Back Pain: A Practical Checklist
Back Pain: what is worth doing, what is worth avoiding, and when to stop and see a doctor.
Pain in the lower back, most often without an identifiable structural cause. Most episodes settle within weeks, and the strongest predictor of a bad outcome is resting and avoiding movement.
Key takeaways
- Most common type: non-specific low back pain
- Imaging: not recommended routinely; findings correlate poorly with pain
- Most useful single change: Keep moving and continue normal activities as far as pain allows.
- Commonest mistake: Bed rest beyond a day or two.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
Do
- Keep moving and continue normal activities as far as pain allows
- Use exercise as treatment rather than waiting to be pain-free first
- Use simple analgesia short-term to enable movement
- Return to work early, with adjustments if needed
Do not
- Bed rest beyond a day or two
- Requesting scans for uncomplicated back pain
- Assuming pain equals damage
The numbers behind the list
The reasoning behind both lists, in numbers.
| Measure | Figure |
|---|---|
| Most common type | non-specific low back pain |
| Imaging | not recommended routinely; findings correlate poorly with pain |
| First-line advice | stay active and continue normal activities |
| Recommended | exercise programmes, and manual therapy as part of a package |
| Bed rest | not recommended |
If you change one thing
Keep moving and continue normal activities as far as pain allows. That is the opening item above. Doing only that is still doing something.
Where to go next
- Back Pain: A Beginner-Friendly Start
- A Q and A on Back Pain
- Back Pain — the reference entry
- Falls Prevention: What Published Guidance Supports
- The Evidence on Joint Replacement, Without the Hype
When to speak to a doctor
Seek emergency care for numbness around the genitals or back passage, difficulty passing or controlling urine, loss of bowel control, or weakness in both legs — cauda equina syndrome is a surgical emergency. See a GP urgently for back pain with fever, unexplained weight loss, a history of cancer, recent significant trauma, or pain that is worse at night and not relieved by lying down.
Where this comes from
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.
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