Lower back pain can stop you in your tracks. One wrong move lifting a suitcase, a long flight into Nice airport, a night on a soft hotel bed, and suddenly you cannot bend, sit or sleep comfortably. Most episodes settle, and hands-on treatment can speed that up. As an osteopath, I assess your back, treat the joints and muscles that are not moving well, and give you a clear plan to get moving again.
I am Aloïs Ruetsch, an English-speaking osteopath and manual therapist in central Nice, with 15 years of practice and more than 10,000 consultations. If you see a chiropractor or a manual therapist back home, a French osteopath is the closest equivalent.
This article covers the usual causes, what I do, what the evidence says, and when to see a doctor instead.
The essentials
- Most lower back pain is mechanical, meaning joints, muscles and discs are irritated rather than seriously damaged, and it settles with time and movement.
- Osteopathy has good evidence for low back pain when it is combined with exercise and advice (NICE guideline NG59).
- A recent episode usually needs one to three sessions; long-standing pain needs a longer plan and your own effort.
- Keep moving gently, use heat, and avoid bed rest beyond a day or two.
- Numbness between the legs, bladder or bowel changes, fever or growing leg weakness need a doctor the same day. In France, dial 15 or 112.
What causes lower back pain?
Most lower back pain comes from the joints, muscles, ligaments and discs of the lumbar spine being overloaded or irritated, and in most cases nothing is seriously damaged. Doctors call this non-specific or mechanical back pain. Typical triggers I see in Nice are a long flight followed by hauling luggage, a weekend of padel or cycling after months at a desk, a hotel mattress that is too soft, or bending and twisting awkwardly on the beach pebbles.
Less often, a disc bulge presses on a nerve and causes pain down the leg, which is sciatica. Stiff hips, a weak core after pregnancy, stress and poor sleep all lower the threshold at which the back complains. Rarely, back pain has a medical cause such as a fracture, infection or inflammatory disease, which is why I screen for warning signs at every first visit.
What does an osteopath actually do for lower back pain?
I start with a conversation and a physical examination, then treat with my hands and finish with advice you can use straight away. I ask how the pain started, what eases or worsens it, and about your general health, then check how your spine, hips and pelvis move. If anything suggests a medical problem, I refer you on first.
Treatment is adapted to you. It may include soft-tissue work on tight back and hip muscles, gentle articulation and mobilisation of stiff spinal and pelvic joints, muscle energy techniques where you push lightly against my resistance to free a joint, and, where appropriate and with your consent, a short-lever manipulation (the ‘click’). I never force anything. The session ends with simple guidance on moving, sleeping and getting back to your activities, because what you do between sessions matters as much as the manual therapy itself.
Does osteopathy work for lower back pain?
Yes, for most people, provided it is part of a package that includes movement and advice. The UK guideline on low back pain and sciatica (NICE NG59) recommends considering manual therapy, which covers the techniques osteopaths use, alongside exercise and education, for both recent and long-standing low back pain. It does not recommend hands-on treatment on its own, and neither do I.
In practice, osteopathy can reduce pain and stiffness and help you return to normal life sooner, while the lasting result depends on you staying active. Osteopathy does not change a disc on a scan and it does not replace medical care. Osteopaths in France do not make medical diagnoses, so if your pain needs imaging or medication, your médecin généraliste remains the right person to organise that.
How many sessions will I need?
For a recent episode of lower back pain, one to three sessions are usually enough. Many visitors and expats in Nice come once, feel freer the same day, and finish their week with a few self-help instructions. After the first session I will tell you whether a second is worthwhile.
If your back has been painful for months or years, be realistic. Manual therapy can help you turn a corner, but a chronic back usually needs a longer plan: a few sessions spread over several weeks, a gradual return to sport, and often some work on sleep, stress and sitting habits. If you are not improving after three or four sessions, I will say so and suggest another route rather than keep treating.
What can I do myself in the meantime?
Keep moving, as normally as the pain allows, because bed rest beyond a day or two slows recovery. Short, frequent walks along the Promenade des Anglais are better than one long effort. Heat on the lower back for 15 to 20 minutes can ease muscle spasm. Change position often if you sit at a laptop, and break up long drives along the coast.
For sleep, lie on your side with a pillow between your knees, or on your back with a pillow under them. Over-the-counter pain relief can help for a few days; pharmacists in Nice can advise you, and many speak English. Return to padel, running or sailing gradually once the sharp pain has settled, rather than waiting until you feel perfect.
When should you see a doctor instead?
See a doctor urgently if your back pain comes with any of the following: numbness or tingling in the saddle area (between the legs and around the back passage), new difficulty controlling your bladder or bowels, weakness in one or both legs that is getting worse, fever, unexplained weight loss, pain that follows a major fall or accident, a history of cancer, or severe pain at night that does not ease when you change position.
These signs are rare, but they need medical assessment before any manual therapy. In France, dial 15 (SAMU) or 112 for an emergency, or go to the nearest emergency department (urgences). For a non-urgent medical opinion, a médecin généraliste or SOS Médecins can see you without a referral. If I spot any of these signs, I will send you to the right place.
Osteopath, chiropractor or physio: who should I see in Nice?
For most lower back pain in Nice, an osteopath is the simplest first stop, because you can book directly, no referral is needed, and the profession covers the same ground as a chiropractor at home. Osteopaths and chiropractors are very similar hands-on professions. In France osteopathy is the everyday choice, with a five-year state-recognised degree, while chiropractors are far fewer.
Physiotherapists (kinésithérapeutes) are excellent for rehabilitation and exercise programmes, but in France they usually need a prescription from a doctor, and the state-reimbursed sessions are short. The French system works like this: your médecin généraliste handles diagnosis, prescriptions and scans; pharmacies give over-the-counter advice; SOS Médecins makes home visits; and 15 or 112 are for emergencies. Osteopathy sits alongside all of these, and I work with local doctors when a patient needs more than manual therapy.
How do I see an English-speaking osteopath in Nice?
You can book me directly, often the same day, by WhatsApp on +33 7 71 27 24 25 or online via Doctolib. My clinic, Pôle Ostéo, is at 22 rue Gounod in the Musicians’ quarter, a few minutes on foot from the Promenade des Anglais. A session lasts about 45 minutes and costs €90 at the clinic.
If you cannot move, or prefer to be treated where you are staying, I visit hotels, villas, apartments and yachts at berth in Nice and along the nearby Côte d’Azur coast for €120, with no surcharge for evenings, weekends or same-day calls. I am open seven days a week, take card or cash, and give you a receipt for your travel or health insurance, in English on request. No referral is needed in France to see an osteopath or manual therapist.
In practice
Illustrative example, details changed. A British yacht engineer in his forties messaged me on a Sunday morning after his back had locked while lifting a toolbox on the quay in Nice. I saw him at the clinic that afternoon: no warning signs, a very stiff lower spine and pelvis, and a lot of muscle spasm. After soft-tissue work, gentle mobilisation and advice on walking and sleeping, he left moving more freely. A second session three days later eased the remaining stiffness, and he went back to the boat with a plan for the week ahead.
Frequently asked questions
Is an osteopath the same as a chiropractor?
Will you crack my back?
Can I be treated on the same day I contact you?
Do I need a scan before seeing an osteopath?
Is osteopathy covered by my insurance?
Book an English-speaking osteopath in Nice
Clinic at 22 rue Gounod (€90) or a visit to your hotel, villa, yacht or home in Nice (€120, no surcharge). Seven days a week, often same day. Write in English, Spanish or French.