Medical information for patients

Low back pain

Low back pain is pain affecting the lower part of the back. It is described as:

Low back pain is very common, costing millions in lost work, as well as millions in medical, state and insurance resources every year. Most back pain does not signify any serious underlying problem and will sort itself out within a few days to a few weeks.


Low back pain means a pain or ache somewhere between the bottom of the ribs, at the back, and the top of the legs. The pain often begins suddenly and may follow an obvious strain or injury, but may seem to come on "out of the blue" or come on slowly.

The pain may travel to, or be felt, elsewhere. It often goes into the buttocks, but may go further down the leg and even into the foot.

The pain may be worse on bending and is often worse sitting, especially in an easy chair. Sometimes turning over in bed and sitting up are agonising. Coughing or sneezing can often make the pain much worse. The muscles of the back may go into a painful spasm.

Back pain may be combined with pain into the leg, travelling down below the knee. This is otherwise known as sciatica, because the main nerve to the leg (the sciatic nerve) is being irritated by pressure on it.

In this section I have been talking about what we term simple or mechanical back pain, which is far and away the most frequent cause of low back pain. There are various other symptoms which may go with back pain, some of which suggest problems other than back problems, and some of which point to the need for more urgent action by you and your doctor.


Low back pain is common. The main cause for low back pain is a strain of the muscles or other soft structures (such as ligaments and tendons) connected to the back bones (vertebrae). Sometimes it is the cushion between the bones (intervertebral disc) that is strained and bulges out (herniates), pressing on the nearby nerves (as in sciatica).

Exactly what is injured varies from person to person, but you may also get differing theories depending on whom you ask. Thus the poor sufferer may become confused and worried.

Although the experts may not agree on what is causing the problem, there is a surprising amount of agreement on how best to improve the situation.

Various other conditions can cause back pain, and if in doubt about what is causing your pain, you should consult your doctor.


If in doubt, consult your doctor, a physiotherapist, a chiropractor or an osteopath.

The United Kingdom has guidelines for doctors and other professionals on how best to manage a person with back pain. These guidelines cover many aspects, but there are some main principles which are most important.



If in doubt, consult your doctor.

Chronic low back pain

If the pain goes on for more than 12 weeks it is said to be chronic. In these instances, manipulation appears to be less likely to be helpful. Your doctor may arrange for you to have a course of back rehabilitation to help you get going again.


Stay fit. Regular exercise to keep generally fit is more important than any specific exercises aimed at the back muscles.

Be aware of your posture and the position you are in during your daily activities. If you have to lift heavy objects, share the load with other people and try to hold the weight in close to your body, bending at the knees when possible rather than your back.

If carrying shopping, try to carry similar loads on both sides and make a number of journeys, rather than trying to carry too much at one go. Consider the use of a shopping trolley.

School bags are typically far too heavy and often worn on only one shoulder. Try to leave books that you do not need that day in your locker or at home, and wear a rucksack type of bag correctly positioned on both shoulders.

Further information


Beat back pain (52 Brilliant ideas series), by Dr Ruth Chambers
An excellent book, written by a British General Practitioner, which is easy to read, well laid out, and full of helpful ideas.
Treat your own back, by Robin McKenzie
Written by an author well known in this field.
BMA Guide to Back Care, by British Medical Association
A useful quick guide to back pain and care from the British Medical Association.

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