Blog & research

Low back pain and how to manage and treat it

 

Illustration of man holding his back with red colouring indicating where pain is felt.

About low back pain

Low back pain is felt in the lower part of the spine (lumbar spine). Pain in one or both legs may occur with it.

Low back pain is a symptom that can be caused by different things but most times the cause is not serious and it’s linked to minor strains or sprains that most people recover from, even though it may hurt a lot.

Causes of low back pain include:

  • Ageing, where the spine and structures around it gradually wear out over time
  • Trauma/injury
  • Strains, sprains and tears
  • Poor posture
  • Being less active and sitting for too long
  • Overweight

Rarer causes of low back pain include:

  • Disease
  • Neurological conditions
  • Infection
  • Cancer

Sometimes a person may have a medical condition without feeling back pain, and sometimes it can be difficult to work out the cause of back pain.

What symptoms indicate problems with the low back?

There are several symptoms that indicate problems with the low back. Some of these include:

  • Sharp or dull back pain or stiffness
  • Back pain that may spread to legs and feet
  • Numbness or pins and needlesIllustration of man holding pain at his lower back with red colour showing the pain spreading to his leg.

Serious problems with the low back are much rarer but symptoms that indicate serious problems include:

  • Back pain after an injury or fall
  • Back pain with problems passing urine or stool
  • Numbness and tingling

What should I do if I have seriously hurt my back?

If you think you’ve had a serious back injury, see a doctor immediately. Symptoms of a serious back injury include:

  • Back pain
  • Difficulty breathing or shortness of breath
  • Paralysis
  • Numbness, weakness or pins and needles in the arms, hands, legs or feet
  • Fever
  • Dizziness
  • Difficulty urinating or blood in urine
  • Difficulty passing stool
  • Difficulty concentrating
  • Difficulty swallowing
  • Changes to seeing or hearing

If you are with someone who has seriously injured their back, do not move them unless they are in danger.

How is low back pain treated?

Low back pain is treated in different ways, depending on the cause, level of pain and your circumstances.

It is important to see a doctor if:

  • Symptoms do not get better after a week or two
  • The symptoms are very bad
  • You’ve had a serious injury
  • You’ve had an injury and you’re worried
  • You have numbness, pins and needles, or weakness in your arms, hands, legs or feet
  • You have problems with your bladder or bowel

When you see a doctor, they will ask you questions about your pain and your health background. This helps to them to recommend the most suitable treatment. They may also do a physical examination.

If it’s likely the cause is not serious, it’s usually unnecessary to get imaging (such as an x-ray, a CT, MRI or bone scan) of your back. This is because serious back problems are rare, and scans will often only show changes to your spine that are normal for your age and may not be the cause. The doctor will only recommend imaging if it’s possible that there is a serious cause so it can be diagnosed promptly.

How can I recover?

If it’s likely that there is no serious cause, staying active, doing gentle exercises, continuing to go to work and doing your usual activities as much as you can will help you to recover as fast as possible.

It may also help to adjust any activities that have been hurting your back. Heat or cold therapy may give some relief, and over-the-counter painkillers like paracetamol and ibuprofen may help too.

If your pain is very bad or you would like support to recover, you can also see a physiotherapist or exercise physiologist.

It can be difficult to get better if other things are impacting you, such as your mental health, things happening in your life and the way pain affects you. Your doctor may ask you about these so they can recommend the most appropriate support and treatment for you, such as to see a psychologist or pain-management specialist.

What should I do if I’m still not better?

Your doctor may recommend seeing a rehabilitation or chronic-pain specialist if your back symptoms continue. Other medication may be considered but this is just one part of pain management and it’s most effective in the short term, to help you more easily take steps to recover.

If appropriate, your doctor may suggest that you see a medical specialist, such as a neurosurgeon, neurologist or rheumatologist, who can investigate your symptoms further. Depending on your circumstances, they may recommend steroid or cortisone injections, or targeted local anaesthetic. However, the effects and duration of this treatment varies.

If your symptoms continue or worsen, or if the cause is serious, a medical specialist may recommend other treatment to help you recover. For example, a neurosurgeon may recommend surgery if there is a serious change to the spine or to the structures around it such as the spinal nerves.

How can I prevent low back pain?

Low back pain is common but you can do several things to keep your back healthy and lessen the risk of it:

  • Exercise regularly and stay active – this will help to keep your spine flexible and strong.
  • Keep a good posture (keep your back and neck straight), whether your sitting, standing or moving.
  • Don’t sit for too long. If you work in an office or are driving long distances, take regular breaks and stretch.
  • Avoid lifting heavy things, and keep your spine straight if you do lift anything heavy.
  • Maintain a healthy weight and make sure you have enough calcium and Vitamin D.
  • Avoid smoking.

Learn more about spinal conditions.

Read more of Dr Raj Reddy’s blogs.


Sources
  1. Australian Commission on Safety and Quality in Health Care, Low back pain clinical care standard
  2. NSW Government Agency for Clinical Innovation, Model of care for the management of low back pain
  3. NSW Government Agency for Clinical Innovation, Managing low back pain: Information for patients
  4. Victoria Government Better Health Channel, Back pain