Back pain can affect the upper, middle or lower part of the back, with symptoms ranging from localised aching and stiffness to pain that affects movement or daily activities. The possible factors involved can differ depending on where the pain occurs, how it started and whether symptoms extend into other areas.
At One Spine Chiropractic and Physiotherapy, we assess back pain before discussing appropriate care options. Depending on your presentation and individual needs, this may involve chiropractic care, physiotherapy, rehabilitation or other suitable forms of support.
Where Is Your Back Pain?
The back includes different regions, and symptoms can vary according to the area involved. Identifying where you feel discomfort is useful, but location is only one part of understanding a back-pain presentation.
Upper Back
Where: Between the neck and lower rib-cage area.
Aching, burning, muscle tightness, stiffness or discomfort around the shoulder blades may occur.
Mid Back
Where: Central thoracic region.
Dull or sharp discomfort, stiffness with bending or rotation, or tenderness around the ribs may occur.
Lower Back
Where: Lumbar region.
Dull or sharp pain, muscle spasm, difficulty bending or standing, and sometimes symptoms towards the buttocks or legs may occur.
| Area | Where You May Feel It | Common Features |
|---|---|---|
| Upper Back | Between the neck and lower rib-cage area | Aching, burning, muscle tightness, stiffness or discomfort around the shoulder blades |
| Mid Back | Central thoracic region | Dull or sharp discomfort, stiffness with bending or rotation, tenderness around the ribs |
| Lower Back | Lumbar region | Dull or sharp pain, muscle spasm, difficulty bending or standing, sometimes symptoms extending towards the buttocks or legs |
The location of pain alone does not identify its cause. Assessment can help determine which physical factors may be relevant and whether symptoms require another form of medical evaluation.
Upper Back Pain
Upper back pain affects the thoracic area between the neck and lower rib cage. Symptoms may involve the muscles, joints or other structures around this region.
What Does Upper Back Pain Feel Like?
- Aching or burning around the shoulder blades
- Muscle tightness or stiffness
- Discomfort when twisting
- Pain associated with some movements or deep breathing
- Neck stiffness or headaches in some presentations
What May Contribute to Upper Back Pain?
- Prolonged or uncomfortable postures
- Repeated screen-based work
- Muscle strain or overuse
- Carrying loads
- Muscle tension
- Relevant spinal joint or disc-related factors
Mid Back Pain
Mid back pain occurs around the central thoracic region and may involve muscles, spinal joints or rib-related structures.
What Does Mid Back Pain Feel Like?
- Dull or sharp discomfort
- Stiffness when bending or rotating
- Symptoms associated with prolonged sitting or standing
- Tenderness around the ribs or surrounding muscles
What May Contribute to Mid Back Pain?
- Prolonged sitting positions
- Sudden twisting movements
- Muscle weakness or imbalance
- Sports or activity-related injuries
- Relevant joint-related factors
Lower Back Pain
Lower back pain affects the lumbar region and can vary considerably between individuals. Some people experience symptoms primarily around the back, while others may notice discomfort extending into nearby areas.
What Does Lower Back Pain Feel Like?
- Dull or sharp lower-back pain
- Muscle tightness or spasms
- Difficulty with bending, standing or walking
- Symptoms extending towards the hips or buttocks
- Numbness, tingling or leg symptoms in some nerve-related presentations
What May Contribute to Lower Back Pain?
- Lifting-related strain
- Prolonged sitting or reduced activity
- Muscle weakness or reduced physical capacity
- Disc-related changes
- Repetitive physical loading
- Age-related changes
- Previous injury
When Should Back Pain Be Assessed Promptly?
Back pain is often related to musculoskeletal factors, but some symptoms require prompt medical evaluation. This is particularly important when symptoms suggest a potentially more serious underlying problem rather than a routine musculoskeletal presentation.
Seek prompt medical assessment for symptoms such as:
- New or substantial weakness in the legs
- Significant or progressive loss of sensation
- New loss of bladder or bowel control
- Numbness around the saddle or groin area
- Severe back pain following significant trauma
- Back pain accompanied by other concerning systemic symptoms
This is not an exhaustive list. If you're unsure whether your symptoms are appropriate for chiropractic or physiotherapy assessment, medical evaluation or referral may be recommended depending on the presentation.
How We Assess Back Pain
Assessment helps us understand your symptoms before discussing whether chiropractic care, physiotherapy, rehabilitation or another next step may be appropriate.
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Understand Your Symptoms and History
We discuss where you feel discomfort, when it began, activities that affect it, relevant previous injuries and other health information.
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Perform Relevant Physical Assessment
Depending on the presentation, assessment may consider movement, mobility, muscle function and appropriate orthopaedic or neurological factors.
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Review Available Imaging When Relevant
If you already have relevant X-rays or MRI scans, these may be reviewed where appropriate. Imaging is not automatically required for every person with back pain.
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Explain Relevant Findings
We discuss what the assessment indicates and whether another form of evaluation or referral may be appropriate.
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Discuss Suitable Care Options
Where care is appropriate, we discuss available options and obtain your consent before proceeding.
How May Back Pain Be Managed?
Back pain management depends on the presentation rather than following one standard treatment programme. Different approaches may be considered according to assessment findings, physical needs and goals.
| Care Approach | How It May Be Used |
|---|---|
| Chiropractic Care | May address relevant spinal or joint mobility and musculoskeletal factors where appropriate |
| Physiotherapy | May focus on movement, strength, physical function and relevant musculoskeletal needs |
| Rehabilitation & Strengthening | May progressively build physical capacity and support return to relevant activities |
| Home Exercise | May be prescribed according to individual assessment findings and needs |
| Supportive Therapies | Selected modalities may be considered when relevant as part of a broader care plan |
Not every person with back pain needs the same combination of care. Recommendations depend on assessment findings, suitability, individual needs and response.
Chiropractic or Physiotherapy for Back Pain?
The appropriate approach depends on what is identified during assessment rather than the term “back pain” alone. Chiropractic care, physiotherapy and rehabilitation focus on different but sometimes overlapping physical needs.
Chiropractic Care
Chiropractic care may be considered where relevant spinal, joint or mobility factors are involved.
Physiotherapy & Rehabilitation
Physiotherapy may be considered where movement, strength, physical function or rehabilitation needs are relevant. Rehabilitation may incorporate progressive exercise and development of physical capacity where appropriate.
Some people may be suitable for one approach, while others may have needs involving more than one discipline. This is determined individually rather than assuming everyone with back pain requires both chiropractic care and physiotherapy.
What Can You Expect From Your First Visit?
A first visit generally takes around 45–60 minutes. The exact assessment and care provided depend on your symptoms, history and individual presentation.
Depending on your needs, the visit may include:
The purpose of the first visit is to understand your presentation, explain relevant findings and discuss appropriate next steps rather than assuming a particular treatment is required before assessment.
Why Practitioner Assessment Matters
Back pain can have different presentations, and similar symptoms do not necessarily mean two people need the same care. Practitioner assessment helps place your symptoms, physical findings and individual needs into context before recommendations are made.
You can meet our chiropractors and physiotherapists to review practitioner backgrounds and qualifications, or explore our patient experiences and treatment results for additional context about our care environment. Individual experiences and outcomes can vary.
Looking for Support for Back Pain?
If upper, mid or lower back pain is affecting your movement or everyday activities, our team can assess your symptoms and discuss which next steps may be appropriate. Care recommendations depend on your individual presentation, assessment findings and needs.
Frequently Asked Questions About Back Pain Treatment
Upper back pain generally affects the thoracic area below the neck and around the shoulder blades, while mid back pain occurs around the central thoracic region. Lower back pain affects the lumbar region and may sometimes be accompanied by symptoms extending towards the buttocks or legs. Location alone does not establish the cause.
Lower-back symptoms can extend into the buttock or leg for different reasons. In some presentations, nerve irritation or impingement may be relevant, but radiating pain does not identify the cause by itself. Our sciatica and nerve impingement guide explains nerve-related presentations in more detail.
The appropriate option depends on your assessment. Chiropractic care may be considered for relevant spinal, joint or mobility factors, while physiotherapy may be relevant when movement, strength, function or rehabilitation needs are involved. Some people may have needs involving more than one approach, while others may not.
A first visit generally takes around 45–60 minutes. The appointment may include consultation, relevant physical assessment, explanation of findings and discussion of suitable next steps, with treatment after consent where appropriate.
Imaging is not automatically required for every person with back pain. If relevant X-rays or MRI scans are already available, our practitioner may review them where appropriate. Whether additional medical imaging or referral is appropriate depends on the individual presentation.