Muscling in to treat back pain

Physiotherapist Sally Ann Quirke broke her back when she was 20 and has devised a treatment using Pilates

Physiotherapist Sally Ann Quirke broke her back when she was 20 and has devised a treatment using Pilates

PHYSIOTHERAPIST SALLY ANN Quirke knows what it is like to suffer from back pain, having broken her back as a student, aged 20. She was doing a degree in physiotherapy at the University of the West of England in Bristol in 1994: “I was studying for my final exams and was sitting on a wide windowsill. I was laughing with someone and, whatever way I leaned by body, I went shooting forward and landed 15 feet down in a rockery. I have no recollection of it.

“I had two stable fractures in my spine. That was actually lucky as it meant no bone segments were moving around, infringing on my nervous system. I also ruptured my hip and broke my leg.”

Quirke was back on her feet two and a half months after the accident. While her back injury wasn’t an immediate problem, “it affected me hugely later. I was left with back pain for the next five years.


“I had a lot of physiotherapy and osteopathy which helped greatly, but it wasn’t until I started doing Pilates that I really understood how that could help.”

Quirke’s accident resulted in her developing an interest in the treatment of back pain. “Doing Pilates inspired me to use it within the overall management of back pain. A general Pilates class isn’t necessarily suitable for back pain sufferers. It upsets me when I hear advertisements for Pilates. What isn’t said is that there are 100 Pilates exercises.

“I’m very much into clinical Pilates and I have a prescriptive programme for each client who comes to me. Using Pilates for back pain should be done under the guidance of a back pain expert to ensure the patient undergoes the type of Pilates suitable [for their condition]. I employ a full-time Pilates instructor.”

Pilates teaches people the correct position for their body parts, explains Quirke.

“The exercises, which are gentle, help strengthen muscles. Over time, the muscles automatically hold the body in the correct position so it’s not an effort any more.”

Much back pain is easy to diagnose, emanating from disc, muscle or joint injury. “But some people will say that their back is only sore after they’ve been sitting for a long time. That means they have flexion-related back pain. About 90 per cent of what I see is flexion-related back problems, affecting the neck but usually affecting the lower back.”

An example of a flexion activity, where a joint is moved into a “flexed” position is sitting down. “Most of us have sedentary lifestyles, sitting at a computer all day, commuting to work and then going home and sitting on the couch.

“One of the keys to back pain is to break that pattern. Don’t do flexion activities outside work.

“If you have a choice of lying down on the couch to watch a DVD, do that. If you have flexion-related back pain, you need to avoid sitting as much as possible.”

In the past 10 years, Quirke says she has seen an increase in age-related back pain.

“But having back pain as you get older depends greatly on genetics. After that, it’s about how we live our lives. Good posture and aerobic fitness can strengthen the back, leading to flexibility.”

Spinal stenosis is common. The spinal canal is narrowed and nerves are trapped, sending pain down one or both legs. This aggravates lower back pain when walking or bending forward.

“It’s a condition that isn’t diagnosed as often as it should be. In my practice, about a third of my back pain patients have degrees of spinal stenosis. But out of that, only 5 per cent receive a label and diagnosis because physiotherapy alleviates the signs and symptoms of milder cases.”

Yoga is good for back pain provided the pain is related to stiffness and tightness. “Otherwise yoga won’t work and could do more harm than good.”

Early intervention is important in treating back pain.

“If back pain lasts for more than five days, you should see a specialist. If someone comes to see me early enough, two sessions of physiotherapy is probably all they’ll need.”

Sally Ann Quirke's new eBook on managing back pain is free to download from her website:


GET a proper diagnosis

UNDERSTAND your back symptoms

REMOVE the cause of your back pain

LEARN correct posture

GET a good mattress

WEAR correct footwear

LEARN the right lifting technique