Lower Back Pain: Causes, Self-Care and When to See a Physio

How Common Is Lower Back Pain?

Lower back pain is one of the most common reasons people seek help from a healthcare professional, and most people will experience it at some point. For the majority, it is not caused by anything serious, and it improves over days to weeks. That does not make it any less miserable while it lasts, and it can recur.

Common Causes

In most cases, doctors and physiotherapists cannot point to a single damaged structure. Instead, the pain is described as non-specific, meaning it arises from the muscles, joints, ligaments and discs of the lower back working under more stress than they are currently coping with. Common triggers include:

• Lifting, bending or twisting, particularly with poor preparation
• Long periods of sitting or standing
• A sudden increase in activity, such as gardening, DIY or a new exercise programme
• Poor sleep, stress and low mood, which can make pain more sensitive
• Previous episodes of back pain
• A disc problem, which may refer pain into the buttock or leg
• Joint stiffness or wear, which becomes more common with age

What Helps at Home

• Keep moving: short walks, gentle movements and returning to normal activities as soon as comfortable generally support recovery better than bed rest.
• Change position often: avoid staying in one position for too long.
• Find comfortable positions for sleep: a pillow between the knees when on your side, or under the knees on your back.
• Use heat or cold if it helps you, though neither is a cure.
• Ask a pharmacist or GP about pain relief if you need it, since it can make movement easier.
• Build back up gradually, rather than going straight back to heavy lifting or sport.

Warning Signs: When to Seek Urgent Help

Seek urgent medical help (call 999, NHS 111 or go to A&E) if back pain comes with any of the following:

• Numbness around the groin, genitals or buttocks
• New difficulty controlling your bladder or bowels
• Sudden weakness or numbness in one or both legs
• Severe pain following a significant fall or accident
• A high temperature, feeling very unwell or unexplained weight loss
• Constant pain that is not eased by any position, especially at night, or a history of cancer

When to Book a Physio

It is a good idea to book an assessment if your back pain has lasted more than a couple of weeks, if it keeps coming back, if you have pain travelling into the leg, or if it is stopping you from working, sleeping or exercising. You do not need a GP referral.

What a Physio Does for Back Pain

At your assessment, we ask about the pain, your health and what you do each day, then examine how you move and test strength, sensation and reflexes where appropriate. We explain what we think is going on and build a plan. Treatment commonly combines hands-on therapy, exercises tailored to your type of back pain, advice on activity and positions, and help to return to the things you want to do.

Do You Need a Scan?

Most people with lower back pain do not need a scan at first. Imaging is usually only considered when there are red-flag symptoms, when symptoms are not improving as expected, or when an injection or surgery is being considered. Findings on scans, such as disc changes, are common in people with no pain at all, so scans can sometimes cause more worry than help.

Preventing Flare-Ups

Staying generally active, building strength in the back, hips and legs, sleeping well, managing stress and breaking up long periods of sitting all reduce the chance of repeat episodes. A physiotherapist can help build a plan that fits your job and your interests.

Back Pain and Work

Back pain is a common reason for time off work, but returning to work early, with sensible adjustments, often supports recovery. Speak to your employer about temporary changes such as shorter periods of sitting, lighter lifting or a phased return. If your job involves heavy manual work, a physiotherapist can help plan a graded return.

Questions to Ask at Your Appointment

• What do you think is causing my pain?
• What should I avoid, and what should I keep doing?
• How long might recovery take?
• What exercises should I do, and how often?
• What would make you want to investigate further?

Frequently Asked Questions

Related Reading

• How Long Does Sciatica Take to Heal?
• Neck Pain or Shoulder Pain? How to Tell Where It Is Coming From
• Do You Need an MRI? When a Scan Helps and When It Does Not

This article is general information and is not a substitute for an individual assessment. If you are worried about your symptoms, speak to a healthcare professional.