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Management of Back Pain | Physio Penrith

Updated: Jan 13, 2020

Spinal pain can be from a number of different pathologies, injuries or impairments and should usually be triaged into three main categories:

1. Serious pathology- fracture, malignancy, infection, etc.

2. Nerve root pathology- radicular pain or radiculopathy

3. Mechanical back pain- movement or lack thereof related spinal pain

The most common form of back pain is mechanical back pain that is seen in >90% of people. There are a number of treatment options and a combination of these favours a faster and more resilient outcome.

Spinal manipulation

Factors favouring: hypomobility during spring test, low FABQ scores (FABQW <19), hip internal rotation >35º.

Factors against: symptoms below the knee, symptoms that peripheralise with directional testing, increasing episodes of back pain, no pain on spring test.

Specific exercise or movement

Factors favouring: directional preference for extension or flexion, centralisation with motion testing, peripheralisation in direction opposite to centralisation movement.

Factors against: low back pain only, status quo with all movements.


Factors favouring: hypermobility with spring testing, increasing episode frequency, three or more prior episodes.

Factors against: discrepancy in SLR >30º, low FABQ scores (FABQPA <9)

At Sydney Muscle & Joint Clinic our approach is consistent, high quality and based on the best scientific knowledge. We deliver evidence-based physiotherapy, exercise physiology and chiropractic for a range of musculoskeletal conditions, which means you get an approach that is effective, safe, and efficient. Contact your local Penrith physio today.

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