General information only. Not a diagnosis, and not a substitute for an assessment.

What is it?

Lower back pain is pain, stiffness or aching in the lower part of your back. It can feel sharp, dull, or like a spasm (when muscles suddenly go tight).

It is one of the most common reasons people see a physio. Most of the time it is not caused by anything serious, even when it hurts a lot. Your spine is strong.

Common causes

Lifting, bending or twisting in a way your back is not used to
Sitting or standing in one position for a long time
Doing a lot more (or a lot less) activity than usual
Feeling stressed, tired or low, which can make pain feel worse
Often there is no clear cause, and that is normal

When to get urgent help

Call 999 or go to A&E if:

you have back pain and pain, tingling, weakness or numbness in both legs
you have lost feeling around your genitals or bottom (anus)
you have changes in your bladder or bowels, such as finding it hard to pee, or peeing or pooing yourself

These can be signs of a rare but serious problem with the nerves at the bottom of the spine (called cauda equina syndrome). It needs treating in hospital straight away.

Do not drive yourself to A&E. Ask someone to drive you, or call 999 for an ambulance.

Contact NHS 111 or your GP if:

you feel hot, cold, shivery or generally unwell
your pain is severe and started suddenly, or is getting worse quickly
you have lost weight without trying to
there is a lump or swelling in your back, or your back has changed shape
the pain does not get better after resting, or is worse at night
it has not improved after a few weeks of looking after it at home

You can call 111 or get help from NHS 111 online.

How physio can help

Explaining what is going on, which can make pain feel less scary
Gentle exercises to help your back move more easily and get stronger
Hands-on treatment to ease stiffness, if it helps you
Advice on work, sleep, driving and getting back to activities

Everyone is different. We'll talk through what is likely to help you, and be honest if something else would suit you better.

What you can do at home

Keep moving. Gentle walks and your normal daily activities usually help more than resting.
Avoid lying in bed for long periods.
Try a heat pack or a hot water bottle wrapped in a towel.
A pharmacist can give you advice about pain relief.
Change position often if you sit for long periods.

Stop anything that makes your pain much worse, and get advice if you're not sure. Don't stop taking any medicine you've been prescribed without talking to your doctor or pharmacist.

Treatments that may help

Initial assessment — 50 minutes, £65
Follow-up physiotherapy — 40 minutes, £55
Pilates-based rehab classes — 55 minutes, £15
Acupuncture and dry needling — 40 minutes, £55