Low back pain affects the lower part of the back and may come with stiffness or pain travelling into a leg. Most episodes are not caused by serious damage and improve gradually.
Keep moving at a suitable level
Prolonged bed rest is not recommended. Continue normal activities as far as possible and adjust their intensity. Short walks, regular changes of position and comfortable movement are usually more helpful than staying still.
Pain can vary from day to day. A small, temporary increase after activity does not necessarily mean the back has been damaged, but progression should remain manageable.
Build an active plan
Persistent pain may benefit from a personalised combination of education, exercise, psychological support and selected physical therapies. Belts, traction and systematic passive treatments are not routine solutions.
- Understand the pain and the factors that influence it
- Gradually return to meaningful activities
- Improve strength, mobility and endurance with suitable exercise
- Support sleep and break up long periods of sitting
- Use manual therapy, if appropriate, as part of an exercise programme
Imaging is not always needed
An X-ray or MRI is not usually offered at the outset when there are no warning signs, because it often does not change early management. A doctor may request imaging when a specific cause is suspected or when the result could change treatment.
Warning signs
These signs are uncommon but need urgent medical assessment. Pain that does not improve, seriously disrupts sleep or limits activity for a long time also deserves professional advice.
- Significant or progressive leg weakness
- Loss of sensation around the genitals or buttocks
- New difficulty urinating or loss of bladder or bowel control
- Fever, feeling unwell, unexplained weight loss or a history of cancer
- Pain after a major fall, especially with fragile bones