5 Common Causes of Pain and How Physiotherapy Can Help

Pain affects all of us at some point, whether from an injury, repetitive activity or a long-standing condition. When pain lingers, it can be hard to know where to start. Physiotherapy offers practical, evidence-based ways to understand and manage pain and get you moving again. In this post, we look at five common causes of pain and how physiotherapy can help.

1. Sciatica

Sciatica is pain that travels from the lower back or buttock down the leg, sometimes with pins and needles or numbness. It happens when a nerve root in the lower back becomes irritated, most often by a disc bulge, and sometimes by narrowing of the spaces around the nerves (spinal stenosis).

The good news is that most cases of sciatica improve significantly over weeks to a few months, and disc bulges often shrink naturally over time.

How physiotherapy helps

• Explaining what's going on and reassuring you about the usually good outlook

• Advice on staying active and finding comfortable positions, as staying in bed tends to slow recovery

• A graded exercise programme to build movement, strength and confidence

• Hands-on treatment, for some people, to ease pain in the short term alongside exercise

Seek urgent medical help (Emergency Department) if you have numbness around the genitals or back passage, new difficulty passing or controlling urine or bowels, or weakness in both legs. These can be signs of cauda equina syndrome, which needs emergency treatment.

2. Arthritis

Arthritis covers many conditions. Osteoarthritis is the most common and often affects the knees, hips, hands and spine, causing pain and stiffness. Rheumatoid arthritis is an inflammatory, autoimmune condition that needs medical treatment from a rheumatology team.

How physiotherapy helps

• Exercise and education, which international guidelines recommend as the first-line treatment for osteoarthritis

• Strengthening exercises to reduce pain and improve function

• Advice on staying active, pacing and managing flare-ups

• Hands-on treatment, alongside exercise, to ease stiffness in the short term

• Water-based exercise, which can be a comfortable option for some people

3. Tendinopathy (Tendon Pain)

Tendon pain is often called "tendonitis", but in most long-standing cases the problem isn't mainly inflammation. The better term is tendinopathy: a tendon that has become irritable because the load placed on it has outpaced its ability to adapt. Common areas include the shoulder (rotator cuff), elbow (tennis elbow), knee (patellar tendon), hip (gluteal tendons) and heel (Achilles).

How physiotherapy helps

• Load management: adjusting activities that aggravate the tendon without stopping completely

• Progressive strengthening exercises, which have the best evidence for tendon problems

• Education on how tendons respond to load and how long recovery typically takes, often several months

• A gradual, milestone-based return to sport or full activity

Passive treatments such as ultrasound have little evidence of benefit for tendon pain, and complete rest tends to weaken tendons further.

4. Bursitis

Bursae are small fluid-filled sacs that reduce friction around joints. Pain around the outside of the hip, the shoulder or the knee is often labelled "bursitis". In many cases, particularly at the hip, the main source of pain is actually the nearby tendons, and the condition is better described as tendon-related pain.

How physiotherapy helps

• Education and advice on avoiding positions that compress the area, such as crossing your legs or lying on the painful side

• Progressive strengthening exercises, which research shows work well, especially for outer hip pain

• Ice or heat for short-term comfort

• A gradual increase in activity

A bursa that is hot, red and swollen, especially if you feel unwell, should be checked by your GP the same day, as it could be infected.

5. Muscle Strain

A muscle strain happens when muscle fibres are overstretched or torn, often during sudden movements, lifting or sport. Symptoms include pain, tenderness, bruising and difficulty using the muscle.

How physiotherapy helps

• Early advice on protecting the area for a short time, then starting gentle movement and loading early

• A progressive strengthening programme to restore strength and capacity

• A gradual, milestone-based return to activity or sport to reduce the risk of re-injury

• Hands-on treatment, for some people, to ease pain and stiffness in the short term

Why Choose Physiotherapy?

Physiotherapy takes a whole-person approach to pain. Rather than just masking symptoms, it helps you understand your pain and build the strength, movement and confidence to manage it. Physiotherapists assess and treat pain using:

• Exercise therapy: targeted, progressive exercise to restore strength, movement and function

• Education: helping you understand your condition and take control of your recovery

• Hands-on treatment: used where helpful, alongside exercise, for short-term relief

• Activity advice: guidance on pacing, work, sport and daily life

If you're struggling with any of these problems, a physiotherapy assessment can be a helpful first step. With a clear plan and achievable milestones, most people can reduce their pain, return to the activities they enjoy and learn how to manage independently in the future.