Condition guide
Lower Back Pain: Common Causes and What Usually Helps
Lower back pain is the single most common problem we see, and for most people it is far less sinister than it feels. It can be severe, frightening and hard to move with, and still be a simple mechanical problem that settles. This page explains the usual causes, what tends to help in the first two weeks, and when back pain is a reason to be seen urgently rather than booked in for physio. This page is general information, not a diagnosis. If anything here matches your symptoms, an assessment is the sensible next step.
What is Lower Back Pain?
Most lower back pain is what clinicians call non-specific, meaning no single structure can be blamed with certainty. Muscles, discs, joints and nerves all share the same pain pathways, so the exact tissue often matters less than how the back is loading, moving and recovering. That is not a fudge, it is why treatment focuses on restoring movement and load tolerance rather than chasing a label.
Typical Symptoms
- Ache or sharp pain across the low back, sometimes to one side
- Stiffness first thing in the morning, or after sitting or driving
- Pain when bending, lifting, twisting or standing up from a chair
- Spasm or a locked feeling that eases as you move gently
- Pain that spreads into the buttock or thigh (leg symptoms below the knee suggest nerve involvement)
Common Causes & Triggers
- A sudden overload, for example lifting awkwardly, a heavy day in the garden or a new gym session
- Gradual build-up from long sitting, driving or repetitive bending at work
- A flare of a previously irritable back, often triggered by a small movement rather than a big one
- Age-related disc and joint change, which is normal and very often painless
- Poor sleep, stress and low activity levels, all of which raise pain sensitivity
How We Treat Lower Back Pain at Bluebell
- 1
A full assessment first: history, movement testing, neurological screening where indicated, and clearing red flags.
- 2
Hands-on treatment to ease guarding and restore movement, chosen for what your examination shows.
- 3
A short, specific exercise plan you can actually do, rather than a printed sheet of twenty exercises.
- 4
Practical load advice for work, driving, lifting and sleeping positions.
- 5
Progressive strengthening once symptoms settle, because that is what reduces recurrence.
Honest Recovery Timeline
Being honest: a large proportion of simple lower back pain improves substantially within two to six weeks whether or not you have treatment. Physiotherapy is most useful when pain is severe, when it is not improving on the expected curve, when it keeps coming back, or when you need to get back to work or sport safely and quickly.
When Lower Back Pain Needs Urgent Medical Attention (Not Physio)
- •Loss of bladder or bowel control, or numbness around the saddle, groin or inner thighs, go to A and E immediately.
- •Sudden severe weakness in one or both legs, or a foot that drags, same day GP or A and E.
- •Back pain after significant trauma such as a fall from height or a road traffic collision, urgent medical review.
- •Fever, unexplained weight loss, night pain that stops you sleeping, or a history of cancer, see your GP.
Lower Back Pain — Common Questions
Should I rest or keep moving?
Keep moving within what you can tolerate. Short rests are fine when pain is at its worst, but staying still for days tends to slow recovery and stiffen everything up.
Do I need a scan for back pain?
Usually not. Scans commonly show age-related changes in people with no pain at all, so imaging is reserved for red flags, unexplained progression or when specialist input is being planned.
Is heat or ice better?
Whichever genuinely eases your symptoms. Heat suits muscular stiffness and spasm for most people, ice can help a very acute, hot flare. Neither is treatment on its own.
Why does my back keep going?
Recurrence is common when the underlying capacity has not been rebuilt. Once pain settles, progressive strength and load work is the part that changes the pattern.
When should I book physiotherapy rather than wait?
If pain is severe, if it is not improving after around two weeks, if it is spreading down the leg, or if it is stopping you working or sleeping, get it assessed rather than waiting it out.