Lower Back Pain: Assessment and Referral Information, Mosman

What this page covers

This page explains what lower back pain is, what a musculoskeletal assessment looks at, and the circumstances in which you should see a GP or an emergency department rather than a chiropractor. It does not tell you what chiropractic care will do for your back, because that varies from person to person and we are not able to promise an outcome.

Pain in the lower back is a symptom, not a diagnosis in itself. The same area can be uncomfortable for very different reasons, and the reason matters, because it changes what should happen next. That is why an assessment starts with questions rather than with hands on the spine.

What can bring lower back pain on

Everyday things account for most of it. Lifting something awkwardly. A sudden twist while getting out of a car. Hours at a desk. The accumulated load of a busy week. Often there is no single moment at all, and the ache simply builds over days.

Common musculoskeletal contributors include:

Strain of the muscles and ligaments around the lower back and pelvis
Irritation of the small joints at the back of the spine
Changes in the discs that sit between the vertebrae
The way load is shared between the hips, the pelvis and the lower back
Long periods held in one position, at a desk, in a car or on a plane

Lower back pain sometimes comes from something outside the musculoskeletal system altogether. That is uncommon, but it is the reason a good history asks about your general health and not only about your back.

Why long periods of sitting can make your back ache

Many people on the Lower North Shore spend long days at a desk or commuting into the city, and sustained sitting is a common thread in lower back discomfort. When you hold one position for hours, some muscles work continuously while others do very little, and the spine loses the varied movement it is built for. The lower back can then feel stiff or tired, often most noticeably in the first minute after you stand up.

Things that commonly come up when we take a history:

Long, unbroken periods of sitting with little change of position
A workstation set-up that encourages slumping or leaning to one side
A drop in general activity across the working week
Carrying tension through the shoulders and lower back

If you want general information on desk set-up and everyday movement, we have separate pages on office work and the spine and on lower back exercises.

Is it muscular, or is it the disc?

People often want to know whether their pain is muscular or whether a disc is involved. This is an educational point rather than a diagnosis. Strain of the muscles and joints is very common and usually behaves differently from a disc related presentation, which can refer discomfort or altered sensation into the leg. An in person assessment, and in some cases imaging, is needed to tell these apart.

If what we find points towards a disc related presentation or towards nerve related leg symptoms, we will tell you what we found and what it means. If the right next step is your GP rather than us, we will say so plainly.

What an assessment involves

A first appointment is an assessment. Your chiropractor will take a history: what aggravates it, what eases it, how long it has been going on, what you do day to day, and what your general health is like. They will then look at how you move and load your spine. Where it is relevant, that includes checking strength, sensation and reflexes in the legs, because those findings change what should happen next.

You will be told what was found, and what the options are. Those options may include manual care, lower force techniques, movement and exercise guidance, doing nothing for now, or referral to another practitioner. You can decline any technique, and you can ask for a lower force approach at any point.

Our chiropractic care page describes the techniques used at the clinic and what each involves.

When to see someone else first

Some symptoms need medical assessment before, or instead of, musculoskeletal care. See your GP promptly, or an emergency department, if you have:

Numbness or weakness in the legs
Any change to bladder or bowel control
Pain that wakes you at night
Unexplained weight loss
A fever
Back pain following a significant fall or accident

Depending on what we find, the right next step may be your GP, a physiotherapist, an exercise physiologist, or another practitioner. If that is the case we will say so. We are also happy to work alongside anyone already involved in your care.

Movement, rest and everyday activity

Australian clinical guidance for uncomplicated low back pain is that prolonged bed rest is not recommended, and that staying gently active as tolerated is usually reasonable. That is general guidance rather than personal advice, and what is sensible for you depends on your own presentation and on anything else that is going on medically.

If a movement sharply increases your pain, ease off and check in with your practitioner or GP. If your pain is severe, keeps getting worse, or comes with any of the symptoms listed above, do not wait for an appointment with us. Seek medical assessment.

Visiting the Mosman clinic

ReFigure Chiropractic Health Centre is at 18A Spit Road, Mosman NSW 2088, with the entrance via Brady Street. The centre is open six days a week and no referral is needed to book. You can call the clinic on (02) 8937 2740, book online, or get in touch with a question first. You can find our clinic on Google. You can read about the practitioners on our team page.

Book an assessment at our Mosman clinic

An assessment starts with a history and an examination. You will be told what was found and what the options are, including referral elsewhere if that is the better step.

Book your appointment Call (02) 8937 2740

Frequently asked questions

Do I need a scan for lower back pain?

Not usually, and not as a first step. Imaging is considered when something in your history or examination points to a reason for it. Australian clinical guidance is explicit that routine imaging for uncomplicated low back pain is not recommended, because incidental findings are common and can be misleading.

Should I rest or keep moving?

Prolonged bed rest is generally not recommended. Staying gently active as tolerated is the general guidance for uncomplicated low back pain. That is general guidance rather than personal advice. If a movement sharply increases your pain, ease off and check in with your practitioner or GP.

Do I need a referral to see a chiropractor?

No referral is needed, and you can book directly. We are happy to work alongside your GP or any other health practitioner involved in your care.

When should I see a GP instead?

See your GP promptly, or an emergency department, if you have numbness or weakness in the legs, any change to bladder or bowel control, pain that wakes you at night, unexplained weight loss, a fever, or back pain following a significant fall or accident. These symptoms need medical assessment before, or instead of, musculoskeletal care.

These pages cover neighbouring topics in the same general way:

Please note: this page is general information, not a diagnosis and not personal health advice. It does not describe what any care will do for an individual. Outcomes vary from person to person, and anything we do is based on your own assessment. If you are unsure about your symptoms, speak with your GP.

Lower back pain: what assessment involves