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Lower back pain treatment options

If you suffer from lower back pain, you are not alone. In a Canadian study, researchers found approximately 11% of the adult population studied had been disabled by lower back pain in the previous six months. If like myself in the past your lower back pain has stopped you in your tracks it is time to look for some professional help. But who should you go to first? In this blog, I outline the merits of different lower back pain treatment options with a specific emphasis on physical therapies.

A trusted professional healthcare practitioner

In the majority of cases, the cause of lower back pain is purely muscular there are occasions when it can be more serious in nature and require medical attention. Below is a list of some such conditions:

  • Kidney stones
  • Ovarian cysts
  • Fibroids
  • Endometriosis
  • Pancreatic Cancer
  • Osteoporosis
  • Psoriatic and Rheumatoid Arthritis

Based on this information, it is important that you firstly consult a trusted professionally trained health care practitioner. For most this may be your family physician but I would also consider a chiropractor, physiotherapist or osteopathic manual practitioner. All these professions undergo extensive training in the proper diagnosis of lower back pain.

Lower back pain treatment options

Family Physician

If you have consulted with your family doctor and they have ruled out any underlying conditions they will often prescribe rest, muscle relaxants and pain killers. If the pain persists, they order an x-ray of your back, and eventually an MRI scan. If all else fails, then the final treatment option may be surgery especially if you have a herniated disc.


Chiropractors undergo extensive training in the diagnosis and treatment of musculoskeletal conditions. Diagnosis of lower back pain is based on taking a comprehensive case history, physical examination and occasionally an x-ray. In general, a chiropractor will predominantly use spinal adjustments in the treatment of lower back pain, but they also employ other treatment modalities. For example, the chiropractor I see also uses the Graston method and acupuncture.

Massage Therapists

Although massage therapists are a regulated profession in Ontario, they are not allowed to diagnose any medical conditions. They do however undergo an intensive four-year training course. Massage therapy has a reputation for being just for relaxation; however, the massage therapist I see can treat specific conditions such as lower back pain. As well as using physical techniques, massage therapist will also give exercises.

Osteopathic Manual Practitioners

Just like Chiropractors, Osteopaths also receive extensive training. Osteopathy is a relatively new treatment option available in Canada while in Europe is much more established. Diagnosis of lower back pain is also based on a case history and thorough physical exam, but X-rays are only ordered if appropriate. Osteopaths can use many different techniques in the treatment of lower back pain including cranial osteopathy, massage, spinal manipulation, and visceral manipulations. They may also give you exercises and some lifestyle advice.


Typically you have to go to school for six years to become a physiotherapist. Like chiropractors and osteopaths, physiotherapists are taught how to differentiate between musculoskeletal and more dangerous causes of lower back pain.  For lower back pain, physiotherapists commonly use various types of medical equipment including tens machines and ultrasound as well as dry needling and advising on exercises.

Above I have described the different lower back pain treatment options with a specific emphasis on physical therapists. No matter what therapy you choose, it is critical that you get a proper diagnosis for your symptoms. If in any doubt I recommend first seeing you family physician. When choosing a particular therapy, if none of the above approaches appeals to you I suggest speaking to friends or family for a recommendation.

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