Back
Lower back pain
Pain across the lower part of the back that is extremely common and usually due to muscle or joint strain that settles within a few weeks, but which occasionally signals nerve compression, a fracture or another serious cause needing urgent care.
Education and reference only. This explains the common causes of lower back pain and the warning signs that need urgent help, in plain language — it is not a diagnosis or a substitute for advice from a clinician. If you feel very unwell or are worried, seek medical help.
Quick answer
What is lower back pain?
Lower back pain affects most people at some point and is one of the commonest reasons for time off work, yet in the large majority of cases it is non-specific — meaning it comes from the muscles, ligaments and joints of the back rather than a serious disease, and it improves over days to weeks with sensible self-care and keeping active. Sometimes pain travels down a leg because a nerve is irritated or pinched, known as sciatica, and conditions such as wear-and-tear arthritis of the spine or, in inflammatory back pain, stiffness that is worst in the morning point to specific causes.
- Get urgent help: Go to A&E now if you lose control of your bladder or bowel, have numbness around the back passage or genitals, or weakness or numbness in both legs — this may be cauda equina syndrome, an emergency. Seek urgent help for back pain after a significant injury, or in someone with osteoporosis, as this can mean a fracture.
- Self-care: For ordinary lower back pain, the best advice is to stay as active as you can rather than resting in bed, as gentle movement helps the back recover and prolonged rest tends to make stiffness worse.
About lower back pain
Lower back pain affects most people at some point and is one of the commonest reasons for time off work, yet in the large majority of cases it is non-specific — meaning it comes from the muscles, ligaments and joints of the back rather than a serious disease, and it improves over days to weeks with sensible self-care and keeping active. Sometimes pain travels down a leg because a nerve is irritated or pinched, known as sciatica, and conditions such as wear-and-tear arthritis of the spine or, in inflammatory back pain, stiffness that is worst in the morning point to specific causes. The rare but vital cases to recognise are those signalling pressure on the nerves at the base of the spine, a possible fracture in someone with thin bones or after injury, or pain accompanied by fever, weight loss or night-time worsening — each of which needs prompt assessment.
When to get help
Call 999 or go to A&E if lower back pain comes with any of these warning signs:
- Go to A&E now if you lose control of your bladder or bowel, have numbness around the back passage or genitals, or weakness or numbness in both legs — this may be cauda equina syndrome, an emergency.
- Seek urgent help for back pain after a significant injury, or in someone with osteoporosis, as this can mean a fracture.
- Seek urgent assessment for back pain with fever, unexplained weight loss, or pain that is much worse at night.
- See a doctor promptly for back pain with progressive leg weakness, numbness or difficulty walking.
- See a doctor if pain is severe, not improving after a few weeks, or spreading down both legs.
When to see a doctor
Most lower back pain eases within a few weeks and does not need a doctor. Arrange an appointment if the pain is severe, is not improving after a few weeks of self-care, keeps coming back, or is stopping you doing your normal activities. Seek urgent help, rather than waiting, if back pain follows a major injury or occurs in someone with thin bones, or if it comes with fever, unexplained weight loss, or night-time pain. Any loss of bladder or bowel control, numbness around the back passage, or weakness in both legs is an emergency that needs A&E straight away.
Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.
What can cause it
Common causes of lower back pain
Lower back pain has many possible causes. Each links to a full, plain-language guide to that condition — what it is, how it's treated and when to seek help.
What helps
Self-care and what you can do
For ordinary lower back pain, the best advice is to stay as active as you can rather than resting in bed, as gentle movement helps the back recover and prolonged rest tends to make stiffness worse. Keep doing everyday activities within the limits of your pain, return to normal routines gradually, and try gentle stretching and walking. Heat from a warm pad or bath, good posture, and not staying in one position too long can all ease discomfort. A pharmacist can advise on suitable over-the-counter pain relief if you need it. Most back pain improves within a few weeks; staying positive and active is one of the most important things you can do for recovery.
Answers
Lower back pain: frequently asked questions
Should I rest or stay active with back pain?
Staying active is best for most lower back pain. Gentle movement and keeping up everyday activities within the limits of your pain help the back recover, while prolonged bed rest tends to make stiffness and recovery worse. Return to normal routines gradually.
How long does lower back pain usually last?
Most non-specific lower back pain improves over a few weeks with self-care and staying active. See a doctor if the pain is severe, is not settling after a few weeks, keeps returning, or comes with warning signs such as leg weakness, fever or weight loss.
What is cauda equina syndrome?
It is a rare emergency caused by pressure on the nerves at the base of the spine. Warning signs include loss of bladder or bowel control, numbness around the back passage or genitals, and weakness or numbness in both legs. Go to A&E immediately if these occur.
When is back pain a sign of something serious?
Most back pain is not serious, but seek prompt help for pain after a significant injury, in someone with osteoporosis, or with fever, unexplained weight loss, night-time pain, or leg weakness. Loss of bladder or bowel control is an emergency.
Sources
Where this is drawn from
- NICE CKS: Low back pain - without radiculopathy.
- Versus Arthritis: back pain information.
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