Lower back pain

We don’t know for sure, and this can be frustrating for you and us. However, for most people with back pain – we never find an exact cause, and it gets better by itself. In most cases, a problem with the muscles or joints of the back is likely causing the pain.

Having heard your story and examined you, we feel there are no worrying signs that something more serious is going on. However, we will talk about warning signs to look out for, and if they appear we need to review you again.

Although it often feels that this would be helpful, scans can’t usually help with
the treatment of your back pain.

X-rays often don’t show us what’s wrong, as they can’t see muscles or joints. Some people may benefit from an MRI scan.

Those people will have worrying symptoms – and if you notice these appear – we want you to return to the emergency department.

We would like you to come back to the emergency department straight away if
you notice these symptoms:

• new severe pain shooting down both legs from your back
• any new weakness or numbness in both of your legs
• any change to the sensation of your bladder or bowels (knowing when you want to go for a wee or poo), or if you can’t control when you go for a wee or poo
• any numbness around your bottom, or your genitals
• for patients who have a penis - if you have new problems getting an erection

Keep active – we now know that bed rest is unlikely to be helpful and may make things worse. It is important to know that moving will not hurt your back, and may speed your recovery.

Painkillers may be helpful, to help you start moving. However, back pain is tricky to treat, and there is no good research that says a certain tablet is helpful.

Some people find back exercises helpful - such as Pilates - to strengthen the back and help improve pain. Some examples can be found on the national NHS website back pain page. 

For sleeping; try sleeping with a pillow tucked under your knees to help relieve pain.

The good news is that it is likely to start improving in 2 weeks, and most people feel it has gone by 6 weeks.

Everyone is different, and some people will need longer to recover.

A good recovery is possible, even with a lot of pain initially.

Firstly – we want to see you in the emergency department if you develop any of the worrying signs above.

If you find that your back pain continues to affect your day-to-day life at 6 weeks, consider booking a review with your GP, who may consider referral to physiotherapy at this point if they feel this is the right plan for you.

Reviewed by Dr H Greenslade in May 2022, next review in May 2024. 

If you need this information in an alternative format, please contact the Patient Experience and Engagement Team on 01226 434922.

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