Assessment
A detailed history, then a thorough examination of movement, strength and the affected area. You leave with a working diagnosis you understand and a plan agreed with you, not handed to you.
What We Treat
Low Back Pain & Sciatica Treatment in London
Your back is built to bend, lift and sit through long days, but when the load you put through it outruns what it can currently take, it flares. Most low back pain and sciatica is non-specific and recovers well, and we treat it the way NICE advises: no routine scans, no opioids, no weeks of bed rest.
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- Self-referral; no GP letter needed.
Overview
Understanding low back pain & sciatica
Low back pain is one of the most common reasons UK adults seek help, and most episodes are non-specific: no single structure can be pinpointed as the cause. It usually comes down to load outrunning what the back can currently take, when sitting, lifting and daily loading climb past the tissue's tolerance, or that tolerance drops after time off, and the back flares. Sciatica describes leg pain, tingling or numbness following the path of the sciatic nerve, usually from irritation of a lumbar nerve root.
This is why NICE guideline NG59 (Low back pain and sciatica in over 16s) puts physiotherapy, exercise and self-management education first, and explicitly advises against routine imaging, opioids and prolonged rest. At Kaizen we start by ruling out the rare red flags, then build an individualised plan around exercise and graded activity that grows what your back can handle rather than just quietening the pain.
We treat City professionals managing desk-driven flares as well as recreational and elite athletes returning to sport. Most acute episodes settle within weeks, while recurrent or persistent pain responds well to structured exercise rehabilitation supported by manual therapy. Settling the flare is only the start: we then rebuild the strength and load tolerance that stops it returning, offering Reformer Pilates as an exercise-based option where appropriate, in line with the NICE NG59 emphasis on exercise.
Excellent
From 6 five-star Google reviews
Source: Google
David helped me when I started to have a strong tibia pain only 5 weeks before the marathon. I genuinely thought at some point that I wasn’t going to be able to do it and I did my PB!
After suffering with terrible back pain, Gus has helped me make huge improvements. Very professional and happy to explain the processes and treatments. Many thanks
Couldn’t recommend this physio team enough! They helped me recover from a knee injury 3 weeks before the London Marathon which I thought was going to prevent me from running it! Everyone was really friendly, supportive and genuinely cared about helping me reach my goal. Special thanks to Charlie, Gus, Brad and Stef!
I came to Dave with an ongoing injury that I’ve been struggling with for months! He helped sort it out straight away, also giving me some exercises to help target the area to get back to full strength. I’m now back to running pain-free already and training properly — I’ll definitely be recommending Kaizen Physiotherapy to my clients!
Gus worked miracles to get me running a marathon after being injured 6 weeks out. He worked out the issue really quickly and provided a clear and actionable plan to deal with it. The sports massages were the best I’ve ever had too — thanks Peggy! Can’t recommend Gus and Peggy enough.
I had such a positive experience working with Brad at Kaizen. He supported me through a meniscus tear and got me all the way back to running a half marathon and HYROX training. Everything was structured, progressive, and easy to follow, and I always felt like I was in safe hands.
Physiotherapy for low back pain and sciatica can help to:
Settle the flare
Manual therapy and clear education calm the early, guarded phase, in line with NICE first-line guidance. No routine scans, no strong painkillers, no bed rest: the evidence backs hands-on care plus movement, and that is exactly what your first sessions deliver.
Keep you moving
Prolonged rest slows recovery and raises the risk of persistent problems. We show you what to modify and what to keep doing, so walking, work and most of your routine continue while the flare settles instead of everything stopping for weeks.
Calm sciatica without surgery
Most sciatica improves over several weeks, and the majority of cases resolve without an operation. Graded activity and specific exercise take pressure off the irritated nerve root while we track your leg symptoms, strength and sensation at every visit.
Rebuild a stronger back
Deconditioning is one of the biggest drivers of recurring back pain. Once symptoms ease, progressive exercise rebuilds the strength and load tolerance your spine needs for desk days, training and lifting, so the back finishes more capable than it started.
Unload the desk hours
Long hours sitting, commuting and repetitive lifting are the most common triggers we see. We adjust how your day loads your back, then build the movement habits and breaks that spread that load, because the daily pattern usually decides whether pain returns.
Cut the risk of the next episode
A previous episode is the strongest predictor of another one. Finishing your rehabilitation, keeping the strength you have rebuilt and continuing with exercise, including physiotherapy-led Reformer Pilates, all reduce how often flares return and how hard they hit.
Why it happens
What causes low back pain & sciatica?
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Sustained postural loading from long desk hours, commuting or repetitive manual work
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Sudden mechanical overload, such as lifting beyond current capacity or abrupt twisting under load
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Irritation or compression of a lumbar nerve root, the usual driver of true sciatica
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Deconditioning: reduced strength and movement after time off, illness or surgery
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Pregnancy and the post-natal period, which alter how the lumbar spine and pelvis are loaded
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Stress, poor sleep and low mood, all well-evidenced amplifiers of pain perception
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Recurrent flares from a long-standing weakness or an unhelpful movement pattern
At your first appointment we work out what is really holding you back, then agree the plan with you before you leave.
Your initial visit runs 45–60 minutes: a detailed history, then a thorough examination of movement, strength and the affected area. We explain what we find in plain English and agree a working diagnosis together.
Treatment starts the same day, and you leave with the first exercises of a plan built around your goal.
Better than yesterday. Kaizen means continuous improvement: small, repeatable gains, built session by session, until you are back to what you love and no longer need us.
- One team across five London clinics: Soho, Liverpool Street, Marylebone, Canary Wharf and Wimbledon Village, plus online appointments.
- Rated 5.0 on Google across 218 reviews.
- Founded in 2022 by David Thomas and Gus Hadonou. You see the same physiotherapist at every visit, so each session builds on the last.
Fees and insurance
Book online through Jane and self-refer, with no GP letter needed. If you are using private health insurance, check your policy first: some insurers ask for a GP referral before your first session.
- Initial assessment and treatment: £155 for a full 45–60 minutes
- Follow-up treatment: £93, with your plan progressed at each visit
- Sports massage: £115 for 60 minutes, £155 for 90 minutes
- Performance MOT & Screening: £300 for a 90-minute screen with force-plate testing and a written report
- Recognised by Bupa, AXA Health, Aviva, Cigna, WPA and Allianz
Your journey
with Kaizen
Everything starts with a proper assessment. We find what is driving the problem, treat it, and build the strength that keeps it fixed, so you finish performing, not just pain-free.
Treatment
Hands-on care to settle symptoms and restore movement: manual therapy, with acupuncture, shockwave or soft-tissue work where they genuinely help. The first home exercises go with you the same day.
Rebuild
Progressive exercise that returns strength, control and load tolerance, from Reformer Pilates to strength and conditioning. Each follow-up reassesses against your baseline, so progress is measured rather than guessed.
Perform
Criteria-based milestones return you to work, sport and training. Discharge happens by mutual agreement once you can manage independently, with a Performance MOT available to catch the next weak link early.
We specialise in:
- Musculoskeletal and sports physiotherapy
- Western medical acupuncture (AACP)
- Physiotherapy-led Reformer Pilates
- Specialist hand therapy and splinting
- Shockwave therapy for stubborn tendons
- Strength and conditioning for rehabilitation
- Running and gait analysis
- Performance MOT and movement screening
Treatment approach
How do we treat low back pain & sciatica?
Physiotherapy
Combined assessment, education, manual therapy and progressive exercise is the NICE NG59 first-line treatment for both non-specific low back pain and sciatica.
See treatment detail →Sports Physiotherapy
Graded, individualised exercise rehabilitation rebuilds strength and load tolerance in the lumbar spine and supports a confident return to work and sport. It is the strongest evidence-based defence against recurrence and a core element of NICE NG59 care.
See treatment detail →Reformer Pilates
Reformer Pilates with our Chartered physiotherapists rebuilds controlled trunk and lower-limb strength under supported load. It is an exercise-based way to maintain movement and reduce recurrence, consistent with the NICE NG59 emphasis on exercise.
See treatment detail →FAQ
Frequently asked
questions
When should I go to A&E for back pain or sciatica?
Go to A&E immediately if you develop loss of bladder or bowel control, numbness around the saddle or genital area, or progressive weakness in both legs. These can signal cauda equina syndrome, a rare emergency needing urgent imaging and surgery within hours. Also seek urgent care after significant trauma. Physiotherapy is not the first step in these cases.
Do I need an MRI scan for my back pain or sciatica?
Usually not. NICE NG59 advises against routine imaging for non-specific low back pain and sciatica, because it rarely changes treatment and often shows incidental findings, such as disc bulges or mild degeneration, that are common in pain-free people. We reserve imaging for genuine red flags or symptoms that fail to improve and suggest a specific cause needing investigation.
Should I rest or stay active when my back or leg hurts?
Stay as active as your pain reasonably allows. NICE advises against prolonged bed rest, which slows recovery and raises the risk of persistent problems. Walking, gentle movement and keeping to your normal routine where possible are recommended even during an acute flare. Your physiotherapist will guide what to modify and what you can safely keep doing.
How long does sciatica take to get better?
Most sciatica improves over several weeks, and the majority resolve without surgery. With physiotherapy, an acute first episode of low back pain often settles within a handful of sessions, while recurrent or longer-standing pain responds more gradually over a longer course of structured exercise. Your physiotherapist will give you an honest, individual projection at your first appointment.
Related What We Treat
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Kaizen Physiotherapy & Performance • 111 Charing Cross Road, Soho, London WC2H 0DT
BookAppointments typically available within 1–2 weeks