Last Updated on 6 mins ago by Jayne Raven
It’s not unusual for us to see patients at Sundial who have quietly carried on coping with back pain for months or even years. An unexpected crisis brings them in to see us, when they often realise they could have dealt with chronic pain long ago.
It’s human nature to put small niggles on the backburner while you deal with daily life. Other things can often get in the way of self care but taking action now to find out what’s causing your back pain will not only avert unnecessary agony but will also give you back your leisure time. Just tot up all the activities and fun “have-a-go” moments that you’ve had to say No to! Pain narrows your options, steals spontaneity and a lot of joy.
The team at Sundial always aims to get you back to your more active self. Not every back is the same, and not every back needs the same thing, so when you come in for an initial assessment with one of our chiropractors or physiotherapists, we’ll have a proper discussion about what helps, what the evidence says and how we can treat your particular issues.
Why “just one thing” rarely fixes back pain
From our mid-forties onwards, it’s very common for back pain issues to rear their ugly head. Pain can keep coming back or become chronic, building up over time. Why does that happen? The natural changes that occur in the spine and surrounding muscles as we age often combine with old injuries to cause stiffness. That stiffness gets exacerbated by daily habits like sitting down for too long, spending ages bent over screens or working at a desk. Stiffness discourages you from moving freely and so, gradually and unconsciously, you find yourself reducing your natural range of movement without even noticing. To get this sorted, you need the right kind of guidance, treatment and a personal exercise plan.
Your pain will have its own particular pattern. What caused it, how long you’ve had it, your general health and daily habits all have a bearing on treatment. There can never be a “one size fits all” approach to treatment.
Our chiropractor Matt Cunningham offers this insight into a typical patient’s recovery story.
“When Tom B. first came to Sundial, he was suffering from intense back pain that wasn’t improving. He told me that whilst helping a friend move house, he’d picked up a light box and felt his back go into spasm. The continuing pain over the next few days made it almost impossible to carry on as normal. In order to get his recovery started, I had to do a bit of detective work to find out what had triggered the reaction. I took a detailed history and what emerged was a long-term pattern of muscle tension caused by his work as a hairdresser. Years of holding an awkward stance whilst cutting hair had irritated lumbar spine joints and muscles. With that information, I was able to go ahead with treatment and we agreed on a plan of action. Over the next six weeks, he improved noticeably by keeping to his appointment schedule and doing his home exercises.”
What the research says about chiropractic care and spinal adjustment
Sundial practitioners keep on top of the latest research with an evidence-based approach to treatment. Spinal manipulation (the technique that chiropractors specialise in) has been shown to be one of the few effective treatments for back pain, performing as well as other NICE recommended methods, and it is very safe. It works best alongside information about what’s wrong and what caused it as well as exercise therapy and ongoing support.
That means that we discuss the context of your pain and explain what in you daily activities has led you to this point. We’ll advise on how to manage it with effective pain relieving strategies, make sure you have the right exercises to do at home and check on progress as treatment goes along. Those exercises are tailored to your specific needs. Sticking to them between appointments has been shown to significantly reduce pain and help to restore movement (you can read the clinical studies below). We try to make sure that the exercises are not just the most appropriate ones but also the ones you feel that you can keep doing.
How an assessment can set you on the right track
At your first appointment, after a detailed conversation about your symptoms and history, you will have a thorough examination of your spine, posture and range of movement, followed by appropriate treatment. Then your chiropractor will devise a home exercise plan to support your recovery, suggest how many treatments may be needed to improve things and also talk about how to stay pain-free in the future. Once a Treatment Plan has been agreed, your subsequent appointments won’t need to be so lengthy, although each time you come there’ll be an element of checking in on your progress before treatment.
At Sundial, the great advantage of working closely as a team of chiropractors, physiotherapists and sports massage therapists is that we can draw on the expertise of all. Where your recovery is best helped by the treatment methods of a physio or the soft tissue work of a sports massage therapist, your chiropractor will refer you to one of their colleagues who’ll be able to consult seamlessly on your progress.
On the other hand, we never assume that chiropractic or physio are automatically the right paths for you or that Sundial has the answer to every back problem. Not every cause of back pain is covered by the conservative care options we offer and so, if appropriate, you might be referred to your GP or another specialist for further investigation.
An overview of chiropractic techniques you might come across
There’s nothing magical or mystical about the chiropractic techniques you’re likely to come across in your treatment at Sundial. They’re all well-established and evidence-based, designed to help recover movement in your muscles and ease pressure on joints and nerves. Your first appointment will include a careful check for red flags (see our list below) and various orthopaedic and neurological tests to identify where your pain is coming from. Once all that’s been done, your chiropractor can decide on the best treatment to suit your needs. They might use some of the following approaches.
Spinal manipulation or adjustment. This is used to improve joint mobility and reduce stiffness in a targeted area. Here at Sundial, we often use ‘no-click’ handheld devices, which deliver precisely-calibrated, brief pressure to exactly the right places. You can read more about how this works here. Chiropractors can also administer spinal adjustments manually, if you prefer (and that’s when you might hear the legendary clicking sound in your back, as gas moves within the joint fluid).
Flexion-Distraction is a gentle technique which can help to relieve pain in disc-related issues like bulging or herniated discs, sciatica and spinal stenosis. The specialised chiropractic table we use is designed to flex and stretch the spine, painlessly creating space between the vertebrae to ease compression of inflamed nerves and improve circulation.
Spinal mobilisation is a gentler, slower movement through the joint’s range, often used where a firmer adjustment isn’t appropriate or preferred.
Soft tissue techniques work on the muscles and connective tissue around the spine, which are often tight or guarding when back pain has been present for a while.
Guided exercise and rehabilitation builds strength, control and confidence in movement over time. Your chiropractor will ensure you understand your personalised exercise plan so that you can carry on your recovery at home between appointments. This is consistently one of the best-evidenced parts of healing from chronic back pain.
The Sundial team takes care to identify what may be causing your pain and chooses the most appropriate methods to help you.
Realistic timelines for improvement
People often ask if their back pain will ever properly settle and, of course, how long will it take to feel better? The answer depends on what kind of problem it is and how long you’ve had it.
If your back pain is recent you are likely to notice that carrying out your daily activities becomes less painful after a few treatments, particularly if you keep to your appointments and do your home exercises. You can often expect to see improvements in the first few sessions and lasting improvements in 6 to 8 sessions.
And, of course, “non-specific” does not mean it’s not real. It’s a term applied to the vast majority of back pain -but not by us. It is usually used to mean that the cause is not traceable to nerve compression, a structural spinal condition or other issues such as an injury. Usually, it means that the person telling you it’s non-specific low back pain is not a spinal specialist and has not examined you thoroughly. Here at Sundial, we’ll give you a specific cause for your pain based on a thorough understanding of what’s happening. You can learn more in our free booklet Back Pain – What To Do About It.
If your pain has been going on for months or years, improvements tend to be more gradual. Recovery is not just about dealing with the presenting issue but also has to address the habits of restricted movement and posture which have built up in response to the pain. This takes time and you might have off-days along the way, which is normal. It’s important to remember that setbacks don’t mean that progress is all lost or treatment has failed. And we’ll be there to support you.
Simple self-help steps that may help in the meantime
While you’re deciding whether to seek an assessment or waiting for your appointment, there are simple things that most people find helpful.
- Keep moving. You may be tempted to sit still or even rest in bed because of back pain, but this will almost definitely make things worse. Comfortable movements that are part of your daily routine, like gentle walking or normal household tasks, will prevent you from stiffening up. Joints need movement to stay lubricated and allow blood flow to circulate better. Spinal discs lose fluid when they’re under prolonged pressure too (like staying in one seated position) so moving around redistributes stress and allows them to “plump up” again.
- Don’t get stuck. Whether you’re working at a desk all day long or sitting down watching television in the evening, remind yourself to move every 20 to 30 minutes or so. Aim to shift your position regularly because even apparently relaxed muscles are being held in position through tension, which builds up lactic acid. You can set a timer on your phone to remind you to move, if you need to.
- Sleep position matters. Put a pillow between your knees when you lie on your side or put one under your knees when lying on your back. This eases pressure on the lower back during the night.
- Gentle exercises. Try some slow, controlled movements like knee-to-chest stretches or the cat-cow exercise. This video shows you some more suggestions.
Red flags: when to take it easy, and when you need urgent advice
Most back pain is not dangerous, but a small number of symptoms need prompt medical attention rather than a chiropractic or physiotherapy appointment. Please seek urgent medical care (call 999 or go to A&E) if you experience:
- Numbness around the saddle area (inner thighs, genitals or around the back passage)
- New difficulty controlling your bladder or bowel, or loss of sensation when using the toilet
- Sudden, unexplained weakness in one or both legs, or difficulty walking that comes on quickly
- Back pain following significant trauma, such as a fall or road traffic accident
- Fever, unexplained weight loss, or a history of cancer alongside new or worsening back pain
These can, rarely, indicate a serious problem such as cauda equina syndrome, which needs same-day medical assessment. Everyday stiffness, aching or pain that worsens with certain movements is not in this category and is very common. If in doubt, your GP or NHS 111 can help you work out which category you’re in.
When a professional assessment is sensible
Don’t wait until back pain becomes unbearable. Book online here for a first appointment or even just a free phone consultation if you recognise yourself in the list below.
- Back pain lasting more than a few weeks without improvement
- Broken sleep due to discomfort when lying down in bed
- You’ve changed your daily activities to fit round the back pain
- It’s happened before and keeps coming back
- You’re not sure whether the pain comes from muscles, nerves or even exactly where it starts from
- The stress of dealing with it is wearing you out
At Sundial, an appointment does not commit you to a long course of treatment. We will find out, explain and then treat what is actually happening to cause your pain. We’ll suggest how to get yourself better in the quickest possible time span.
Frequently Asked Questions
Is chiropractic treatment safe for people over 45? For most people, yes. Chiropractic care is generally well tolerated, and serious complications are rare when treatment is delivered by a registered, appropriately trained practitioner following a proper assessment. As with any physical treatment, some mild soreness after a first session is common and usually settles within a day or two.
Will I need to keep going forever once I start? No. A well-run course of care has a clear purpose and is reviewed regularly. Many people are seen for a defined number of sessions to address a specific episode, with the goal of building enough strength, mobility and confidence to manage independently, sometimes returning for occasional maintenance if that suits them, but this is a choice, not a requirement.
Can chiropractic help sciatica as well as general back pain? Sciatica (nerve-related leg pain, often from the lower back) can respond to a combination of manual therapy, targeted exercise and advice, but it depends on the underlying cause. It’s a good example of why assessment matters before treatment, as sciatica needs a slightly different approach to straightforward lower back stiffness.
What’s the difference between seeing a chiropractor and a physiotherapist for back pain? Both are trained to assess and treat musculoskeletal pain, and there’s genuine overlap in what they offer, including hands-on treatment and exercise-based rehabilitation. Chiropractors tend to have a particular focus on spinal joint assessment and manipulation, while physiotherapists often bring a broader rehabilitation and movement-retraining focus. At a multidisciplinary clinic, the honest answer is often that either is a reasonable starting point, and your assessment will guide what’s genuinely most useful for your presentation.
How soon should I expect to feel a difference? It varies, but many people notice some change within the first few sessions, with fuller improvement building over several weeks as strength and movement improve. Long-standing or recurrent pain tends to take longer to settle than a recent flare-up.
Do I need a GP referral to see a chiropractor or physiotherapist privately? No. You can book directly for a private assessment. If your assessment suggests something needs medical investigation or GP input, we’ll explain that clearly and support you in taking the next step.
Sources
Rubinstein et al., BMJ 2019;364:l689. Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials
NICE NG59: Low back pain and sciatica in over 16s: assessment and management
Hayden JA, Ellis J, Ogilvie R, et al. “Some types of exercise are more effective than others in people with chronic low back pain: a network meta-analysis.”
About Matthew Bennett, Chiropractor Brighton
Matthew Bennett is the founder and principal chiropractor at Sundial Clinics Brighton, established in 1991. With over 35 years of clinical experience, Matthew qualified from the Anglo-European College of Chiropractic in 1987 and served as President of the British Chiropractic Association for four years. As a Fellow of the Royal College of Chiropractors and former team chiropractor for Brighton and Hove Albion FC and the British Alpine Ski Team, Matthew combines evidence-based chiropractic treatment with sports performance expertise. His authority in musculoskeletal health has been recognised through national media appearances, expert witness roles and contributions to professional publications. Matthew’s commitment to clinical excellence ensures patients receive the most effective chiropractic care in Brighton.