Starting Out With Low Back Pain
Low Back Pain: the few things that matter most, and the mistakes that catch people out early.
Pain in the lower back, most often with no identifiable structural cause.
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.
Why bother
Most episodes settle within weeks, and the strongest predictor of a poor outcome is resting and avoiding movement.
Start here
Just these two to begin with. The rest can wait.
- Keep moving and continue normal activities as far as pain allows
- Use exercise as treatment rather than waiting to be pain-free first
Then add these
After that, these.
- Use simple analgesia short-term to enable movement
- Return to work early, with adjustments if needed
The numbers, in one place
| 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 |
| Bed rest | not recommended |
| Recommended | exercise programmes, and manual therapy as part of a package |
Common early mistakes
- Bed rest beyond a day or two
- Requesting scans for uncomplicated back pain
- Assuming pain equals damage
Where to go next
- Low Back Pain: What Published Guidance Supports
- Making Sense of Low Back Pain
- Low Back Pain — the reference entry
- What the Guidance Really Says About Sciatica
- Neck Pain: What the Evidence Actually Says
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 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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