Back and lower back pain
Back pain physiotherapy, Hobart
The reason it keeps coming back is usually the same: the pattern that's driving it was never addressed.
Most people who come to us with back pain have had it before. They've tried massage, stretching, maybe a round of physio. It helped for a bit. Then it came back.
Book initial assessment Our approach
No referral needed. All major health funds.
- No referral needed
- All major health funds
- GP care plans accepted
- Hobart
Your back probably isn't weak.
Most people come in believing their back is weak. That's what they've been told. Sometimes it's true, but more often the real problem is the opposite.
What we see most is an extension bias. The back is overworking because the muscles that should share the load, glutes, deep core and hamstrings, aren't doing their job. The back isn't weak. It's exhausted from doing everyone else's work.
Extension bias and facet loading
Glutes, hamstrings and deep core aren't sharing the load, so the facet joints and erectors cop everything. Feels like stiffness, fatigue and that jamming sensation with certain movements.
Disc-related pain
Disc bulges, herniations, degenerative changes. Can refer into the glutes or legs. Often sounds scarier than it is. The scan doesn't tell the full story.
SIJ dysfunction
One-sided lower back or buttock pain. Often confused with disc pain or nerve symptoms. We look for the loading imbalance driving it.
Muscle and coordination issues
The right muscles aren't firing in the right order. The body still gets the job done, but the wrong structures take the load.
People avoid bending, move with an extension bias, and load the facet joints and back extensors over and over. More extension work doesn't change that. The answer is offloading the back by reloading the hamstrings and glutes, then bringing bending and arching back in the right order.
What's actually driving it.
Think of a square pulled from all four corners equally. That's a balanced joint. Stop using one corner and the other three overwork, the joint loads unevenly, and that's where the wear happens. Back pain is rarely one thing.
Flexion avoidance
Bending with a stiff spine, never loading through the hamstrings. Over time the back extensors do everything, and eventually they can't keep up.
Muscle inhibition
Glutes, deep core and hamstrings that aren't switching on properly. You get stronger in the wrong places and weaker where it matters.
Exceeded capacity
Moving house, a new program, a long day at work. Your back wasn't conditioned for what it was asked to do.
Incomplete rehab
The last episode settled and treatment stopped, but the pattern that drove it was never sorted. The most common reason backs keep flaring.
The whole picture
Stress, sleep, nutrition and isolation all amplify pain. We look at all of it, not just the joint.
Fear and pain memory
Having had back pain changes how you move. You protect. You avoid. The avoidance becomes the problem.
Sound familiar?
- Stiff in the morning, eases once you're moving, then builds again through the day
- A sharp catch when bending, lifting or rolling over in bed
- Aching that builds with sitting, especially driving or long flights
- Pain into one or both buttocks, and you think it might be the disc
- Can't stand up straight after sitting. Takes a few steps to get going
- Scared of bending. You bend your knees for everything
- It's come back again, and this time you want to actually sort it
- It's stopping you hiking, lifting, playing with your kids, or doing what you love
The By Design approach to back pain.
We don't have a back pain protocol. We have a process for finding your pattern, and that decides everything else.
Find the pattern
Bending, arching, rotating. Squat, lunge, single leg. We're looking for the movement sequence that puts your back in the wrong position under load.
One or two exercises
Not a list of ten. The one or two things that make the biggest difference right now, sent with video so you can't get it wrong.
Explain what's happening
We walk you through the anatomy, link your scan to what we found, and show you why your back has been doing what it's doing.
Hands-on when needed
Joint mobilisation, manual therapy, dry needling where appropriate. Not the end goal, just enough to start loading the right structures.
Progressive loading
Once you can hinge and brace, we head into the gym and add load. Building the capacity your back needs for real life.
Graded exposure
The movement that scared you most: we bring it back step by step, until it's just normal again.
Where you're headed.
Calm
Basic control through the lower back and pelvis. Moving without fear.
Coordination and capacity
Hinge, pelvic tilt, bracing, glute control. Light load many times, then heavier.
Challenge
Strength training for life, in the gym. Where clients stay.
We measure it. You see it.
Your starting point is different from everyone else's, so we track your measures instead of handing you a generic recovery timeline. A typical set looks like this.
| Measure | First session | Re-test | What decides the next step |
|---|---|---|---|
| Bending forward | How far, and where it catches | Same test, same way | Moving freely, we load the hinge |
| Sitting tolerance | How long before it aches | Same chair, same timer | Tolerance up, longer days and drives |
| Glute and trunk strength | Bridge and brace holds | Same holds, more load | Controlled under load, into the gym |
Keep building once the pain's gone.
Phase three happens in our own gym. When you're ready, Strength By Design is where that work carries on, coached and physio-designed.
What makes us different.
We look at how you move
Not just where it hurts. The movement sequence, the coordination, the pattern you've been avoiding.
Strength is the treatment
Pain relief is the start. Loading the right muscles in the right order is what builds a back that handles the load.
We explain the why
You leave every session knowing more about your back than when you arrived.
Graded exposure
The movement that scared you, brought back step by step until it's normal again.
One standard of care
Every physio works to the same assessment-led method, every session.
Progress you can see
We measure where you start and re-test as you go, so you always know where you're at.
Common questions about back pain.
My scan shows a disc bulge. Does that mean I need surgery?
Scans often look worse than the clinical picture, and many people with significant findings on imaging have no pain at all. What matters is your scan in the context of how you move and what's loading your back. We'll walk you through what yours means for your situation.
I've been told my core is weak. Is that right?
Sometimes. More often the back is overworking, because the glutes, hamstrings and deep core aren't doing their share. Generic core work without sorting that pattern can make things worse. We look at the movement sequence first.
Should I rest or keep moving?
Keep moving, within your tolerance. Complete rest tends to make back pain worse over time. The key is the right type and amount of movement for your presentation.
I've had physio before and it didn't last. Why would this be different?
Treatment often stops when the pain settles, before the pattern is sorted and the capacity is built. We don't discharge at the point pain eases. That's where the capacity work starts.
Do I need a referral?
No. You can book directly without a GP referral, unless your insurer or GP has specified otherwise. If you have a GP care plan (CDM or EPC), we accept it: you pay the full fee, we lodge the Medicare claim for you, and Medicare pays the rebate to you.
Ready to get on top of your back pain?
No referral needed. All major health funds. Hobart.
Or call or text 0483 947 716, or email hello@bydesignphysio.com