Back pain treatment that targets the root cause

Detailed history of pain behaviour (what eases it? what worsens it?), movement screening including repeated movement testing (McKenzie method) to identify directional preference, neurological exam for radicular signs, and spinal segmental mobility assessment.

Directional preference exercises (extension or flexion bias), manual therapy (segmental mobilisation, soft tissue release for protective paraspinal spasm), ergonomic modification for sitting and sleeping postures, and pain neuroscience education to de-threaten the experience.

Progressive deep stabiliser activation (transversus abdominis, multifidus), lumbo-pelvic motor control training, hip mobility work (tight hip flexors and hamstrings are common contributors), and introduction of functional loading patterns.

Progressively loaded spinal movement in all planes (flexion, extension, rotation, lateral flexion), lifting mechanics training, sport-specific or occupation-specific conditioning, and a long-term maintenance program to prevent recurrence.