Lower back pain

Why does it keep coming back

Because the episode gets treated and the reason does not. Pain settles, you get on with life, and the strength and movement that were missing before the episode are still missing afterwards. That is the pattern behind most recurring back pain, and it is the part of treatment people skip once they feel better.

What treatment involves

Assessment first, to establish what is driving it and to rule out the small number of causes that need a doctor. Then treatment to settle the pain, which may include hands on work, and movement you can do at home. Then the less exciting half, which is building the strength and control that make the next episode less likely or less severe.

NICE recommends staying as active as you can manage, alongside exercise and manual therapy as part of a package of care. Bed rest makes most back pain worse rather than better, which is the opposite of what instinct suggests.

When to see a doctor instead

Numbness around the saddle area, loss of control of your bladder or bowel, weakness in both legs, or back pain alongside unexplained weight loss or fever all need checking the same day, with your GP or at hospital. If you describe any of those to us we will send you straight there.