Chronic Neck & Back Pain Management

Lower back pain is the leading cause of disability globally. Neck pain is the second most common musculoskeletal complaint in South African primary care. Both are among the most responsive to skilled physiotherapy intervention, and both are among the most frequently managed with approaches (prolonged rest, passive treatments, imaging-guided interventions) that the evidence consistently shows to be inferior to active, exercise-based physiotherapy.

At this practice, chronic neck and back pain is managed through a combination of manual therapy techniques that reduce pain and restore movement, dry needling targeting the deep cervical and lumbar multifidus muscles that consistently show inhibition and disuse in chronic spinal pain presentations, progressive exercise prescription that rebuilds the strength and endurance of the spinal stabilising system, and postural and ergonomic correction that addresses the daily loading patterns perpetuating the condition. For patients who have been told their back pain is due to disc degeneration or arthritis visible on an MRI, it is important to understand that imaging findings correlate poorly with pain and that the presence of degeneration does not mean the pain cannot be resolved. The tissue does not need to be normal for the pain to improve. It needs to be loaded appropriately, moved correctly, and managed with the right clinical tools.