WhatsAppBook

Physiotherapy · Low back pain

Low back pain physio in Phuket

Our physios check for warning signs, calm the flare and get you moving. Then your coach builds a back that copes with work, lifting and sport, so it is less likely to come back.

For a new flare, back pain that keeps returning, or pain that has lasted months.

Book a free physio assessment

Opens WhatsApp with a message ready to send.

Questions first? Ask us on WhatsApp

Rated 5.0 from 57 Google reviews

What the research says

Flares ease. Keeping them away is harder.

Your back is strong and adaptable. The work is calming this flare, then building a back that copes with your life.

  • 6weeks

    On average, pain from a new episode eases a lot within about six weeks.1

  • 7 in 10

    people who recovered had another episode within a year, in one study.2

  • 45%

    lower risk of a new back pain episode with exercise plus education, in pooled prevention trials.3

How we work

Reassure, move, then build strength

Guidelines recommend reassurance, returning to normal activity and avoiding bed rest, and they advise against routine scans unless there are warning signs.4 Then we build capacity with exercise you will keep doing.

  • Exercise is the core

    For long-standing back pain, exercise reduced pain by a meaningful amount compared with no treatment, usual care or placebo, at least in the short term.5 No single type of exercise is clearly best.6

  • Match support to your risk

    A short questionnaire sorts people by their risk of ongoing problems. In one UK trial, matching care to risk slightly improved disability and lowered costs.7 One US trial found no difference.8 We use it to guide your care.

  • Measure, do not guess

    We measure how much your back limits you, plus your strength and endurance, at the start. Then we retest at set points, and the numbers decide when you move on.

  • Finish with a coach

    The last two phases are training, not treatment. Your physio signs off each stage, then your coach builds the strength, power and confidence for work, lifting and sport.

Your recovery

Four phases, moved through by milestones

Timeframes are typical. Your milestones decide when you move on, and a flare may mean a short step back. That is normal.

  1. 01

    Typically 0 to 2 weeks

    Calm and keep moving

    Your physio checks for warning signs, explains what is going on and gets you moving comfortably. Back pain is rarely caused by serious disease.9 Short walks, gentle movement and breaking up long sitting.

    Move on whenThere are no warning signs, you can walk 10 minutes several times a day, getting out of bed and chairs is easier, and sleep is improving.

  2. 02

    Typically 2 to 6 weeks

    Build movement capacity

    Your physio helps you bend, lift and twist normally again, without bracing or holding your breath. Hip hinges, bridges, squats, side bridges and carries. Avoided tasks in small steps.

    The handover gateDisability score 30% better (or already low), a light kettlebell lifted from the floor relaxed, a 30-minute walk, and two weeks of green or amber. Your physio signs it off.

  3. 03

    Typically 6 to 12 weeks

    Get strong

    Your coach builds whole-body strength with progressive lifting, carries and trunk endurance, plus fitness work you enjoy. Load goes up only after a green next morning. Your physio reviews you every 3 to 4 weeks.

    Ready for impact and sport whenDeadlift three quarters of bodyweight for 5 (or your work or sport need), side bridge 45 seconds each side, and green after your heaviest sessions.

  4. 04

    From about 12 weeks

    Return to full training

    Heavier lifting, rotation, power and your sport, step by step. Running is an option too: in one small trial, a 12-week run-walk program reduced pain and disability compared with no program.10

    Full sport whenTwo weeks of full training with a green response every morning, your sport ladder completed, and a flare plan you are confident with. Your physio signs off matches and sparring.

Keep strength training and walking in your week after the program ends. Exercise plus education lowered the risk of a new episode in pooled trials.3

Between sessions

A simple traffic light for every session

Some pain during exercise is fine if it settles within a day. If you are unsure, ask your physio.

The morning after each session, check three things: back pain and stiffness against your normal, any leg symptoms, and how bending and getting up feel.

  • Green: progress

    Back pain and stiffness are back to your normal by next morning, with no new or spreading leg symptoms. Progress as planned.

  • Amber: hold

    A little more pain or stiffness that settles within a day. Repeat the same session, or adjust range, speed or load.

  • Red: step back

    Pain still up 24 hours later, or leg symptoms spreading: step back a level and tell your physio. New numbness or weakness: see them today.

Go to hospital now if

Call 1669 in Thailand.

  • Numbness around your genitals, bottom or inner thighs
  • Difficulty peeing, new leaking, or changed feeling when peeing
  • You can’t feel a full bowel, or new bowel leaks
  • New sexual problems, or symptoms spreading into both legs
  • Severe or worsening leg weakness, or a dragging foot
  • Fever with back pain, or a major injury

See a doctor within days if you have a history of cancer, weakened immunity, unexplained weight loss, night pain, or osteoporosis with new back pain.

Had back pain for months?

Months of pain can still change

Back pain that lasts over three months can involve more than the back: sensitivity, stress, sleep, fear of certain movements and habits like bracing. Each of these can be worked on.

The RESTORE trial included 492 people with disabling back pain for over three months.11 A physio-led approach of up to seven sessions over 12 weeks, combining making sense of pain, gradually facing avoided movements and lifestyle change, reduced disability more than usual care, at lower overall cost. In those followed up at three years, most of the benefit was still there.12

4.6

points (of 24) less disability than usual care at 13 weeks11

3 yrs

most of the benefit was still there in those followed up12

Patient reviews

What our patients say

Rated 5.0 from 57 Google reviews

  • “I came to Optimize with chronic back pain and absolutely no ability to train. I was first matched with Khun Meaw, a highly skilled rehabilitation trainer who helped me eliminate my back pain completely. … After that, I continued training with Kate for a full year.”

    nesterzhzhotGoogle review

  • “Meaw has been incredible. She helped me recover from long term neck and lower back pain and gave me personalized exercises that I now do daily. These have made a huge difference in my strength, mobility, and overall well-being. I’m so grateful for her expertise and highly recommend her to anyone looking for real, lasting results!”

    Jeff CraigGoogle review

  • “I have been seeing Karim for long term issues with my neck and the results have been fantastic. I have attended several physios in the past and none compare to Karim. His skills and knowledge helped to pinpoint the exact cause of the issues and the treatment plan has made massive improvements.”

    joyce billingtonGoogle review

  • “I have been working with Khun Meaw on some strengthening exercises for my shoulders, hips and knees. … Her goal has been to give me the tools I need to work on my specific areas of need and not to keep me in an endless cycle of needing help……so professional and a joy to work with.”

    Catlin McCrackenGoogle review

  • “Optimise is a fantastic set up, I have been working with Khun Meaw on a physio front, and she is awesome and really gets to the root of the problem and starts from there – could not recommend highly enough. Having seen a couple of different physios on the island, Khun Meaw is certainly number 1.”

    Jamie AllworkGoogle review

  • “I honestly can’t thank Karim at Optimisefit enough … I’ve lived in five different countries and, unfortunately, had to deal with many injuries, so I’ve seen quite a few physios over the years. But no one has ever come close to the level of knowledge, care, and clarity that he brings.”

    Unfiltered OpinionsGoogle review

  • “I started seeing Khun Maew last August for a knee issue and within 15 minutes she had identified a multitude of issues I’d been dealing with for more than 20 years … I have been pain free for 6 months and am now in the gym working to rebuild my mobility and strength.”

    Michelle LawlorGoogle review

Read all 57 reviews on Google

Questions

Back pain questions

Does back pain mean something is damaged?

For nearly all people with back pain, no specific cause can be found.9 Disc changes show up on scans of many people with no pain at all: half of pain-free 40 year olds have a disc bulge on MRI.13 Hurt does not have to mean harm.

Should I rest until it stops hurting?

Guidelines advise staying active and returning to normal activity,4 and in trials, advice to stay active slightly beat advice to rest.14 Gentle, regular movement usually helps more than bed rest.

Do I need a scan?

Usually not. Guidelines advise against routine scans for back pain unless there are warning signs.4 Your physio checks for those at your first visit and refers you if needed.

Is there one right exercise for backs?

Many kinds of exercise help, from strength training to walking.6 Pilates and McKenzie exercises did slightly better in one analysis,15 but the best exercise is one you enjoy and keep doing.

Will stronger painkillers get me better faster?

In one placebo-controlled trial, opioids were no better than placebo for recent back or neck pain at six weeks.16 In another, paracetamol did not speed recovery.17 Physios do not advise on medicines, so ask your doctor.

What if the pain goes down my leg?

If leg pain is your main problem, it may be sciatica. Read our sciatica guide, and tell your physio at your assessment.

Physio team

Your back pain team

Meaw leads our clinical standards and works with our coaches on every handover.

How physiotherapy works here
  • Meaw, Head Physiotherapist at Optimise

    Meaw

    Head Physiotherapist

  • Karim, Physiotherapist at Optimise

    Karim

    Physiotherapist

Also on the team Sukanya, Physiotherapist

Next step

Find out where your back stands

Message us on WhatsApp to book your free physio assessment. We check for warning signs, explain what is going on and build your plan.

Book a free physio assessment

Opens WhatsApp with a message ready to send.

Questions first? WhatsApp +66 65 914 1604

SciaticaShoulder painKnee arthritisRunner’s kneeACL rehabAnkle sprainNeck painTendon painHamstring strainMeniscus tearsHeel painHip arthritisFrozen shoulderRotator cuff tearsKnee and hip replacement
Sources (17)
  1. Wallwork SB, et al. The clinical course of acute, subacute and persistent low back pain: a systematic review and meta-analysis. CMAJ. 2024;196(2):E29-E46.
  2. da Silva T, et al. Recurrence of low back pain is common: a prospective inception cohort study. J Physiother. 2019;65(3):159-165.
  3. Steffens D, et al. Prevention of low back pain: a systematic review and meta-analysis. JAMA Intern Med. 2016;176(2):199-208.
  4. Oliveira CB, et al. Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. Eur Spine J. 2018;27(11):2791-2803.
  5. Hayden JA, et al. Exercise therapy for chronic low back pain. Cochrane Database Syst Rev. 2021;9(9):CD009790.
  6. George SZ, et al. Interventions for the management of acute and chronic low back pain: revision 2021. J Orthop Sports Phys Ther. 2021;51(11):CPG1-CPG60.
  7. Hill JC, et al. Comparison of stratified primary care management for low back pain with current best practice (STarT Back): a randomised controlled trial. Lancet. 2011;378(9802):1560-1571.
  8. Delitto A, et al. Stratified care to prevent chronic low back pain in high-risk patients: the TARGET trial. EClinicalMedicine. 2021;34:100795.
  9. Hartvigsen J, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356-2367.
  10. Neason C, et al. Running is acceptable and efficacious in adults with non-specific chronic low back pain: the ASTEROID randomised controlled trial. Br J Sports Med. 2025;59(2):99-108.
  11. Kent P, et al. Cognitive functional therapy with or without movement sensor biofeedback versus usual care for chronic, disabling low back pain (RESTORE): a randomised, controlled, three-arm, parallel group, phase 3, clinical trial. Lancet. 2023;401(10391):1866-1877.
  12. Hancock M, et al. Cognitive functional therapy with or without movement sensor biofeedback versus usual care for chronic, disabling low back pain (RESTORE): 3-year follow-up of a randomised, controlled trial. Lancet Rheumatol. 2025;7(11):e789-e798.
  13. Brinjikji W, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811-816.
  14. Rizzo RR, et al. Non-pharmacological and non-surgical treatments for low back pain in adults: an overview of Cochrane reviews. Cochrane Database Syst Rev. 2025;3(3):CD014691.
  15. Hayden JA, et al. Some types of exercise are more effective than others in people with chronic low back pain: a network meta-analysis. J Physiother. 2021;67(4):252-262.
  16. Jones CMP, et al. Opioid analgesia for acute low back pain and neck pain (the OPAL trial): a randomised placebo-controlled trial. Lancet. 2023;402(10398):304-312.
  17. Williams CM, et al. Efficacy of paracetamol for acute low-back pain: a double-blind, randomised controlled trial. Lancet. 2014;384(9954):1586-1596.

This page is general information based on the research listed here. It is not a diagnosis. Your physio will tailor the plan to you, and your surgeon’s or doctor’s instructions come first. Clinically reviewed by Meaw, Head Physiotherapist at Optimise, November 2026.