Frequently asked questions

Click on the headings to view the answers to these frequently asked physiotherapy questions.

Spinal / lower back pain

  • The best treatments for lower back pain are exercise, education and medication (National Institute for Health & Care Excellence, Lower Back Pain Guidelines 2016).
  • 2 years after a spinal operation for leg pain the improved outcomes are the same as having not had an operation.
  • 1540 patients per year are seen by a Spinal Specialist, only 33% (508) need imaging investigations and only 23% (354) go on to have an injection.

  • A MRI scan is used mostly to identify if a nerve is trapped (which would result in arm or leg pain) not to identify the source of lower back pain.
    • 70% of trapped nerves causing leg or arm pain will settle within 4 months.
    • 90% of trapped nerves settle within 1 year.
  • 8000 Spinal patients are treated in Physiotherapy Out-patients per year, only 19% (1540) need to be seen by a Spinal Specialist.

  • The only causes of lower back pain that imaging investigations can identify are fractures, tumours or inflammatory arthritis like Ankylosing Spondylitis. These are relatively rare or very rare to occur.
  • Nerve injections are for leg/arm pain only NOT numbness/tingling or weakness as they do not help.
  • 20% of patients following spinal surgery for leg pain need a repeat operation within one year.
  • 1540 patients per year are seen by a Spinal Specialist, only 6% (92) go on to have surgery.

  • People with low back pain with or without leg pain who are being referred for specialist opinion, may not need imaging (National Institute for Health & Care Excellence, Lower Back Pain Guidelines 2016).
  • 80% of 50 year olds will have disc wear on a MRI scan and have no symptoms, these findings are normal.
  • 40% of 30 year olds and 50% of 40 year olds will have a disc bulge on a MRI scan and have no symptoms. Disc bulges are common findings.

  • Surgical treatment for lower back pain has only a 50% success rate and is limited to either.
    • Killing the nerve that serves the small joints in the spine.
    • Fusing the spine at one or more levels.
  • Injections for lower back pain are not recommended by National Institute for Health and Care Excellence, they only have an approximate 30% success rate, reducing the pain only on average 2-4 months.
  • Lower back pain is common, 80% of the UK population will have an episode in their lifetime.

Physiotherapy, spine, lumbar, and related information leaflets.