Low Back Pain in Eastbourne: Causes, Assessment and Treatment
Updated: 4 hours ago
Lower back pain is one of the most common problems I assess at my Eastbourne osteopathy clinic. Often, no single cause can be identified, and an X-ray or MRI is not needed. An assessment starts with your symptoms, how they affect daily life and whether there are signs that need medical investigation.
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Your appointment in EastbourneFirst appointment £70 · approximately 60 minutes. Follow-ups £60 · approximately 30 minutes. Andy Duckmanton, GOsC Registered Osteopath. Natural Fitness and Therapies, Royal Parade, Eastbourne BN22 7AQ. |
When back pain needs medical help
Call 999 or go to A&E for back pain with any of the following:
Symptoms affecting both legs, including pain, tingling, weakness or numbness.
Reduced sensation around the genitals or anus; new bladder or bowel changes, such as difficulty passing urine or loss of control; or new changes in genital sensation or sexual function.
Chest pain, or pain beginning after a serious accident.
Do not drive yourself to A&E or wait for an osteopathy appointment.
Ask for an urgent GP appointment or contact NHS 111 if back pain comes with feeling feverish, shivery or generally unwell, or severe pain starts suddenly or worsens quickly.
Seek urgent medical advice for new or worsening leg weakness, such as difficulty lifting your foot or a foot that starts dragging. Contact your GP urgently or NHS 111; do not wait for a routine osteopathy appointment. Follow the emergency instructions above if any of those warning signs are present. NHS guidance on leg weakness (page 2)
See a GP if pain is not improving after a few weeks, limits everyday activities, is worse at night, or comes with unexplained weight loss. The NHS back-pain page gives fuller guidance.
Causes of lower back pain
Muscles, joints, discs and nerves can all contribute to back pain. Often, an examination cannot identify one structure as the cause. This is called non-specific lower back pain. The assessment focuses on your symptoms, movement and daily activities, while checking for conditions that need different care.
How long does back pain last?
A recent episode of non-specific low back pain often improves considerably in the first six weeks, although some symptoms can last longer. Recovery times vary. Recovery research (CMAJ, 2024)
Pain lasting more than three months is usually called persistent or chronic pain. This describes its duration; it does not, by itself, mean permanent damage. Pain can continue after an injury has healed. New or changing symptoms still need assessment rather than being dismissed as part of an old problem. NHS information on persistent pain
Muscle
Muscles can contribute to lower back pain, particularly following unfamiliar activity, lifting or exercise. Muscle soreness, tenderness and increased tension may also develop in response to pain from other structures in the back.
I check for tenderness and ask which activities bring on the pain. These findings help guide advice and treatment, but do not always identify a single cause.
Joint
The small facet joints at the back of the spine can sometimes contribute to lower back pain. Age-related changes such as osteoarthritis may also be present, although changes seen on scans do not necessarily explain a person's symptoms.
I check how your back moves and which movements bring on your symptoms. Joint stiffness or tenderness is considered alongside the rest of the examination.
Disc
Discs sit between the bones of the spine. A “slipped disc” has not literally slipped: part of it has bulged or pushed out. If a nearby nerve is irritated or compressed, this can cause leg pain, tingling, numbness or weakness. Not every disc problem causes symptoms, and not all sciatica is caused by a disc. NHS: slipped disc
Changes seen on a scan do not necessarily explain your pain; disc bulges and age-related changes can also be found in people without back pain. Scan findings need to be checked against your symptoms and examination. Routine imaging is not usually needed for uncomplicated back pain or sciatica. Even a specialist referral does not automatically mean you need a scan: it is considered when the result is likely to change your care. NICE guidance on scans
Osteopathic treatment for lower back pain
At your first appointment, I ask about your pain, general health and the activities you are struggling with. I examine your back and any other areas relevant to your symptoms, and check whether you need further medical assessment.
We then discuss what may help. Depending on the assessment, this could include exercises, advice on daily activities and hands-on treatment such as joint mobilisation, manipulation or soft tissue techniques.
Mobilisation uses controlled movements of a joint. Manipulation uses a brief, controlled thrust. You can ask which technique is being suggested and why. Cochrane: manual treatment explained
For low back pain, with or without sciatica, NICE says manual therapy should only be considered as part of a treatment package that includes exercise.
Hands-on treatment is optional. You can choose advice and exercise without manipulation. A 2026 Cochrane review found little average difference in pain and a small improvement in everyday function at one month compared with other non-surgical care for persistent back pain. The evidence was uncertain. These findings concern manipulation and mobilisation; they do not show that osteopathy as a profession is better than other forms of care. Cochrane review, 2026
Before treatment, I explain the possible benefits, relevant risks and alternatives, and ask for your consent. You can ask questions or ask me to stop. Temporary soreness can occur afterwards; contact me if you are concerned, and follow the urgent medical advice above for warning symptoms. GOsC appointment guidance
Physiotherapy or osteopathy?
Physiotherapists and osteopaths can both offer assessment, exercise advice and hands-on treatment. Approaches vary between practitioners, so ask what the plan involves and how progress will be checked. Physiotherapists are regulated by the HCPC and osteopaths by the GOsC. NHS physiotherapy · GOsC: what to expect
For NHS physiotherapy locally, the East Sussex MSK Community Partnership offers self-referral for eligible patients. Check whether your GP practice is covered and read the current eligibility information before applying.
What can I do to help my back pain?
If your symptoms are manageable and improving, self-care may be enough. Keep track of your progress and follow the medical-help advice above if warning symptoms develop or the pain is not improving. NHS self-care advice
Keep moving and continue manageable daily activities rather than staying in bed. Try short, comfortable bouts of activity. Wrapped heat or cold packs may help temporarily. Stop an exercise that worsens pain and seek advice.
Ask a pharmacist or GP which pain relief is suitable for you. Anti-inflammatory medicines such as ibuprofen are not suitable for everyone. Paracetamol on its own is not recommended for lower back pain. NHS pain-relief advice
If you are unsure how to start exercising, an assessment can help you choose a starting point. Seek medical advice first if pain is severe or worsening, or you have new leg weakness or other warning symptoms listed above.
Which exercises can help persistent back pain?
Exercise can help reduce persistent non-specific back pain and improve everyday function, although average gains in function are smaller. Walking, other aerobic activity and strengthening are all options. Choose something you can manage and are willing to continue. Cochrane exercise review · NICE exercise guidance
Start with a manageable amount, then increase gradually. For example, a short walk may be a better starting point than a long outing. Pilates or adapted yoga are also options, but neither is essential. Yoga has not shown a clear advantage over other back-focused exercise. If an exercise worsens your pain, stop and seek advice. Cochrane yoga review
Is lower back pain the same as sciatica?
No. Sciatica usually causes pain travelling from the buttock down the leg, sometimes with tingling, numbness or weakness. It happens when a nerve supplying the leg is irritated or compressed.
You can have back pain without sciatica, or sciatica with very little back pain. The examination helps check for signs of nerve involvement.
When might a specialist opinion help?
If sciatica remains disabling despite non-surgical care, a GP or specialist can discuss further assessment. Surgery to relieve pressure on a spinal nerve may be considered when pain or function has not improved and scan findings match the symptoms. NICE guidance on surgery for sciatica
Call 999 or go to A&E now for any emergency symptoms listed above. NHS emergency guidance
What if the pain keeps returning?
It can help to note what was happening around each episode, including changes in activity or work. We can use this to plan exercise and ways to manage a flare-up. Repeated hands-on treatment is not automatically the best answer.
After recovery from an episode of non-specific back pain, the WalkBack trial found that an individual walking programme combined with education delayed another episode that limited activity. Physiotherapists supported the programme. This supports a gradual, supported return to activity; it does not establish the same benefit from walking alone. WalkBack trial (The Lancet, 2024)
For practical ideas on adapting walks, housework and desk work, read our back pain flare-up guide.
Persistent pain can disrupt sleep, work and mood as well as movement. Tell your clinician which of these are affecting you, so they can be included in your care. Addressing these difficulties does not mean the pain is imagined. New or changing symptoms still need medical assessment. WHO guidance on low back pain
How will we judge progress?
We agree on a few practical goals, such as walking, dressing, sleeping or working more comfortably. At follow-up, we review those activities, your pain and how the exercises are going, then decide whether the plan needs to change.
What if treatment is not helping?
If treatment is not helping, we reconsider the assessment and discuss changing or stopping treatment, other rehabilitation options or medical advice. New or worsening symptoms need earlier review. There is no fixed course of treatment that everyone must complete.
About the author
Andy Duckmanton BOst (Hons) is a registered osteopath (GOsC registration 6400) who has been practising since 2007. He assesses and treats patients with lower back pain at his Eastbourne clinic.
The clinic is on the seafront promenade beside the Redoubt Fortress. There are three entrance steps and one internal step. Please call before booking if you have access needs. See online booking for current appointment availability, or call if you cannot find a suitable time.
Book a back pain appointment
If you would like help with your back pain, you can book an assessment with me at Eastbourne Osteopathy. We will discuss what the findings mean and what to do next. If you need medical investigation, I will explain the next steps.
Sources and further reading
Page updated: 12 October 2026.