General Low Back Pain Advice

Your spine is strong and designed to move. Low back pain is very common and, although it can be distressing, it is rarely caused by a serious problem. Most people will experience back pain in their lifetime. Most occurrences are usually short lived and will pass in 4-12 weeks. Some people experience pain following an injury, whereas others do not have a clear trigger.

Low back pain is often caused by a combination of factors affecting the muscles, joints and other tissues in your back. It is not always possible to identify one specific structure causing the pain. The structures of the lower back are all in close proximity. It is therefore not always possible to establish which one is causing the pain. Even when the exact source of pain is unclear, the treatments that help are often similar. Most cases of low back pain settle naturally within 4-12 weeks. The best approach to improve your symptoms is to stay as active as possible. There are lots of self-help treatments that you can use. Further investigations are rarely needed.

Steps to take to recovery

Adjust Activities

Try to temporarily avoid movements or activities that aggravate the pain. If you have had a recent injury your back may need a little time to settle. In the early stages avoiding irritating your back may be helpful. Trying to move frequently is often helpful, for example avoiding prolonged static positions.

Use Ice or Heat: Some patients find this helpful to reduce their pain. If you have had a recent injury, some people find a cold pack helpful during the first few days. If you have a longer standing back issue, then heat packs may help soothe some of your pain. Wrap ice or heat packs in a towel and do not place them directly onto your skin to avoid ice or heat burns.

Staying at work, where possible, is usually helpful for recovery. If you are struggling to do your job you may want to speak to your employer about modified duties for a few weeks. You may need short rests between tasks, but try to continue your normal activities as much as possible.

Exercise

Consider light aerobic exercise at first such as walking, swimming, or cycling. Gentle mobility exercises and graded strength exercises can also be helpful. Start with gentle stretches to improve flexibility and range of motion. Focus on moving in a tolerable range. However, if exercise causes a significant increase in symptoms that does not settle, reduce the amount and build up more gradually. Arthritis UK back exercises may be helpful.  

Pain Relief

Over-the-counter medicines: Over-the-counter pain relief may help you stay active. Always follow the advice provided with the medicine.

Topical creams: Some people find topical creams or gels helpful for short-term relief of pain and stiffness.

It is important to check whether you can take these medicines. If you are unsure whether you can take these medicines, speak to a pharmacist or another healthcare professional.

"10 Things to Know" 

The Chartered Society of Physiotherapy have produced a "10 things you need to know about your back" webpage which has useful information. 

Select one of the conditions listed to find out more about back problems. We have only included the most common problems. We will describe how these present and how they are usually treated/what our service can offer. If you would like further support from our team for your back issue you can refer yourself to physiotherapy. 

Know When to Seek Help

If you have symptoms that could suggest cauda equina syndrome, seek urgent medical assessment. This is usually through A&E because early assessment is important. If untreated, it can sometimes cause permanent problems affecting the legs, bladder, bowel or sexual function. You can download a cauda equina syndrome information card for further information.

There are many causes of back pain. Although the symptoms can be distressing, most do improve with time. There are circumstances where a medical opinion is appropriate. If you are experiencing any of the following, please contact 111 or your GP for advice.

  • New weakness in one or both legs, or difficulty walking or coordinating your legs.
  • Pain which is worse at night especially if it is severe and does not change with movement or position
  • Fever (temperature above 38 degrees) and severe back pain
  • Pain that started after a serious accident, such as after a car accident
  • Back pain and a history of previous cancer
  • Back pain with a diagnosis of osteoporosis

Lifestyle factors that influence health

Lower back pain is common and is influenced by our overall health. Physical activity levels, body weight, long-term stress and sleep quality can all influence back pain. Smoking and alcohol consumption may also negatively impact bone health and affect the spine over time. Improving general physical and mental health can help reduce symptoms and support long-term back health. More support with health and lifestyle factors can be found on our Your Musculoskeletal Health page.

When to seek further advice

Call 111 / Go to A&E immediately if you experience:

Bladder problems

  • New (within the last two weeks) difficulty passing urine
  • Not knowing when your bladder is full
  • Loss of sensation when passing urine
  • Episodes of incontinence
  • Loss of bladder control e.g. difficulty stopping or controlling the flow of urine

Bowel problems

  • Incontinence (leaking) or loss of sensation during bowel movements

Numbness in the "saddle" area

  • Loss of feeling/pins and needles between your inner thighs, genitals and/or anus
  • Sexual Dysfunction i.e. erectile dysfunction, reduced sensation during intercourse or impaired ability to reach climax

These symptoms could suggest cauda equina syndrome. If you have these symptoms please seek urgent medical assessment. This is usually through A&E because early assessment is important.