Lower back pain
Lower back pain is the most common reason for a visit about musculoskeletal problems. In the vast majority of people it is non-specific pain, which means there is no single structure that can be shown on a scan and labelled as the culprit.
The pain can appear suddenly when lifting or bending, or it can creep up over weeks as stiffness that is worst in the morning and flares up again after sitting for a long time.
What keeps the pain going
Prolonged rest is among the most common reasons recovery drags on. Lying down for more than a few days weakens the muscles, reduces mobility and often prolongs the pain.
Fear of movement, poor sleep, long-term stress and a sudden increase in physical load, for example moving house or weekend renovations after months of sedentary work, also contribute to this.
Sitting in itself is not the culprit, but sitting for long periods without a break makes symptoms worse. Changing position every few tens of minutes does more than searching for the perfect chair.
When not to go to a physiotherapist but to seek emergency help immediately
If you have numbness in the area between the legs, the genitals or the inner thighs, problems passing urine or opening your bowels, or sudden weakness in the legs, call 112. These are signs typical of compression of the nerve roots in the lower part of the spinal cord and require immediate action.
Pain after a serious fall or a road traffic accident, especially in older people or people with osteoporosis, needs a medical assessment before any therapy.
You also need a medical assessment before physiotherapy if you have fever and chills with lower back pain, pain that regularly wakes you at night and does not ease in any position, unintentional weight loss, a history of cancer, or pain spreading into the leg below the knee together with loss of strength.
When imaging makes sense
With non-specific lower back pain, routine imaging does not improve the course and often does not change treatment. Bulging intervertebral discs and wear-related changes are also found in a large proportion of people who have no symptoms at all.
Imaging is justified with the warning signs in the previous paragraph, after a serious injury and when a procedure is being considered.
A report without context can do harm. A diagnosis read off a scan often convinces people that their spine is damaged, and it is precisely this belief that slows the return to movement.
What care with a physiotherapist involves
The first session is largely a conversation and an examination. The physiotherapist asks about the course of your symptoms, what makes them worse and what eases them, and about your work and exercise habits, then assesses mobility, strength and movement control. A plan is made from this.
The core of care is therapeutic exercises that you continue at home, as it is regular exercise at home between visits that leads to the greatest progress. Manual therapy, muscle relaxation techniques and trigger point treatment are used as support, not as the whole treatment.
A physiotherapist does not make a diagnosis. If the response differs from what is expected or warning signs appear, they will direct you back to a doctor.
Physiotherapy at Medicinski center Ljubljana is self-pay; you do not need a referral. Appointments are booked with the clinic that runs the service. Come to your session in comfortable clothes and bring any results you have.