How I use the Whole-Body Health pillar in my Truro Physiotherapy Clinic to help relieve chronic low back pain and sciatica

If you are looking for a physiotherapist near the Cornish coast who understands chronic pain, then you are in the right place!

As a physiotherapist specialising in persistent back pain and sciatica, I fundamentally believe that whole-body health determines the recovery trajectory of chronic low pain and sciatica.

Actually – any chronic pain condition for that matter!

If you come to see me in my back pain clinic in Truro, Cornwall then you shouldn’t be surprised if the conversation steers away from your back and onto the wider aspects of your bodily health. This is because our understanding of chronic pain is evolving at an ever-increasing pace and we now recognise that things like diet, oral health, gut health, sleep, stress (chronic stress), sunlight exposure, artificial light at night all have the potential to change the intensity and persistence of chronic pain.

That’s why one of my three pillars for chronic pain physiotherapy Cornwall is whole-body health!

MRI scans of the spine are useful for ruling out sinister conditions that could be causing your pain, or obvious nerve root compressions but they are less useful for establishing other structural contributing factors (Kash et al., 2022).

Aside from the fact that MRI scans (or any scan of any joint) cannot pick up on the fact you have only slept 2 hours in the last 5 nights because your toddler is teething, or that you’ve just been made redundant in your job – all of which can impact pain sensitivity and intensity – the scans are unable to factor in the contributions from the immune system, peripheral or central nervous system sensitisation, hormonal factors like HPA-axis dysfunction, mitochondrial dysfunction (Nijs et al., 2026; Song et al., 2023; Willemen et al., 2023) etc.  

Essentially, it misses the factors that involve the human being that the spine belongs to!

That’s why the whole-body health pillar is so important – it allows us to explore other systems in the body and infer (with some accuracy) which systems may be contributing to persistence of symptoms. For example, if you were wondering can physiotherapy and nutrition help chronic sciatica? The answer is yes – it either makes pain louder or helps calm it down and is something I have answered in a prior blog article here.

Another example is how the healthy bacterial colonies of your mouth and gut – the oral-gut axis – can directly influence your back pain through altering neuroimmune molecules and immune regulation that affect sensitivity to pain of the tissues in the back and your central nervous system (Ahmed et al., 2025).

One of the major ways is through increasing systemic inflammation as evidence by increased CRP, IL-6 and other cytokines and inflammatory molecules (Ahmed et al., 2025) with the downstream consequences of this being decreased pain thresholds and increased tissue sensitivity. The consequences of inflammation are far reaching and is a topic that I frequently discuss with my patients for chronic back pain treatment Truro.

Your circadian health? Yep, that too has a massive impact on your levels and persistence of pain.

People who are not living in alignment with their circadian health have a higher risk of developing low back pain and spinally referred leg pain and in those that already have pain, it massively turns up the pain sensitivity dial (Warfield et al., 2021).

There are a whole host of other factors, like mitochondrial dysfunction, that I could mention but it goes beyond the scope of this short post. Your results of your MRI scan of your back is not a reason to despair – structure rarely contributes solely to pain and the whole-body health factors that I have just described above are modifiable.

They will need guidance, particularly if they are new terms and concepts to you – but if you nail all of them, your experience of your low back pain and sciatica will improve over time!

If you are looking for a physiotherapist specialising in persistent back pain and feel that some of the factors above are ringing a bell with you but you don’t know where to start, then book an appointment into my back pain clinic Truro Cornwall and let’s make a plan to get you back to the sports and activities that you love!

References

Ahmed, I., Nijs, J., Vanroose, M., Vandeputte, D., Kindt, S., Elma, Ö., ... & Lahousse, A. (2025). Oral and Gut Health,(Neuro) Inflammation, and Central Sensitization in Chronic Pain: A Narrative Review of Mechanisms, Treatment Opportunities, and Research Agenda. International Journal of Molecular Sciences, 27(1), 114.

Kasch, R., Truthmann, J., Hancock, M. J., Maher, C. G., Otto, M., Nell, C., ... & Schmidt, C. O. (2022). Association of lumbar MRI findings with current and future back pain in a population-based cohort study. Spine, 47(3), 201-211.

Song, C., Xu, Y., Peng, Q., Chen, R., Zhou, D., Cheng, K., ... & Liu, Z. (2023). Mitochondrial dysfunction: a new molecular mechanism of intervertebral disc degeneration. Inflammation Research, 72(12), 2249-2260.

Nijs, J., Arendt-Nielsen, L., Johansson, E., Davis, K. D., Giordano, R., Fauchon, C., & Polli, A. (2026). An integrated systemic approach to chronic primary pain from epigenome to brain: a narrative review. British Journal of Anaesthesia.

Warfield, A. E., Prather, J. F., & Todd, W. D. (2021). Systems and circuits linking chronic pain and circadian rhythms. Frontiers in neuroscience, 15, 705173.

Willemen, H. L., Ribeiro, P. S. S., Broeks, M., Meijer, N., Versteeg, S., Tiggeler, A., ... & Eijkelkamp, N. (2023). Inflammation-induced mitochondrial and metabolic disturbances in sensory neurons control the switch from acute to chronic pain. Cell Reports Medicine, 4(11).