What Is Lower Back Pain?
Lower back pain is pain, stiffness, or discomfort in the lumbar spine, the lower part of the spinal column. The lumbar spine sits below the upper spine and protects the lower part of the spinal cord.
The lower back supports much of the body’s weight. It helps you sit, stand, walk, run, bend, lift, and twist. Because it is involved in so many daily movements, it is also one of the most common areas for pain.
Up to 80% of adults experience lower back pain at some point during their lives, often adding unnecessary stress to their daily routines. Most cases are not dangerous, but the pain can still affect work, sleep, exercise and daily activities.
Acute lower back pain comes on suddenly and often improves within days or weeks. Most cases of acute lower back pain resolve within 12 weeks with self-care and the appropriate movement. Chronic back pain lasts longer than three months or keeps returning, and it can flare up repeatedly, requiring longer-term care.
Lower Back Pain Symptoms
Lower back pain symptoms can include:
- Aching
- Stiffness
- Sharp pains
- Dull aches
- Muscle spasms
- Limited movements
- Pains that travels into the hip, buttock or leg
Lower back pain may come on gradually or suddenly. Sudden back pain can occur after lifting, bending, twisting, coughing, sneezing, or playing sports. Some people describe a sharp catch. Others feel a deep ache that worsens after sitting or standing too long.
Lower left back pain and lower right back pain can come from muscles, joints, discs, nerves, or referred pain from the hip or pelvis. Discomfort on one side does not always mean the problem is serious, but it should be assessed if it persists, worsens, or travels down the leg.
If a nerve is irritated, other symptoms may include tingling, numbness, burning pain, weakness, or radiating pain into one or both legs, often associated with sciatica.
Lower Back Pain Causes
Lower back pain causes include muscle strains, ligament sprains, disc irritations, joint stiffness, arthritis, nerve compressions, spinal narrowings, and poor load tolerances.
- Muscle strains can occur from poor posture during lifting, sudden twisting, or doing more than the back is ready to handle.
- Disc problems may occur when a disc bulges or slips and irritates a nearby nerve.
- Herniated discs can compress nerves and cause sciatica, which may lead to pain, numbness, tingling, or weakness down the leg.
- Degenerative disc disease occurs as spinal discs wear out with age.
- Arthritis can cause inflammation and stiffness in the small joints of the spine.
- Spinal stenosis, which means narrowing around the nerves, may cause back and leg pain during standing or walking.
- Osteoporotic fractures, also called compression fractures, can occur when weakened bones collapse, especially in older adults with osteoporosis.
Risk factors for lower back pain are also influenced by lifestyle and the patient’s physical capacity. Prolonged sitting, weak core and hip muscles, poor sleep, stress, excess weight, repeated lifting of heavy objects, and low physical activity are common risk factors that can increase the risk of spinal strain-related pain.
Lower Back Pain Diagnosis
Lower back pain is diagnosed through a clinical assessment that evaluates symptoms, movement, strength, nerve signs, and medical history.
Your physiotherapist will take a medical history. Then a physical examination may include assessing your posture, your gait, spinal movement, hip mobility, muscle strength, flexibility, reflexes, sensation, balance, and nerve tension. Your physiotherapist may also test how the back responds to different movements or positions.
Imaging is not always needed. X-rays, MRI or CT scans may be useful when the symptoms are severe, persistent, linked with trauma, or include certain symptoms such as nerve signs. Blood tests may be ordered when conditions like infection, inflammation, or kidney stones need to be ruled out.
When to Seek Immediate Attention for Lower Back Pain
Most lower back pain is not dangerous. Seek urgent medical attention if you have loss of bladder or bowel control, numbness around the groin or saddle area, worsening leg weakness, fevers, unexplained weight loss, pain after a fall or accident, or severe night-time discomfort that does not improve with rest.
You should also seek medical attention if the pain persists beyond a few weeks, keeps returning, affects walking or causes unsteady walking, prevents sleep, or stops you from working or exercising. People at higher risk include those with prior back injury, older adults, and those whose pain interferes with their daily activities.
Common Lower Back Pain Conditions & Treatment
Different lower back pain conditions require different treatment plans, depending on the structures involved and how the symptoms present. Lower back pain treatment usually starts with conservative care, including education, movement, physical therapy, pain relief and exercise. In most cases, early treatment of pain leads to a good recovery without surgery. Lifestyle changes and a healthy diet also support back pain relief.
| Condition | What it means | Treatment options |
| Muscle strain or ligament sprain | Overstretched or irritated soft tissue in the lower back | Relative rest, walking, manual therapy, Dry Needling when muscle spasm is present, INDIBA®, Sports Massage, prescribed exercises |
| Disc bulge or herniated disc | A disc pushes outward and may irritate or compress a nerve | Physiotherapy, nerve mobility exercises, core and hip strengthening, INDIBA, EMTT in selected cases, injections if needed, and surgery if severe nerve compression persists |
| Degenerative disc disease | Spinal discs, which act as shock absorbers, lose height and shock absorption with age | Strengthening, mobility work, Clinical Pilates, activity pacing, INDIBA, Red Light Therapy when appropriate |
| Sciatica | Nerve pain that travels from the lower back into the leg | Movement-based physiotherapy, nerve glides, analgesic approaches, hip and trunk strengthening, and medical review if weakness or worsening symptoms occur |
| Facet joint pain or arthritis | Irritation or inflammation in the small joints of the spine | Manual therapy, mobility exercises, strengthening, INDIBA, Red Light Therapy when appropriate, and injections in selected cases |
| Spinal stenosis | Narrowing around the spinal nerves | Flexion-based exercises, walking modification, strengthening, and Clinical Pilates. A medical review is needed if symptoms limit walking or worsen |
| Osteoporotic compression fracture | A spinal bone weakens and collapses due to osteoporosis | Medical assessment, imaging, pain management, activity modification, posture work, staged rehabilitation, specialist review |
| Persistent non-specific lower back pain | Pain without one clear structural cause | Education, graded exercise, Clinical Pilates, strength work, pacing, INDIBA, Red Light Therapy, home exercises |
This table is a guide only. Treatment for right lower back pain depends on a full assessment.
Acute Lower Back Pain Treatment
During the first 48 hours of acute lower back pain, applying ice packs in the first few hours may help reduce the inflammation and ease soreness. Heat may be more useful when the back feels stiff or sore. Short periods of rest can help during a flare-up, but complete bed rest is usually not recommended. Gentle walking and simple movement often support recovery.
Medication may help during painful flare-ups and relieve pain for some, but it is not suitable for everyone, especially those with stomach, kidney, heart, bleeding, or medication concerns. Medical advice is important.
Physiotherapy
Physiotherapy is central to lower back pain treatment because it addresses movement, strength, flexibility, posture and load tolerance. Treatment may include manual therapy, soft-tissue work, movement retraining, lifting advice, gait or running assessments, and strengthening and flexibility exercises as part of a home exercise plan.
Clinical Pilates
Clinical Pilates may be useful for patients who need better trunk control, posture awareness, hip strength, and movement confidence. It is especially helpful when lower back pain keeps returning or when a person feels unsure about how to move safely.
Ergonomic Adjustments
Ergonomic adjustments can reduce a back strain during daily activities and improve the work environment. This may include changing desk height, improving chair support, adjusting screen position, taking movement breaks, and learning safer lifting or carrying habits. A firm mattress can also help find relief, as sleep posture can affect spine alignment during rest. A supportive mattress, side sleeping with a pillow between the knees, or back sleeping with support under the knees may also help.
Adjunct Modalities
Adjunctive care may be used when appropriate:
- INDIBA® therapy may help with pain, stiffness, tissue repair and inflammation reduction as part of a broader rehabilitation plan.
- Dry Needling may help when tight muscles or trigger points contribute to discomfort.
- EMTT may be considered for selected musculoskeletal pain presentations.
- Red Light Therapy may support comfort and tissue recovery in some cases.
- Shockwave Therapy is not usually used for the spine itself, but it may be considered when a separate soft-tissue or tendon-related problem is contributing to back discomfort.
Surgery
Surgery is not needed for most cases of lower back pain. Most episodes settle with conservative care. When severe back pain is linked to structural instability, compression of spinal nerves in the spinal canal, deformity, or advanced degeneration, surgery may be considered. Other treatments may be offered before surgery. Spinal fusion surgery is one possible intervention in selected severe cases, usually after conservative care has not helped or when there is a clear surgical reason.
Exercises for Lower Back Pain
Exercises for lower back pain help restore mobility, build strength, and reduce the risk of recurrent flare-ups.
The best starting point depends on the person. Early physiotherapy exercises for lower back pain may include gentle walking, breathing drills, pelvic tilts, knee rolls, supported spinal mobility, and light core activation. As pain improves, strengthening exercises for lower back pain may include bridges, bird dogs, side planks, squats, hip hinges, glute strengthening, and controlled lifting practice.
Stretches for lower back pain may help when stiffness in the hips, hamstrings, or back is limiting movement. They should feel controlled and comfortable, not sharp or forced. Stretching alone is rarely enough. It works best when paired with strength and movement retraining.
Prevention
Lower back pain can often be prevented from returning by improving strength, movement habits, flexibility, ergonomics, and load management.
Prevention is not about sitting perfectly or avoiding all bending. It is about building a back that can tolerate normal life. The best treatment plan combines regular exercise, a healthy weight, good sleep and frequent movement breaks to protect the back.
- Maintaining a healthy weight reduces load on the lumbar spine.
- Strengthening the core, hips, glutes, leg muscles and back muscles helps reduce pressure on the lower back. Strong back muscles support the spine through the day.
- Good lifting habits also matter. Keep loads close, bend through the hips and knees, and avoid twisting while holding heavy objects.
- For runners and athletes, prevention may include gradual training progressions, hip strength, trunk control, recovery days, and flexibility work.
- For office workers, it may include changing position often, improving workstation setup, and building exercise into the week.
HelloPhysio Can Help
If lower back pain affects your work, sleep, sport, or daily life, HelloPhysio can help. Our physiotherapists can assess your symptoms, explain the likely causes, and develop a treatment plan that includes manual therapy, prescribed exercises, Clinical Pilates, and adjunctive care where appropriate. Contact HelloPhysio today to book a consultation and find relief from your lower back pain.
FAQs about Lower Back Pain
What is the best way to get rid of lower back pain?
The best way to get rid of lower back pain is to stay gently active, avoid prolonged bed rest, manage pain during the early flare-up, and follow a specific exercise and strengthening plan. Physiotherapy can help identify the cause and guide the safest treatment.
What are the five red flags of low back pain?
Five red flags include loss of bladder or bowel control, numbness around the groin or saddle area, worsening leg weakness, fever or unexplained weight loss, and severe pain after trauma such as a fall or accident.
How can I tell if my lower back pain is serious?
Lower back pain may be serious if it is linked with weakness, numbness, bladder or bowel changes, fevers, unexplained weight loss, cancer history, major trauma, or pain that does not improve with rest or appropriate care.
What are three causes of lower back pain?
Three common causes are muscle or ligament strain, disc irritation, such as a bulging or herniated disc, and arthritis or joint irritation in the spine.