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Chronic Back Pain Treatment Gold Coast — For Complex & Persistent Cases

When your back pain hasn’t responded to treatment — here’s a different approach

Most back pain responds well to standard treatment. But some cases are more complex — and if yours hasn’t improved despite doing everything right, the assessment may need to go deeper than where it hurts.

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Based at Varsity Lakes, this practice sees clients from across the Gold Coast — including Robina, Burleigh Heads, Mudgeeraba, Mermaid Waters, and surrounding areas.

This case documents the progression of a 55-year-old recreational runner diagnosed with severe multi-level lumbar disc herniation. Prior physiotherapy had provided limited sustained improvement, and the clinical outlook at the time suggested a guarded prognosis regarding structural change.

 

Over a 39-month period of assessment-led management, the focus shifted toward restoring load tolerance, movement efficiency and functional capacity. The progression below outlines the measurable outcomes that followed.

Real outcomes from a complex case

“At presentation she could barely walk and was in despair of ever being able to run again. Prior physiotherapy had provided no meaningful relief.” — Clinical record, November 2022

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  • 3 Months: Pain-free walking

  • 5 Months: 16 km continuous run with minimal lumbar symptoms

  • 6 Months: Pain-free return to recreational running

  • 21 Months: 42 km marathon completed without limiting symptoms

  • 30 Months: 65 km ultra trail completed

Why does back pain sometimes not respond to standard treatment?

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The answer is often not about the diagnosis on the imaging report. Population research (Brinjikji et al., 2015) consistently shows that disc bulges, herniations, and degenerative changes are found on MRI in people who have no pain at all:

  • 60–69% of pain-free 50-year-olds have disc bulge on imaging

  • 36–38% have disc protrusion

  • 80–88% have disc degeneration

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This doesn’t mean imaging is useless — it means structural findings alone don’t explain why someone is in pain, and treating the image rather than the person can miss the actual driver of symptoms.

Structural appearance does not define functional capacity. And imaging findings alone should not be used to limit what you believe is possible.

In complex or treatment-resistant cases, the real driver is often:

  • Neuromuscular compensation patterns built up over years of chronic pain

  • Fascial restrictions across the thoracolumbar chain, hips, and pelvis

  • Load asymmetry — the body protecting one side by overloading the other

  • Respiratory mechanics dysfunction affecting intra-abdominal pressure

  • Speed- or load-dependent thresholds that only appear under demand

None of these are visible on imaging. All of them are identifiable through assessment.

What a whole-body assessment reveals in chronic back pain

At Heal Young Massage, every first appointment begins with assessment before any hands-on treatment. For complex back pain cases this includes:

  • Medical history review and imaging analysis

  • Observational gait analysis — antalgic patterns, guarding, compensation

  • Bilateral spinal palpation — tissue density, fascial restriction, asymmetry

  • Active and passive range of motion throughout the lumbar, thoracic, and hip chain

  • Respiratory assessment — diaphragmatic function and breathing pattern

  • Functional movement screening — load avoidance and motor compensation

  • VALD ForceDecks bilateral force platform testing (where indicated) — objective measurement of force output and asymmetry

In the case documented above, this assessment identified a speed-dependent pain threshold (symptoms only above 8 km/h), eccentric deceleration chaos (CoV 203.6% on force plate testing), respiratory dysfunction, and fascial restrictions across the sacroiliac joint, thoracolumbar fascia, and lateral chain.

 

“These factors are not always visible on imaging and may not be assessed in standard protocols.”

If your back pain hasn’t improved despite doing everything right, an assessment may be the missing piece.

The clinical timeline — from barely walking to ultra trail running

This case unfolded across seven distinct phases over 30 months:

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Phase 1 – Structural Diagnosis (2017)

MRI Lumbar Spine showed severe multi-level disc herniation with neural canal compromise.

 

Phase 2 – Presentation (Nov 2022)

Significant difficulty walking and limited confidence returning to running.

 

Phase 3 – Objective Baseline (Feb 2023)

Marked neuromuscular variability and load asymmetry identified.

 

Phase 4 – Functional Restoration (Apr–May 2023)

Continuous 14–16 km running achieved within five months.

 

Phase 5 – Imaging Follow-Up (Feb 2024)

Degenerative changes persisted on imaging, despite significant functional improvement.

 

Phase 6 – High-Load Performance (May 2024)

Improved neuromuscular consistency under higher demand tasks.

 

Phase 7 – Peak Performance (2025)

42 km marathon and 65 km ultra trail completed without limiting lumbar symptoms.

What objective measurement revealed

Two VALD ForceDecks assessments across the treatment period provide before-and-after evidence of neuromuscular change:

Importantly, the follow-up assessment involved a significantly higher mechanical and neurological demand task. Despite this increased load, neuromuscular variability reduced markedly.

 

This suggests improved load tolerance and movement control under stress — not simply short-term symptom reduction.

 

In practical terms, the body demonstrated a more consistent and efficient strategy for absorbing and redistributing force, which aligned with the client’s ability to return to long-distance running without recurrence of limiting lumbar symptoms.

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Objective measurement was used to guide clinical reasoning and monitor progression, rather than relying solely on subjective symptom reporting.

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What was treated — and how

Treatment was directed at the neuromuscular compensation patterns, not the structural findings on imaging. The core components were:

  • Myofascial release — thoracolumbar fascia, hip flexor complex, bilateral hamstrings, quadratus lumborum, and surrounding chains

  • Grade I–II joint mobilisation — lumbar and thoracic segments, sacroiliac joint, hips

  • Respiratory retraining — diaphragmatic function restored to regulate intra-abdominal pressure

  • Load redistribution and movement retraining — rotational mobility drills, single-leg loading, oblique activation under load

  • Self-management tools — foam roller, S-ball techniques, graduated running progression

Treatment frequency began fortnightly, progressively reducing to monthly then bimonthly maintenance as functional capacity improved and sustained gains were demonstrated between sessions.

Is this approach right for you?

This type of assessment-led approach is particularly suited to:

  • Chronic or recurring back pain that hasn’t resolved with standard treatment

  • Cases where imaging shows pathology but treatment directed at those findings hasn’t helped

  • People who’ve been told their prognosis is poor or that nothing more can be done

  • Athletes with persistent back pain that limits training or performance

  • Anyone whose pain has a load-dependent or speed-dependent quality

  • People who want to understand why they’re still in pain, not just manage it

Back Pain Assessment — Varsity Lakes, Gold Coast

 

If you’re based on the Gold Coast and dealing with persistent or recurring back pain, assessments are available at the Varsity Lakes clinic. Clients attend from Robina, Burleigh Heads, Mudgeeraba and surrounding areas.

The first appointment at Heal Young Massage is always an assessment before any hands-on treatment begins. I review your imaging, your history, and how your whole body moves — then build a treatment plan based on what the assessment actually finds.

If you’ve been searching for answers, I’d welcome the opportunity to take a fresh look.

Clinical Note

Written consent has been obtained from the client for clinical and educational use. Client identity has been fully de-identified. All VALD ForceDecks data and clinical records are held on file. This page references Brinjikji et al. (2015), AJNR, a peer-reviewed systematic review of imaging findings in asymptomatic populations.

Frequently Asked Questions About Back Pain (Gold Coast)

Can a disc bulge heal without surgery?

 

Many disc changes seen on MRI are common in pain-free individuals. In some cases, symptoms improve significantly with load management, movement retraining and progressive rehabilitation.

 

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Why does back pain return after physiotherapy?

 

Sometimes the initial pain settles but the underlying load asymmetry or compensation pattern hasn’t fully resolved. When training intensity increases, symptoms can reappear.

 

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Can I run with a lumbar disc herniation?

 

In some cases, yes — if load tolerance is rebuilt progressively and movement strategy is stable. A structured assessment helps determine readiness.

 

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Does imaging always explain back pain?

 

No. Structural findings such as disc bulges are common in people without pain. Imaging is one part of the picture, not the whole explanation.

 

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When should I see a back pain specialist on the Gold Coast?


If pain has persisted despite appropriate treatment, keeps returning, or limits your training or daily movement — whether you're based in Varsity Lakes, Robina, Burleigh Heads, Mudgeeraba, or elsewhere on the Gold Coast — a deeper assessment may be helpful.

 

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How long does back pain usually last?

 

Back pain varies significantly. Acute episodes often settle within weeks, but cases involving compensation patterns, load asymmetry, or chronic tissue changes can persist much longer without targeted assessment and treatment.

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