Most lower back pain has no single identifiable cause and improves within a few weeks. Staying gently active helps recovery; bed rest usually slows it down.
See a doctor if
- GO TO HOSPITAL IMMEDIATELY: loss of control over the bladder or bowels, or numbness around the genitals, buttocks or inner thighs — this can be cauda equina syndrome and is a surgical emergency
- Weakness in a leg or foot, or a foot that drags when you walk
- Back pain after a significant fall or accident
- Back pain with fever, or with unexplained weight loss
- Pain that is severe at night or wakes you from sleep
- New back pain starting after about age 50, or in anyone with a history of cancer or osteoporosis
- Pain that is not improving at all after four to six weeks
Common causes
These are causes doctors commonly see. This list cannot tell you which one applies to you.
- Non-specific back pain — muscle and ligament strain with no single identifiable cause, which covers the large majority of cases
- Lifting something heavy or awkwardly, or a sudden twist
- Long hours sitting, particularly with poor support and little movement
- A slipped or bulging disc pressing on a nerve, which typically also causes pain down the leg
- Weak core and back muscles, and being significantly overweight
- Age-related wear in the spine, which is normal and often painless
- Less commonly: infection, fracture in thinned bone, or cancer that has spread
Frequently Asked Questions
Should I rest or stay active with lower back pain?
Stay gently active. Bed rest was advised for decades and turned out to slow recovery down. Keep moving within what the pain allows, and return to normal activity as it eases.
How long does lower back pain usually take to settle?
Most back pain improves within a few weeks, and the large majority has no single identifiable cause. Pain that is not improving at all after four to six weeks should be assessed.
When is back pain a medical emergency?
Go to hospital immediately if you lose control of your bladder or bowels, or develop numbness around the genitals, buttocks or inner thighs. This can be cauda equina syndrome and is a surgical emergency. Weakness in a leg or a foot that drags also needs urgent assessment.
What to do next
Note when the symptom started, how it has changed, and anything that makes it better or worse. Take that information — and a list of your medicines — to your doctor. It makes the consultation considerably more useful than trying to recall it on the spot.
If any of the warning signs above apply to you, do not wait for an appointment. Go to a hospital, or call 112.