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The Sarah Key Method for back pain

This unique approach to ‘low back pain’, is based on decades of experience at the coal-face by Physiotherapist to the Royal Family, Sarah Key.

Of utmost importance is correct diagnosis involving comprehensive, history, physical examination, and review of X-Rays and scans to discover the ‘nub’ of the problem in the overall cascade of spinal breakdown.

The Sarah Key Method describes 5 levels of spinal breakdown:

  1. Stiff Spinal Segment
  2. Facet Joint Arthropathy
  3. Acute Locked Back
  4. Prolapsed IVD
  5. Unstable Spinal Segment

All spinal problems fall into one (or more) of these categories which usually progress sequentially, however, may skip from one category to the next.

Once a diagnosis is made, healing aims to reverse the stages of breakdown. Diagnosis identifies the segmental level and stage of break down of the primary problem.


Treatment incorporates manual therapy, supervised and home exercise. Depending on the diagnosis, a treatment regime will include:


Mobilisation of stiff spinal segments and facet joints to restore segmental movement. This will need to be performed by a qualified manual therapist.


Decompression of the lumbar spine to allow improved fluid exchange and nutrition for the discs. Decompression is performed by patients at home on a daily basis, using a simple draping exercise over a Back Block.


ROM/Stretches to restore full scale movement. These need to be progressed at an appropriate rate to avoid aggravating patients symptoms while ensuring progress.


Strengthening of abdominal and spinal intrinsic muscles (eg Multifidus) will be performed in the clinic and by the patient at home on a daily basis.

The combination and rate of progression of the above regime will vary from one patient to the next, depending on the specific diagnosis, extent of the problem, and irritability. After a short to medium term of Therapist-directed treatment, the ultimate goal is to empower the patient to manage their own back.

Tony Morley is an Accredited Practitioner of the Sarah Key Method having successfully completed Stage 1 & 2 Courses, involving over 50 hours direct instruction from Sarah Key and then passed a theory examination, 3 case-presentations and a Practical Exam. In addition Tony has been invited to assist Sarah during her Back In a Week Courses. In September 2009 he conducted a training course for Physiotherapists at Kensington Palace on behalf of Sarah Key.

Tony Morley consults from our Lismore and Ballina Office.

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