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Common Causes of Back Pain

There are as many causes of back pain as there are letters in the alphabet. The good news is that the vast majority of back pain is mechanical in nature – which means it was caused by a movement or awkward position or something mechanically affecting the back from the outside.  This generally makes this sort of back pain relatively straightforward and relatively simple to deal with. This is not to minimise how uncomfortable and debilitating it can be, but hopefully you can find this reassuring and it can help ease your anxieties.


The most common form of sudden mechanical back pain is a simple muscle strain. A muscle strain is caused by a muscle moving beyond its full length, or contracting and working at an odd or unusual angle that is not used to working in.

A muscle is made of many of fibres and in a strain some of these fibres get a bit disturbed. the body’s natural repair processes including inflammation cause of the area to get warm and to become a bit uncomfortable. this is designed to help it heal it’s usually takes between 4 and 6 weeks depending on how severe the strain is. Even a very severe muscle strain will repair itself.

Muscle strains can happen anywhere in the back and in fact anywhere in the body. They are extremely common. The more common places in the back for people to experience this type of strain is in the upper back at the back of the shoulder near where the upper part of the shoulder blade approaches the spine – sometimes you can feel this in the neck as well.  Another common spot is in the middle to lower back across the lower part of the ribs, and also where the low back attaches to the pelvis/

How do you know you have a muscle strain? A classic example of a muscle strain is bending over or reaching quickly and experiencing a sharp pain this pain can then be reproduced with that same movement and sometimes casually can also then create a more generalized and diffuse ache around the area. Occasionally the area can be sore to the touch as well. Generally muscle strain pain is eased when the muscle is not being overused or overstretched and typically these strains take between 4 and 6-weeks to heal fully.


First went to see Tracy due to a very painful bicep and shoulder blade which I had been suffering with for over a month, Tracy worked on me which was amazing on its own, she provided me with a video exercise program which was brilliant, so good being able to see how to do the exercises correctly, I could not believe how quickly results came, it was brilliant. I have been back for another issue I have and once again so impressed. Would highly recommend Tracy and I am so grateful for her help.
After trying several osteopaths and physiotherapists in Ascot and Sunningdale with no improvement for what was diagnosed as a lower back disc/nerve injury I visited Tracy. After nine months of treatment, I have had consistent improvement from day 1. I have a training plan and guided rehab from Tracy that I have stuck to and it works. I am now doing the things that I could not attempt a year ago. I could not walk or sit for over 30 mins without pain, but now I am back in the gym and running again. I have had lots of experience with Osteopaths with over 35 years of sports injuries, this lady is the absolute real deal. Visit it her, the treatment I have had has had an amazingly positive effect on my health and well being.
I’ve seen Tracy now on a number of occasions for a range of problems including back pain and shoulder post surgery. She’s excellent and I’d recommend her without hesitation. She’s highly knowledgeable (and up to date on practices) and her level of experience is clearly seen in all interactions. I do a lot of sports – and have seen many healthcare professionals over the years due to various injuries – and would rate Tracy as one of the best.
Fantastic service at especially short notice.I was in a bad way with my lower back just two weeks before having to travel abroad for a golf trip, bed bound in pain i called Tracey who was my most local osteopath on my google search. She managed to get me an appointment at her ascot premises the very next day and set to work on repairing me. Two weeks later i was walking onto the plane ready for a great trip pain free.Lovely lady with extensive knowledge of her profession, set in a warm and welcoming environment. 5 stars minimum.
I highly recommend Tracy! I visited Tracy after suffering with really painful lower back pain as a result from constant exercising during the lockdown (Courtney black workouts some people may be familiar with how intense these are!) I was unable to do anything, and even walking became painful. I visited Tracy twice and it was my first time seeing an osteopath. She is very friendly, knowledgeable and made me feel very comfortable! She examined my problem and gave me a set of stretches to work on every day and within one month I was able to start jogging again. I still complete these exercises most days and after every workout/run and I am almost back to normal! Thanks so much Tracy
Tracey was super professional and helpful in helping me understand the problem and to manage it moving forward. She was extremely cautious and safe in how she dealt with the situation in the current climate and I felt comfortable being around her and being touched. I had lower back problems and she gave me so many stretches I could use to help ease this and it worked very quickly! If you are struggling with your back like me then she is the one to help you. Thanks so much tracey!
After having put my back out and being in pain for a week, I went to see Tracy for help. Her treatment combined with the gentle stretches she prescribed have worked miracles. I wholeheartedly recommend Tracy to anyone looking for a brilliant osteopath.
I have been suffering from shoulder, knee, and back pain for 3+ years and I have visited a lot of physios, osteopaths, etc and no one has been able to explain how to be pain-free. I have already been visited from Tracy twice and I do really appreciate her treatment and her clear explanation on how to get back playing football and exercising. The truth is that recovering from and injury and pain requires time, manipulation, and strength exercises in a progressive way and, most importantly, a person who you can trust and can help psychology. Tracy will provide all of this!!! Thank you, Tracy!!!
Tracy was brilliant today, very professional with great communication skills. Explained the issues with my back really clearly and gave some very effective treatment. I will definitely recommend her to others and visit her again!
I went to Tracy for a disconfort into my lower back which was also extending to the left leg, and I was a bit worried it could affect the scaitic nerve. Eventually everything was OK, but I really enjoyed her treatement and I’m definitely planning to go back if needed.
where to begin? Tracy has helped me with my back condition for quite some time now & only, today, I had to get treatment after a considerable time (3 years) of not having to make an appointment! That’s because the treatment & program that she gave me previously worked amazingly. I can’t recommend her highly enough but not only of her expertise but as a person too!
Tracy saw me over the Christmas break when I was back home for a few days, managing to squeeze me in between Christmas and New Year. She really helped me out, taking a full and detailed history of my injury, suggesting exercises for me to work on and offering advice on the next stages of recovery. The sports massage was thorough and I definitely felt the difference the following day!
I’ve been using Tracy for the last few years and she’s been a life saver having really helped me with my back issues as well as a few other nagging injuries. She offers a caring and personal touch in regards to diagnosing and discussing what direction the treatment should go in and also is great at making the experience a pleasant one each time.
During a competitive sports tournament, Tracy was the only one who was able to keep me going throughout the week. I had terrible back pain, piriformis syndrome, and groin tightness that followed from the above. Tracy somehow could feel exactly where the problem was and within a few treatments I was cured. She’s the real deal.
Tracy is such a professional – she gets right to the problem and has a sensitive, kind personal style. I have persistent back issues and she is making progress in a more considered way than other practitioners have in the past.
I have had consistant back pain and had a few Treatments with Tracy… With her magic hands and professional approach to my problem, I no longer have pain and I hope its for good! I super recommend her Treatment.
Tracy has worked wonders on my back! When I first visited her in 2015 I was suffering with regular back spasms and joint pain from multiple old injuries that had built up over the years. Over the course of a few treatment sessions she had helped me work out the core pain and even gave me additional treatment on an old shoulder problem that was bothering me as well as providing me with helpful advice on how to manage my recurring issues. After some more visits the work she did on my back was so good I didn’t need anymore treatments for well over year and went pain free for the longest period I can remember since the initial problems began. The service is affordable, comfortable and friendly highly recommended!
I can totally recommend Tracy. She is professional, friendly and give good advice. I had lower back problems and she got it sorted. Thanks Tracy
This was my first visit to an Osteopath and I didn’t know what to expect. I had felt a certain discomfort particularly on the upper back, neck and jaw area. After a thorough examination, Tracy Hannigan clearly explained what was causing this discomfort and how she would proceed to work on the area to provide relief. I truly appreciated her caring approach – from listening to examining to explaining and then gently treating the area, putting firm yet comfortable pressure on the precise points to release tension. I felt an immediate relief! Tracy also gave me a few stretching tips, which definitely helps.


You might be wondering what the difference between a sprain and a strain is. As explained above a strain is with as a little bit of destruction of the muscle fibres as a result of a movement. A strain is a disruption of the tissues that attach bones together.  It’s very uncommon for simple daily movements to cause a sprain – ligaments are extremely strong tissues and usually disrupting and require some sort of outside force or trauma such as a fall or an accident.

Even if you do have a sprain please don’t panic!  You’re not going to fall apart. most ligaments particularly the ones in the back are relatively small and there are lots and lots of tissues such as muscles, tendons (which connect muscles to bone) fascial tissue and other ligaments holding everything together.

The body is quite clever that way. There are multiple redundancies in order to protect you from major injuries during minor daily activities.

What can you do for your sprain or strain?

The worst thing that you can do is simply lay in bed. Bedrest used to be the main advice given to people many years ago before they really understood tissue healing. In order for tissues to heal properly they have to move – and move along with the kinds of movements and experience the kinds forces that the normal tissue has to deal with on a daily basis. If you don’t move the tissues at all – you lie in bed and don’t move because you’re afraid or because it’s a little bit uncomfortable – those tissues don’t experience the forces that they need to experience while they are healing you will develop a blob of scar tissue instead of new healthy tissues that are lined up correctly to perform their job in the future. This could put you at risk of future injury.

Generally speaking if you have a strain or a sprain in their relatively mild you want to make sure that you’re eating well and that you’re getting good sleep. The body tends to heal most during the nighttime hours. During the day you want to perform gentle movements as normally as possible. This might mean that you are not doing the explosive movements that you might do on a sports pitch, if you are a sports person –  but you could probably do things pottering around the house and going to the shops and doing gentle to moderate levels of activity.

No matter your background, the most important thing is to keep the gently moving. This helps promote circulation which brings important healing compounds to the area and help flush out debris and immune molecules that have done their job.  And additionally those very important gentle movement forces help the tissues get the signals they need to line up properly and to heal well for the future.

You pain and movement range should steadily improve. Don’t jump straight back into high levels of activity without gradually approaching that level of activity.

Joint problems

Joint problems are much less common than muscle strains.  A lot of people think that the most common joint problem is something being “out of place”. There is absolutely zero proof that this happens and in fact the evidence suggest the opposite. Joints are extremely tough structures and typically the only way of joint is going to go “out of place” is if you experience of trauma like a high impact accident. In this fine we would call this a spondylolisthesis. Many people have small naturally occurring spondylolisthesis but these are not something that anybody should try to “put back into place”.

Unfortunately over the years many therapists have continued to use this very outdated language which sets people up with a very strong mental image of physical damage which simply isn’t there. This creates fear, which is the number one correlate to the development of persisting pain. This fear also causes people to not move beacuse they are worried about moving – or they have to move in only ‘certain ways’, which inevitably creates more problems.  I want to avoid all of these things by being correct in the terms that I use and explaining them well.

All of that said, the most common joint problems in the back are minor facet joint irritations.  Very commonly a facet joint can become irritated by an awkward movement typically extending the back in some way or extending and rotating it. This typically feels like a sharp pain that takes your breath away which passes very quickly after changing your position – but then sometimes you develop a painful muscle spasm around the area which continues to produce a different kind of discomfort.

What do I do if I have a joint problem in my back?

Typically these joint irritations will fade and resolve themselves within 3 to 4 days. In fact if you come for treatment too soon it can be difficult to impossible to fully assess and treat you because the area is too reactive. Typically when I have had patients with this problem I advise them to wait a couple of days before booking in to see me and to perform the self care activities that provide specifically for them in the meantime. Sometimes comprehensive self care advice is all people need for future managing of these particular kind of joint irritations.

When can back pain be serious?

Obviously any significant discomfort is serious for the person who is experiencing it. What I mean by serious here is a non-mechanical cause for your pain that needs further investigation.

All of the kinds of back pain we’ve discussed so far are mechanical causes that usually come on suddenly and resolve relatively quickly. If you have a pain in your back that has been growing steadily, that’s not alleviated by changing your position, if it’s worse at night,  or if your otherwise unwell you need to get your back pain checked out.  You might find it interesting to read the case study about Mrs S who called me for back pain but who was actually passing a kidney stone. Back pain is most commonly mechanical – but it can be a symptom of many serious conditions –  so if in doubt get it checked out

You should also get checked out if you have any pain or pins and needles in your arms, hands, legs or feet.  If you are experiencing pain down both of your legs or pins and needles or numbness inyour legs or if you’re having difficulty with your bowel or bladder or sexual function or you have numbness in your saddle area you need to go to accident and emergency immediately.

With most types of back pain, osteopathic treatment and sometimes clinical sports massage can help you feel better.  I can also advise you on ways to help prevent it from recurring, and give you strategies to help manage it yourself if it does.  If you have persisting back pain, we can discuss other evidence-based strategies for managing chronic back pain in a way that allows you to live your life to the fullest

If you need a medical referral, I’ll help ensure you get the right care. Read more about me, and then book in today for an assessment at either the London or Ascot clinic.