neck pain

Neck pain can be very debilitating, and people with an acute episode may find they cannot even straighten their neck into an upright position. The pain can be severe and is associated with a high degree of muscle spasm. This spasm is often a protective mechanism to stop any danger to the spinal cord. Different types of neck pain requires different solutions, from traction and joint mobilisation to massage, manipulation and exercise. Understanding the impact of poor spinal mechanics and postures is critical to preventing long-term problems.

Neck pain_MG_7598

Neck treatment_MG_7607

Treat the spine_MG_7623

Simple neck pain
This is often a point-specific pain or stiffness that may occur spontaneously, or due to activity. Manual therapy with stretches can give rapid improvement if the pain is treated quickly after the initial onset. However, it can become harder to manage if the pain has been present for more than six months. In this case, we take a broader view of the body, and exercises will be more specific and strengthening in nature. There are many positive exercise solutions to help prevent recurrences, which can even be done while sitting at a desk.

Wry neck
A common scenario is waking up in the morning after a night’s sleep and finding you can‘t straighten your neck properly. Often it feels like it’s bent to one side. Manual therapy is the primary focus here, designed to reduce the muscle spasm that’s holding the neck in this position. It is often a worrying period, as the pain can be severe and you may fear that you have injured a disc in the neck. The good news is that with timely intervention, these neck problems can be quickly healed.

Pain generated from the first three vertebrae in the neck often causes headaches, dizziness and migraine-like symptoms. Often chronic sufferers who do not respond to medication can resolve their pain with only a few manual therapy sessions. The key to success is firstly reproducing the symptoms from the neck vertebrae. If this is successful, there will be a high likelihood of successful treatment. Exercises to follow must be specific and target the neck appropriately. It would not be recommended for chronic headache sufferers to do Pilates, for instance, as the series can often load the neck musculature excessively, contributing further to the symptoms.

Disc bulges causing neck and arm pain
If you’re experiencing arm pain and symptoms of pins and needles, or numbness and arm weakness, then you may have a disc bulge pushing on the nerves associated with the arms. This requires careful manual therapy management that avoid neck manipulations or “adjustments”. It’s important to quickly initiate a graded exercise program to reduce muscle spasm and strengthen the neck. With disc bulges there are no quick fixes and patience is required. However, the wrong treatment can lead to prolonged pain and reduced long-term function – so it’s important to get a professional diagnosis.

Referred neck and arm pain
Referred pain in the arms from the joints in the neck can often respond very rapidly to treatment. The therapy offered can be more proactive, and stretches and exercises can be delivered to target specific joints.

A trapped nerve
If pain in the arm is associated with a tight feeling resulting in a loss of range in the shoulder, a nerve down the arm can be caught or trapped. To free the nerve, certain muscles and joints must be targeted in a specific sequence to maximise the result.

Thoracic pain

The thoracic spine has an important function to protect vital organs like the lungs and heart. The thoracic spine with the ribcage provides stability, and offers muscles a leverage point to move the neck and lower back. With such a dynamic role to play, it is important that pain in this area is managed correctly. Often people with scoliosis develop considerable pain in this region. To best manage the thoracic spine, a combination of manual therapy, Pilates, GYROTONIC® exercises, and foam roller or thoracic wedge exercises, in combination with breathing techniques, may be required.

Facet joint sprain
Pain in the mid back, ribs or chest is common and can be a result of an inflamed or stuck joint in the thoracic spine. The injury may be a result of posture or can occur from a specific injury. Pain can be extremely sharp and is worse usually with coughing, sneezing, or when taking a deep breath. The good news is these injuries generally respond very quickly to hands on therapy. Prevention of recurrence is essential and involves postural correction, strengthening and stretching exercises.

Exercise for a better spine




Our back rehabilitation treatments

  • Joint mobilisation
  • Joint mobilisation with movement
  • Body re-alignment
  • Manipulation of the spine and neck
  • Muscle energy techniques
  • Deep tissue release and massage
  • Manual traction
  • Manual guidance with exercise
  • Strapping and kinesio taping more>
  • Real Time Ultrasound
  • Pilates
  • Gyrotonic® exercises
  • Exercise prescription