Lower Back Pain
The commonest reason people come to us, and one of the most over-treated. Most of it settles, with loading rather than rest.
Common symptoms
- , Ache or stiffness across the lower back
- , Worse after sitting, or first thing in the morning
- , Difficulty bending, lifting or straightening
- , Muscle spasm or a sense of locking
- , Pain spreading into the buttock
Common causes
- , Repetitive lifting, particularly with a rounded back
- , Long hours seated or standing on hard floors
- , A jump in physical work or training
- , Weak or deconditioned trunk muscles
- , Disc or joint irritation
Mechanical, not damaged
The overwhelming majority of lower back pain involves muscles, joints and discs that are irritated rather than injured. That distinction decides the treatment: irritated tissue responds to graded movement and does badly with rest and fear.
Pain intensity is a poor guide to how serious it is. Spasm can be agonising and resolve in a fortnight; a low persistent ache is often the more stubborn problem.
Manual work and heat
A large share of the back pain we see on this coast comes from physical work: port and construction work, hotel and kitchen shifts, boat work, fishing. The pattern differs from the office version: less about sustained posture, more about repeated loading without the strength base to absorb it.
Heat contributes in a way people underestimate. Working dehydrated in humidity degrades how muscles tolerate load, and fatigue late in a shift is when the lifting technique slips and the injury happens.
What helps
Hands-on treatment settles symptoms and restores movement, which matters because a guarded back stiffens further. The durable change comes from progressive loading until the tissue tolerates what your work and life actually demand.
Two or three exercises, not twenty. Long programmes get abandoned in the first week and an abandoned programme does nothing.
How we treat it
- , Manual therapy to restore movement
- , Graded loading and trunk strengthening
- , Lifting technique for manual workers
- , Advice on pacing through a working week
- , A short home programme
Typical recovery: Most cases improve substantially within 2–6 weeks
See a doctor urgently if you have
- !Loss of bladder or bowel control
- !Numbness around the groin or inner thighs
- !Progressive weakness in a leg
- !Back pain after significant trauma
- !Unexplained weight loss or fever with back pain
These are not physiotherapy problems. Go to a doctor or hospital rather than booking with us.
Treatments that help
Common questions
Do I need a scan?
Usually not. Scans of pain-free adults routinely show disc bulges and degeneration, so imaging frequently finds things that are not causing your pain and generates worry that makes recovery slower. We will tell you if a scan is genuinely warranted.
I lift for a living. Do I have to stop?
Rarely entirely, and stopping is often the wrong answer, the tissue needs load to recover capacity. Usually we modify what you lift and how for a period, then build back. Tell us what your work actually involves and we will plan around it.
Why does it keep coming back?
Because episodes get treated and causes do not. If the pain settles but the underlying weakness and loading habits are unchanged, recurrence is the expected result.
Book a physiotherapist on the coast
Clinic appointments in Nyali, or a physiotherapist at your door from Mtwapa to Diani. Same-week slots.