Lower back pain is one of the most common things I treat, and it affects around 80% of people at some point in their lives, so that's not surprising. The most frequent presentations are muscular strains, facet joint problems, and intervertebral disc issues.

What does surprise people is the range of individuals affected. Athletes and people in physically demanding jobs come in with wear from years of heavy loading, repeated bending, and extension. But I see just as many desk workers, drivers, and caregivers whose lower backs are struggling from the opposite problem - too much sitting, not enough movement, and poor lifting habits when they do move.

The common thread across all of them is usually the same: poor lumbo-pelvic control and muscle imbalances that put the lumbar spine under more load than it should be handling.

Because exercise helps - but only if it's the right exercise. This is one of the most common frustrations I hear. People are doing something, they just haven't identified what the back actually needs yet.

Lower back tightness that persists despite exercise is almost always telling you that one or more of these things isn't being addressed:

• Anterior pelvic tilt - the pelvis is tipping forward and loading the lumbar spine constantly. Abdominal strengthening with a Posture Pro Dome is the fix
  
• Stiff thoracic spine - if the upper back isn't moving, the lower back compensates. The Dome helps here too
  
• Tight lats and hamstrings - both pull on the pelvis and lumbar spine. Stretch both with a Stretchband
  
• Glute Med and ITB tightness - trigger both with a Pocket Physio MAX
  
• TFL fascial tightness - release it with a Foam Roller or Footeez
  

Address all five and the exercises you're already doing will start to work properly.

Build the foundation before it becomes a problem. Most lower back pain is predictable and preventable. It shows up when the structures supporting the lumbar spine are underperforming for long enough.

The non-negotiables:

• Core strength - specifically the deep stabilisers that control pelvic position. A Posture Pro Dome is designed for exactly this
  
• Thoracic mobility - a stiff upper back shifts load onto the lower back. Keep it moving with a Posture Pro roller
  
• Posterior chain flexibility — tight lats and hamstrings create constant tension through the lumbar spine. A Stretchband used consistently makes a real difference
  
• Regular muscle release - trigger the Glute Med, ITB, and TFL with a Pocket Physio MAX and roll out fascial tightness with a Foam Roller or Footeez
  

Do these consistently and you're maintaining the system that protects your lower back, not just reacting when it breaks down.

Two main categories. The first is stress fractures. These are overuse injuries rather than single-event trauma, caused by repetitive loading through the lumbar spine over time. I see them most in cricket bowlers and young athletes going through intense training during growth phases. Get it diagnosed early, allow it to heal properly, and then address any technical issues in the sport or movement pattern that caused it...because without that last step, it comes back.

The second is acute compressive disc injuries. These do have a clear moment of onset, usually from a sudden twisting and lifting movement combined. The pain is immediate and often severe. These need proper imaging to assess the extent of the injury before any rehab begins, and management depends entirely on what the imaging shows.

It depends entirely on what you're dealing with, which is why imaging isn't optional here:

• Minor disc complaint - around 6 weeks with the right management
  
• Significant protrusion or prolapse - up to 12 weeks, sometimes longer depending on nerve involvement
  
• Surgical cases - up to 12 months before return to full training

MRI is usually the most useful. It shows the disc, the nerves, and the surrounding structures in a way that X-ray can't. Don't guess at severity with a disc injury. The difference between a minor irritation and a prolapse can look identical from the outside, but the management is completely different. Get it imaged, get an accurate diagnosis, and build the program from there.