Low Back Pain

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Sayer Clinics Advice on Low Back Pain

In the UK a third of the population are suffering with back pain and up to 80% of the adult population will suffer significant back pain at some time in their life.

Back pain may be referred to the hip, groin, buttocks, the leg and foot as sciatica .The main causes of most low back pain are muscular weakness and postural strain due to being overweight, sitting too much, lack of exercise, unequal leg-length, trauma or over-exercise. Sometimes it is the cushion between the bones (intervertebral disc) which bulges (herniates) and compresses spinal nerves.
Chiropractors at Sayer clinics diagnose using modern digital computed x-rays, where appropriate, a thorough spinal and postural examination using chiropractic and orthopaedic tests of your joints, ligaments, tendons and muscles and neurological tests of your reflexes, muscular strength and sensory changes.

Digital Computerised X-Rays may be taken while the patient stands, so that major curvature and disc compression can be shown.X-rays may also detect congenital spinal abnormalities, bone cancer and fractures following trauma or due to osteoporosis – brittle bones.


Treatment may involve gentle and specific spinal mobilisation, manipulation, massage and/or postural re-education and exercises, soft-tissue therapy, acupuncture, laser, ultrasound.

Where examination indicates a large disc prolapse with significant neurological symptoms and signs an MRI scan will be arranged and neurosurgical referral made without delay.

Acute or short-term low back pain

Most acute back pain is mechanical in nature – the result of trauma to the lower back or a degenerative disorder such as osteoarthrosis where joints have gradually stiffened, become inflamed and started to calcify through reduced mobility.Pain from trauma may be caused by a sports injury, work around the house or garden, a sudden jolt such as a car accident / whiplash or repetitive stress to spinal bones and tissues.Symptoms may range from muscle aches to shooting or stabbing pain, limited flexibility and joint range of motion or an inability to stand straight.Pain felt in one part of the body may “radiate” or be referred from an injury or disorder elsewhere in the body. Some acute pain syndromes can become more serious if left untreated.

Chronic back pain

Chronic back pain is pain that persists for more than 3 months. It is important to diagnose and treat spinal dysfunction sooner rather than later to avoid further gradual degeneration of spinal joints.

The back is an intricate structure of bones, muscles, and other tissues that form the posterior part of the body’s trunk, from the neck to the pelvis. The centerpiece is the spinal column, which not only supports the upper body’s weight but houses and protects the spinal cord – the delicate nervous system structure that carries signals which control the body’s movements and convey its sensations.

The spinal column consists of over 30 vertebrae which contain round holes which, when properly aligned with all the others, create a channel that surrounds the spinal cord. The spinal cord descends from the base of the brain and extends in the adult to just below the rib cage.

Small nerves (“roots”) enter and emerge from the spinal cord through spaces between the vertebrae. Because the bones of the spinal column continue growing long after the spinal cord reaches its full length in early childhood, the nerve roots to the lower back and legs extend many inches down the spinal column before exiting. This large bundle of nerve roots is called the cauda equina, or horse’s tail.

The spaces between the vertebrae are maintained by round, spongy pads of cartilage called intervertebral discs that allow flexibility in the lower back and act like shock absorbers throughout the spinal column to cushion the bones as the body moves. Bands of tissue known as ligaments and tendons hold the vertebrae in place and attach the muscles to the spinal column.

There are seven cervical or neck vertebrae (C1–C7), 12 thoracic or upper back vertebrae (T1–T12), five lumbar vertebrae (L1–L5 and the sacrum are bones fused together at the base of the spine with the coccyx or tailbones which have a variable number of moveable joints.

Causes of low back pain

As we age, our bone strength, muscle elasticity and tone tend to decrease. Discs lose fluid and flexibility which decreases their ability to cushion the vertebrae.
Pain can occur when you lift something too heavy or overstretch, causing a joint locking or displacement (subluxation) or a sprain, strain or spasm in one of the muscles or ligaments in the back or a disc may prolapse or bulge. This can put pressure on one of the more than 50 nerves rooted to the spinal cord that control body movements and transmit signals from the body to the brain. When these nerve roots become compressed or irritated, back pain results.

Low back pain may reflect nerve or muscle irritation, joint locking or bone lesions. Most low back pain follows injury or trauma to the back, but pain may have other factors such as degenerative conditions such as arthrosis or disc disease, osteoporosis or other bone diseases, viral infections, irritation to joints and discs or congenital abnormalities in the spine.

Obesity, smoking, weight gain during pregnancy, stress, poor physical condition, poor posture and poor sleeping position also may contribute to low back pain. Additionally, scar tissue created when an injured back heals itself does not have the strength or flexibility of normal tissue. A build-up of scar tissue from repeated injuries eventually weakens the back and can lead to loss of normal flexibility and function and more serious injury can result.

Occasionally, low back pain may indicate a more serious medical problem. Pain accompanied by fever or loss of bowel or bladder control, pain when coughing and progressive weakness in the legs may indicate a severely compressed nerve or other serious condition. People with diabetes may have severe back pain or pain radiating down the leg related to neuropathy. People with these symptoms should contact their Chiropractor or GP immediately to reach a diagnosis and find the optimal help to prevent more permanent damage.

Conditions that may cause low back pain and require treatment :

Bulging disc – protruding, prolapsed, herniated or ruptured disc.The intervertebral discs are under constant pressure and may degenerate and weaken, cartilage can bulge compressing a nerve root, causing pain, weakness, numbness and loss of reflexes..A rare and serious complication of a ruptured disc is cauda equina syndrome, which occurs when disc material is pushed into the spinal canal and compresses the bundle of lumbar and sacral nerve roots. Permanent neurological damage may result if this syndrome is left untreated.


Sciatica is a condition in which a herniated or ruptured disc presses on the sciatic nerve, the large nerve that extends down from the lower back to its exit point in the pelvis and carries nerve fibres to the leg. Sciatic nerve compression causes shock-like or burning low back pain combined with pain through the buttocks and down one leg to below the knee, occasionally reaching the foot. In the most extreme cases, when the nerve is pinched between the disc and an adjacent bone, the symptoms involve not pain but numbness and some loss of motor control in the leg due to interruption of nerve signalling.


Spinal degeneration – Osteoarthrosis and Spinal Stenosis. Disc wear and tear can lead to a narrowing of the spinal canal especially if the spine has become twisted or curved laterally – scoliosis. A person with spinal degeneration may experience stiffness in the back on waking and leg pain (sciatica) during walking or while standing for a long time. Specific and careful chiropractic spinal mobilisation and postural changes aim to reduce curvatures and improve symptoms.


Osteopenia / Osteoporosis is a metabolic bone disease marked by progressive decrease in bone density and strength. Fracture of brittle, porous bones in the spine and hips results when the body fails to produce new bone and/or absorbs too much existing bone. Women are four times more likely than men to develop osteoporosis.

We are often the first to diagnose osteopenia ( low bone density) which may show on our digital computed x-rays. We then refer to the patient’s GP for a bone density Dexascan and appropriate medical treatment to improve bone density.


Scoliosis Kyphosis and Lordosis Skeletal irregularities and postural imbalances produce strain on the vertebrae and muscles, tendons, ligaments and tissues supporting the spinal column. These irregularities include scoliosis, a lateral curve or series of curves of the spine to the side; kyphosis, in which the normal curve of the upper back is rounded; lordosis, an abnormally accentuated forward sway in the lower back or neck .A detailed scoliosis assessment ( which may include computed digital xrays ) and expert spinal manipulation and specific exercises can help to straighten and mobilise curvatures and minimise spinal pain and stiffness. Click on : Scoliosis & Postural Correction


Fibromyalgia is a poorly understood chronic disorder characterized by widespread musculoskeletal pain, fatigue, and multiple “tender points,” particularly in the neck, spine, shoulders, and pelvis. Additional symptoms may include sleep disturbances, morning stiffness, bowel sensitivity and anxiety.


Spondylosis refers to chronic back pain and stiffness and Spondylitis to inflammation of the spinal joints. Other painful inflammations in the lower back include osteomyelitis (infection in the bones of the spine) and sacroiliitis (inflammation in the sacroiliac joints).


Back Pain Diagnosis at Sayer Clinics Our Chiropractors take a thorough medical history and perform a physical examination to identify any conditions or family history that may be associated with the pain.
We thoroughly examine the spine and conduct neurologic and orthopaedic tests to diagnose the cause of pain and enable us to provide effective treatment and intelligent advice. Blood tests and xray or MRI imaging may be necessary to diagnose the source of the pain. We make specific referrals to medical specialists when indicated.


Spinal X-rays may help diagnose the cause and location of back pain and look for broken bones or an injured or malpositioned vertebra and shows bony structure and any disc narrowing , osteoarthrotis , joint degeneration or vertebral misalignment.


Magnetic resonance imaging (MRI). We can, without delay, refer patients for private MRI of the spine or joints to help diagnosis of disc prolapse or disease in nerves, muscles, ligaments or blood vessels.


Chiropractic treatment at Sayer Clinics

Sayer Clinics aims to remobilise displaced or locked vertebrae, reducing inflammation, restoring proper function and strength to the back and preventing recurrence of the injury through postural rehabilitation.

Back pain may be referred to the hip, groin, buttocks, the leg and even into the foot as sciatica .

The main causes of low back pain are muscular weakness and postural strain due to being overweight, sitting too much, lack of exercise, unequal leg-length, trauma or over-exercise. Sometimes the cushion between the bones (intervertebral disc) bulges (herniates) and compresses nearby nerves.

Ice (the use of cold compresses) can help reduce pain and inflammation and allow greater mobility. As soon as possible following trauma, you should apply a cold pack or a cold compress (such as a bag of ice or bag of frozen vegetables wrapped in a towel) to the tender spot several times a day for up to 20 minutes.

Bed rest for more than a day or so following onset of low back pain may prolong symptoms and can lead to secondary problems such as decreased muscle tone. You should resume activities as soon as possible. At night or during rest, you should lie on one side, with a pillow between your knees or lie on your back and put a pillow under your knees).

Exercise at the right point in your recovery, is the best way to speed recovery from low back pain and help strengthen back and abdominal muscles. Maintaining and building muscle strength is particularly important for persons with skeletal irregularities. Chiropractors and physical therapists provide a list of gentle exercises which help keep muscles and joints moving and speed the recovery process. A routine of back-healthy activities may include stretching exercises, swimming, walking, and movement therapy to improve coordination and develop proper posture and muscle balance. Pilates and Tai Chi are excellent means to gently stretch and strengthen muscles and ease pain.

Medications are often used to treat acute and chronic low back pain. NSAIDs -Non-steroidal anti-inflammatory drugs eg ibuprofen are unsafe during pregnancy and can cause side effects including drowsiness or stomach irritation with prolonged use. Opioids such as codeine, oxycodone, hydrocodone and morphine, if medically prescribed to manage severe, acute and chronic back pain can produce side effects of drowsiness, decreased reaction time, impaired judgment and potential for addiction.

Spinal manipulation is a safe “hands-on” approach in which professionally registered chiropractors and osteopaths use specific spinal manipulation and a series of exercises to mobilise spinal structures, restore back mobility and function and gradually rehabilitate posture.

Acupuncture involves the insertion of very fine needles at precise points throughout the body to trigger the release of naturally occurring opioid molecules and stimulate the brain to stimulate healing.

Massage and physical therapy (Laser, Ultrasound and Electrotherapy) are therapeutic for muscle, tendon and ligament damage or injury.

Sayer Clinic advice for a healthier back.

Following any period of prolonged inactivity, gradually start regular low-impact exercise. Walking, swimming or cycling 30 minutes a day will increase muscle strength and flexibility. Pilates and Tai Chi can also help stretch and strengthen muscles and improve posture. Ask your chiropractor for a list of low-impact exercises designed to strengthen lower back and abdominal muscles.

Don’t slouch when standing or sitting. When standing, keep your weight balanced on your feet without most of your weight on your heels. Your back supports weight best when spinal curvatures are reduced.

Sit in a chair with good lumbar support and proper position and height for the task. Keep your chest up and don’t poke your head forward. Change sitting positions often and periodically walk around the office or gently stretch to relieve tension. Wear comfortable, low-heeled shoes.

Sleep on your side or back to reduce excessive twisting in your spine. Ideally sleep on a fairly firm mattress.

Don’t try to lift objects too heavy for you. Lift with your knees bent, pull in your stomach muscles, and keep your head down and in line with your straight back. Keep the object close to your body. Do not twist when lifting.

Maintain proper nutrition and diet to reduce and prevent excessive weight which puts a chronic strain on lower back discs and muscles. A good diet without processed food and with sufficient daily intake of calcium, phosphorus and vitamin D helps to promote new bone growth.

If you smoke, stop. Smoking reduces blood flow to the spine and worsens spinal disc degeneration.


Call Ines or Maggie on 020 7937 8978 to make an appointment from 8am to 8pm – we’re here to help you.



There are three Sayer Clinics throughout London.

Each Clinic offers a variety of services for:

  • back pain relief
  • lower back pain relief
  • neck pain, stiff back
  • neck pain, headaches
  • chronic back pain relief


Treatments include Chiropractic, Medical Acupuncture, Physical Therapy and Therapeutic Massage.


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