The Morning Struggle
When she first came through the clinic doors, you could see the fatigue in her eyes before she even spoke. In her mid-40s, she told me, “I feel like I’ve aged 20 years overnight.” Her words weren’t dramatic. They were honest.
For nearly a year, she had been waking up every morning with severe pain at the base of her spine. It wasn’t just discomfort. It was the kind of pain that made the simple act of putting on socks feel impossible. Mornings had become something to endure. It took her at least an hour each day to “warm up” enough to move properly. Only then could she start getting on with life. She could walk. She could manage her day. But by night, the stiffness returned. The next morning, it all started again.
She also felt a deep ache that ran from her lower back into her right leg, travelling down the back of her thigh and into the calf. Not sharp, but dull and constant. Some days were better than others, but there were no pain-free days. The worst part? She had no clear answers. She had seen doctors. She had tried exercises from a physio. None of it helped. And no one had explained why this was happening.
But she hadn’t given up. She still had questions. And that curiosity led her to our clinic.
Looking Beyond the Pain
From the beginning, I could see she wasn’t someone looking for a quick fix. She just wanted her life back. And I knew we needed to look deeper than the pain itself.
During her assessment, a few things stood out. She had a significant arch in her lower back, a posture we call an anterior pelvic tilt. Bending forward, sideways, and rotating were all manageable. But leaning backwards? That lit her pain up immediately.
Then we looked at her feet.
They were a big part of the puzzle. Her medial arches were collapsing quite severely. Her big toe, which plays a crucial role in walking and balance, hardly moved. Her heel bones were tilting outwards, which told me she wasn’t walking on a solid, neutral base.
We often talk about the “kinetic chain” in physiotherapy. It means the body is connected, from the feet all the way up to the head. If one link in the chain is off, the others compensate. With her, it was clear that the way her feet were moving was affecting her knees, hips, pelvis, and ultimately, her lower back. When feet overpronate, the shin and thigh rotate inward. This twists the pelvis forward, causing the lower vertebrae to compress and overwork. That compression leads to wear and tear of the facet joints, which can cause the kind of pain she was describing.
She wanted an MRI scan, even though we didn’t think it was strictly necessary at that stage. But we understood. She had lived with this pain long enough to want answers in black and white. The scan confirmed what we suspected — moderate to severe degeneration of the facet joints in her lower back.
The good news? It didn’t mean she needed surgery. It didn’t mean she needed injections. It meant we had to treat the problem and the cause.
Treatment That Changed Everything
We started by addressing her biomechanics. First, we did a detailed gait and foot assessment using our pressure plate technology. The data confirmed the issues we had seen in the clinic. We fitted her with custom orthotic insoles to help her feet sit in a more neutral position and reduce the strain going up the legs.
We also began regular hands-on treatment, focusing on her lower back and hips. Her glutes were incredibly weak, which added to the load being placed on her spine. So we built her a rehab program to strengthen them. Nothing extreme, just simple, focused movements designed to give her the support her spine desperately needed.
What amazed her most was how quickly things improved.
After just one week in her orthotics, she said she was moving better. The morning routine was getting easier. The pain was still there, but it had stepped back. After her third session, she was 70 percent better. By her seventh and final treatment, she described her symptoms as “just a bit stiff in the morning.” But as she said herself, “If this is how it had been all along, I wouldn’t have even come in.”
That’s how far she had come.
Why Maintenance Matters
Because her pain was rooted in degeneration, we knew that while we could get it under control, this wasn’t a once-and-done situation. Like any joint in the body, once wear and tear begins, it needs to be managed with care.
We set her up with a plan. She’d continue with her exercises. She’d wear her orthotics daily. And she’d pop in every couple of months for maintenance treatment, just to keep everything moving well and reduce any flare-ups before they could take hold.
A year on, she’s still doing brilliantly. No major regressions. No new symptoms. She’s back to living her life the way she wants to, not ruled by pain, not afraid of mornings.
What You Can Take From Her Story
Back pain is common. But chronic back pain that lasts for months or years often has deeper causes than just age or bad luck.
The spine doesn’t work in isolation. The feet, knees, hips, and pelvis all feed into it. If any part of that chain is out of sync, the spine will compensate. And over time, that compensation causes stress, wear, and eventually pain.
In her case, weak glutes and collapsed arches were the drivers of her discomfort. In someone else, it might be tight hips or poor posture. That’s why proper assessment is so important. Not just focusing on where the pain is, but looking at how the whole body moves.
And just because an MRI shows degeneration, it doesn’t mean you’re broken. Most people have some level of wear and tear. But with the right treatment, education, and support, you can live without pain. You can move well again. You can feel like yourself again.
She did. And so can you.
Joe Sharp
BSc (Hons) Physiotherapy
Where Are You Right Now
If you’ve been living with ongoing lower back pain, especially stiffness in the mornings or pain that returns day after day, it might be time to look deeper.
We’ve created a simple Back Pain Scorecard to help you understand where your spine health stands, and whether degeneration, poor movement patterns, or muscle imbalances might be contributing to your symptoms.
It only takes a minute, but it could help you avoid years of unnecessary pain or even surgery.
Take the Back Pain Scorecard now and find out what your next step should be.
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