Physiotherapy to prevent trouble with the back, or to deal with it once it has started, is vital. Few of us with busy lives exercise enough and those who do, probably not in the best way.

A wide variety of exercises can be introduced even to treat the same problem, ranging from gentle walking in a pool to lifting heavyweights. However, getting this wrong can do untold harm. The therapist, therefore, needs to spend some time with the patient, to understand the problem and the way the body has reacted to this, which will allow the therapist to determine the optimum exercise profile. This usually changes as time passes, once certain muscles improve more difficult exercises can be introduced in a graduated or step-wise manner.

Having information from the other members of the clinical team can be enormously helpful. Knowing the clinical findings and the appearances of the spine on the MRI should prevent dangerous exercises being introduced and make a more tailored approach to the pattern of exercises for an individual.