What Nobody Tells You About Lower Back Pain: A Clyde North Chiropractor's Honest Take on Why Yours Keeps Coming Back

There's a phrase I hear almost every week in my clinic.

"I've just got a bad back."

People say it like it's a life sentence. Like having a bad back is simply part of who they are, the same way someone might say they're left-handed or they don't like mornings. They've usually tried things. Some stretching or exercises. Some anti-inflammatories. A few weeks of rest. Things felt better for a while. Then something ordinary happened — bending to pick up a bag, sitting through a long drive, waking up stiff for the fifth morning in a row — and the whole thing came back.

If that's you, I want to offer you a different way of thinking about it. Because in my experience, "I've just got a bad back" isn't a diagnosis. It's what people say when they haven't yet been given a real one.

Lower back pain is the single leading cause of disability worldwide, affecting around 619 million people globally. In Australia, it affects roughly one in six people and accounts for more lost work and quality of life than almost any other condition. And yet the advice most people receive when it strikes is still, somehow, to rest and wait.

I want to explain why that's often exactly the wrong call, what the research actually shows, and what a proper assessment for lower back pain should include. This isn't the standard "causes, symptoms and 10 exercises" article. You've read enough of those. This is the conversation I have in my clinic.

The two words that keep people stuck

If you've ever had your lower back pain investigated, there's a reasonable chance it came back labelled "non-specific." Around 90% of lower back pain cases are classified this way, meaning no single structural cause was identified.

I understand why the label exists. Back pain is complex and genuinely difficult to pin down without a thorough assessment. But "non-specific" is also, too often, a shorthand for not looking hard enough. In practice, what I see is that most lower back pain dismissed as non-specific has underlying drivers that weren't properly assessed: a loss of the spine's natural curves, altered loading mechanics, joints that have been stiff for months, or disc tissue under more compression than it can manage.

A label that tells you nothing about cause gives you nothing to fix. And that's a big part of why so many people end up going in circles.

Why resting your back is often the worst advice you've been given

The default prescription for lower back pain — rest — still gets handed out constantly, and the research has been challenging it for decades.

A systematic review published in the British Journal of General Practice found that bed rest was not an effective treatment for lower back pain and may in fact delay recovery, while advice to stay active produced faster return to normal function, less chronic disability, and fewer recurring episodes.

There's a reason why people say "motion is lotion", and it definitely applies in this situation.

That doesn't mean pushing through severe pain. It means that the instinct to stop moving, to wait for your back to "heal," often works against you. Discs rely on movement and load cycling to draw in fluid and nutrients. Joints stiffen faster than most people realise when they stop being used. The muscles that support the spine weaken rapidly with inactivity, removing the very protection the structure needs most at exactly the moment it's under stress.

Movement, guided carefully and calibrated to what's actually driving your pain, is usually the medicine. Rest is rarely a strategy. It's just waiting.

The scan that scared you probably isn't the whole story

If you've had an MRI and come away frightened by words like "degeneration," "disc bulge," or "arthritis," I want to reframe that for you.

When researchers reviewed imaging of over 3,000 people with no back pain at all, they found disc degeneration in 37% of completely pain-free 20-year-olds, rising to 96% by age 80. Disc bulges were present in nearly a third of pain-free people in their twenties. The findings that look alarming on your report are often just photographs of a spine that has aged normally. They may have nothing to do with why you're in pain.

This matters because chasing what's on the scan rather than what's driving the pain is one of the most common reasons lower back pain doesn't resolve. I see people who've had procedures based on imaging findings that were almost certainly incidental. And I see people whose pain had a clear mechanical driver that the scan didn't capture at all.

The image is one piece of information. It's not the whole story, which is why it's important its taken into account with the findings of a complete musculoskeletal assessment.

When the advice you're getting isn't serving you

Part of my job is helping people make sense of what they've already been told. And there are three situations I come across regularly where I think patients deserve more than they're getting.

If your GP assessed your back with a brief physical examination and sent you away with painkillers. GPs are genuinely excellent at what they do, and I have a lot of respect for the breadth of conditions they manage every day. But spinal and musculoskeletal conditions are a specialty in their own right, and GP training in this area is limited by necessity. A brief hands-on assessment followed by a script for pain relief is not a diagnosis. It's short-term relief. Seek assessment from a practitioner whose entire focus is on the spine.

If you've had scans and been told nothing is wrong, but you're still in pain. The scan didn't find a structural abnormality that the radiologist flagged. But pain always has a cause, and "nothing on the scan" doesn't mean "nothing wrong." It often means the problem isn't visible on that type of imaging, or that the assessment stopped too soon. Push for further investigation rather than accepting a dead end.

If you've been offered a cortisone injection. Injections can reduce inflammation and provide short-term relief, and there are situations where that's genuinely useful. But the research on their long-term effectiveness for lower back pain is poor. If you're being offered one as a primary solution rather than a bridge to active rehabilitation, it's worth asking what the plan is once the effect wears off.

If you've been told you need surgery. Always get a second opinion before committing to a surgical intervention for lower back pain. Ask the surgeon specifically about long-term success rates for your diagnosis, what the risks are if the outcome isn't what you hoped, and what conservative options have been fully exhausted. Surgery carries real risks, and unlike conservative care, the effects cannot be undone if the result isn't what you expected.

None of this is about distrusting the people treating you. It's about making sure you have the full picture before making a decision you can't reverse.

Why it keeps coming back

This is the question I hear most often.

A prospective cohort study following 250 people who had recovered from lower back pain found that roughly two-thirds experienced a recurrence within twelve months. The strongest predictors weren't structural. They were spending long hours sitting, frequent awkward postures, and a history of more than two previous episodes.

Then there's the factor almost no one accounts for: how long the pain has been there.

Chronicity matters enormously in lower back pain, and not just in the way most people assume. The longer pain persists, the more the nervous system begins to treat it as 'normal'. The brain is extraordinarily good at adapting to repeated input, and pain is no different. Over time, the pain pathways become more efficient, the threshold for triggering pain drops, and what started as a mechanical problem becomes increasingly driven by a nervous system that has learned to produce pain even when the original tissue threat has resolved. This is the same central sensitisation process I described earlier, and it's why someone with ten years of lower back pain is significantly harder to treat than someone with ten weeks, even when their scans look identical.

This is also why the advice to "wait and see" carries a real cost. Every month that passes without addressing the cause is a month the nervous system spends reinforcing that pain as a pattern.

This is the difference between symptom relief and structural change. Massage, anti-inflammatories, and even some forms of physiotherapy are genuinely useful at reducing pain in the short term. What they often don't do is change the load distribution through the spine, restore lost curves, or address the postural pattern that's been building for years. When you return to the same posture, the same desk, the same commute, the same problem re-emerges.

Understanding what's actually causing your lower back pain is the only reliable way to break that cycle.

The missing piece that most practitioners miss

Here's where I want to introduce something most practitioners don't assess, and something I consider one of the most important variables in persistent lower back pain: the shape of your spine.

Your lower back has a natural inward curve called the lumbar lordosis. It's what allows your spine to distribute load efficiently, protect your discs, and keep your pelvis balanced. When that curve is reduced or lost, the forces that should be spread across the whole lumbar spine start concentrating in specific spots. Usually the same spots that hurt.

A meta-analysis of 13 studies found that people with lower back pain had a significantly reduced lumbar lordotic curve compared to matched controls, describing the relationship as "strong." A separate systematic review of prospective studies found that loss of lumbar lordosis was a statistically significant predictor of lower back pain requiring intervention.

Nobody handed you a measuring stick for your spinal curve. But it can be measured on X-ray, and it changes the entire clinical picture. A spine that has lost its natural curve isn't just uncomfortable. It's mechanically inefficient in a way that most standard treatments never address, which is precisely why so many people keep coming back with the same problem.

What actually helping looks like

What actually helping looks like

When I assess someone with persistent lower back pain, I'm not just looking for where it hurts. I'm looking for why it keeps happening.

The approach I rely on most is Chiropractic BioPhysics (CBP). Using a combination of specific adjustments, corrective exercises and spinal traction designed to your individual curve measurements, CBP is built to restore the spine's natural curves over time rather than simply managing symptoms.

A systematic review of controlled trials using the CBP approach found increases in lumbar lordosis of 7 to 11 degrees over 10 to 12 weeks of treatment, with most randomised groups maintaining their structural correction at the six-month follow-up. That's not temporary relief. That's measurable change in the architecture of the spine.

Being completely transparent: results vary from person to person, and CBP isn't right for every presentation. But the evidence behind it is substantial and continues to grow, with multiple randomised controlled trials now supporting its ability to create measurable structural change in the spine. What it offers is a pathway to lasting correction rather than temporary relief, which is what most people with persistent lower back pain have never had access to.

For cases involving disc compression or disc degeneration alongside postural changes, I sometimes also use spinal decompression therapy as a complementary tool.

Where to Start: Lower Back Pain Treatment in Clyde North

If your lower back pain keeps returning, or you've been left with nothing actionable, the most useful step you can take is finding out what's actually driving it.

That's what our ClearSpine Pain Assessment is designed to do. We take a thorough history, carry out a full neurological and musculoskeletal examination, conduct a postural assessment, run a thermography scan to objectively map areas of nerve irritation and inflammation, assess your spinal curves with X-ray where indicated, and give you a complete and honest picture of what's going on and what the path forward looks like.

Effective lower back pain treatment in Clyde North starts with the right assessment, not guesswork.

I see people from across Melbourne's southeast, including Berwick, Cranbourne, Narre Warren, Officer and Beaconsfield, here at the clinic in Clyde North.

If you're ready to understand what's actually going on rather than waiting for the next flare-up, book your ClearSpine Pain Assessment or call us on (03) 5915 9895.

A bad back isn't who you are.

It's a problem that hasn't been properly understood yet.

Dr. Ashley Cherrett conducting a thermography scan at Cherrett Chiropractic, Clyde North.

(A brief but important note: if you experience sudden weakness in both legs, numbness around the saddle region, or any loss of bladder or bowel control, seek emergency care immediately. These symptoms are rare but require urgent attention.)

Dr. Ashley Cherrett (BAppSc(Chiro), BHlthSc) is the principal chiropractor and owner of Cherrett Chiropractic in Clyde North, Melbourne. He practises using the Chiropractic BioPhysics (CBP) technique, a structured, evidence-based approach to spinal correction. This article is educational and does not constitute medical advice. Individual results vary, and all care is based on individual assessment.