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Lower back pain

11-minute read

If you have back pain and have lost feeling or movement in your limbs or are having problems controlling your bowels or bladder, call triple 000 immediately and ask for an ambulance.

Key facts

  • Low back pain is common.
  • About 8 in 10 people have low back pain that is not caused by any particular condition — this is called ‘non-specific low back pain’.
  • Most people with non-specific low back pain get better quickly.
  • See your healthcare professional if your back pain is unresolved and limits your movement and activities.

What is low back pain?

Low back pain is a very common problem, with 1 in 6 Australians reporting having back problems. About 4 out of 5 people have low back pain at some time in their lives.

People experience low back pain in different ways — most feel pain, stiffness and soreness.

Back pain can impact you physically and mentally. Some people with low back pain may feel irritable or short-tempered. You may worry about whether the pain will control your life and you may experience feelings of helplessness.

What causes low back pain?

Your spine or backbone is a complex structure. It is made up of 24 small bones called vertebrae that are stacked on top of each other. Discs sit between each vertebra to act as cushions or shock absorbers and give your spine flexibility.

The vertebrae are joined together by small joints called ‘facet’ joints. These joints allow you to move and bend your back. A mesh of ligaments and muscles hold the spine together and provides structural support, which allows you to move.

Low back pain can come from any of these structures, but in most cases, it isn’t caused by any significant damage to your spine. Back pain usually stems from the surrounding muscles, ligaments or joints and occasionally spinal disc problems.

Back pain that is related to a serious medical problem (such as cancer, infection, a spinal fracture or conditions such as ankylosing spondylitis) is uncommon.

Anatomy of the human spine

Non-specific low back pain

About 8 in 10 people have low back pain that is not caused by any particular condition — this is called ‘non-specific low back pain’.

Non-specific low back pain is most common in people aged 35 to 55 years, but it can affect people of all ages.

Risk factors for non-specific low back pain include:

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When should I see my doctor?

If you have back pain and have lost feeling or movement in your limbs or are having problems controlling your bowels or bladder, call triple 000 immediately and ask for an ambulance.

You should see your doctor or other health care professional for further advice if:

You should see your doctor as soon as possible if you:

For most people, low back pain will resolve in a few weeks.

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How is low back pain diagnosed?

Your health professional will first assess your low back pain. They may ask questions including:

They will also ask how the pain makes you feel and if it is affecting your daily activities.

Your doctor will also ask about your other health conditions and do a physical examination. They may refer you for tests. Tests can include blood tests or imaging tests.

In most situations, imaging such as x-ray, CT scans or MRI scans are not helpful, unless there is an obvious injury or strain. Unnecessary imaging tests can be expensive. Many investigations will show changes in your spine that reflect the normal passage of time, rather than damage to your spine.

How is low back pain treated?

You can do several things to manage low back pain. A conversation with your doctor or physiotherapist can help address any concerns you may have and help you to better understand your treatment.

Remember that not all information is trustworthy, so let your healthcare team know about any treatments you are considering before you begin them.

Most people with non-specific low back pain get better quickly. Ways to manage non-specific low back pain include the following.

Keeping active

Try to return to some physical activity or regular work as soon as you can. Your back is designed to move, so don’t rest your back for more than a day or 2.

Physiotherapy

A qualified physiotherapist can assess your pain. They can provide massage and suggest exercises to keep your back moving.

They may also suggest heat or cold packs to relieve back pain.

Exercise

Exercise can help manage back pain. Walking, water-based walking (in a pool), swimming and floor stretches are good choices to start with.

The frequency and intensity of exercises can be increased over time. You may start squats or lunges, or programs such as:

Check with your doctor or physiotherapist if you are not sure about which exercises are best.

Losing weight

If you are overweight, losing weight can help relieve low back pain.

Pain relief medicines

The goal of taking medicines for back pain should be to help you stay active. Use pain-relief medicines to keep moving, not to stop the pain altogether.

Non-steroidal anti-inflammatory drugs (NSAIDs) can provide short-term relief of non-specific low back pain, but side effects may be a concern. If NSAIDs (such as ibuprofen) are not suitable, you can try paracetamol.

If you take pain-relief medicines to manage back pain, use the lowest effective dose for the shortest time possible. For some people, topical NSAIDs (such as a gel formulation) may be a safer option than NSAIDs in tablets.

Strong pain medicines are not recommended for back pain. Research shows strong pain medication provides little benefit and can cause side effects such as drowsiness, sedation and/or dependence.

If you have severe back pain and your current medicine is not adequately managing it, talk to your doctor about a suitable treatment plan.

Psychological treatments

Your doctor may also recommend psychological treatment if they think it will help with your recovery. This may be cognitive behavioural therapy to help you develop coping strategies to manage pain.

Managing stress and getting treatment for conditions such as anxiety and depression can also help you recover.

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How can low back pain be prevented?

Healthy lifestyle choices can help prevent some types of back pain.

Exercise can help prevent non-specific low back pain. Keeping a healthy weight is also important.

Doing exercise helps to keep your back flexible and strong. Exercise improves your posture and helps your muscles to support your spine. Try:

Maintaining a good posture is important when you sit at home, in your workplace, or in your car.

Practise safe lifting in your home or workplace. Whenever you pick up a heavy load, squat down, hold the object close to your body, and lift with your legs.

It may also help to make healthy lifestyle choices.

Complications of back pain

Most people recover from non-specific low back pain within a few weeks. See your doctor if you experience additional symptoms, such as:

For some people, back pain becomes an ongoing problem. Possible complications associated with persistent, long-term back pain include:

See your healthcare professional if your back pain is unresolved and limits your movement and activities. A health care professional can help you find ways to manage your pain and regain a better quality of life.

Resources and support

MyBackPain has tips on managing back pain.

For more information and support, visit the Pain Australia website and find a support group or online community for people living with chronic pain.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.

Other languages

Do you prefer reading in languages other than English? The following website offers translated information:

Apps and tools

Pain Australia has suggested several apps that can help you understand and manage your pain better.

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