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Back pain is very common and usually improves within a few weeks or months.

Pain in the lower back (lumbago) is particularly common, although it can be felt anywhere along the spine, from the neck down to the hips.

In most cases the pain is not caused by anything serious and will usually get better over time.

There are things you can do to help relieve it. But sometimes the pain can last a long time or keep coming back.

The following tips may help reduce your back pain and speed up your recovery:

  • stay as active as possible and try to continue your daily activities – this is 1 of the most important things you can do, as resting for long periods is likely to make the pain worse
  • try exercises and stretches for back pain; other activities such as walking, swimming, yoga and pilates may also be helpful
  • take anti-inflammatory painkillers, such as ibuprofen – remember to check the medicine is safe for you to take and ask a pharmacist if you’re not sure
  • use hot or cold compression packs for short-term relief – you can buy these from a pharmacy, or a hot water bottle or a bag of frozen vegetables wrapped in a cloth or towel will work just as well

Although it can be difficult, it helps if you stay optimistic and recognise that your pain should get better. People who manage to stay positive despite their pain tend to recover quicker.

Back pain usually gets better on its own within a few weeks or months and you may not need to see a doctor or other healthcare professional.

But it’s a good idea to get help if:

  • the pain does not start to improve within a few weeks
  • the pain stops you doing your day-to-day activities
  • the pain is very severe or gets worse over time
  • you’re worried about the pain or struggling to cope

If you see a GP they will ask about your symptoms, examine your back and discuss possible treatments.

They may refer you to a specialist doctor or a physiotherapist for further help.

Alternatively, you may want to consider contacting a physiotherapist directly. Some NHS physiotherapists accept appointments without a doctor’s referral, or you could choose to pay for private treatment.

Read more about how to get access to physiotherapy.

A GP, specialist or physiotherapist may recommend extra treatments if they do not think your pain will improve with self-help measures alone.

These may include:

  • group exercise classes where you’re taught exercises to strengthen your muscles and improve your posture
  • manual therapy treatments, such as manipulating the spine and massage, which are usually done by a physiotherapist, chiropractor or osteopath
  • psychological support, such as cognitive behavioural therapy (CBT), which can be a useful part of treatment if you’re struggling to cope with pain

Some people choose to see a therapist for manual therapy without seeing a GP first. If you want to do this, you’ll usually need to pay for private treatment.

Surgery is generally only considered in the small number of cases where back pain is caused by a specific medical condition.

It’s often not possible to identify the cause of back pain. Doctors call this non-specific back pain.

Sometimes the pain may be from an injury such as a sprain or strain, but often it happens for no apparent reason. It’s very rarely caused by anything serious.

Occasionally back pain can be caused by a medical condition such as:

  • a slipped (prolapsed) disc – where a disc of cartilage in the spine presses on a nearby nerve
  • sciatica – irritation of the nerve that runs from the pelvis to the feet

These conditions tend to cause additional symptoms, such as numbness, weakness or a tingling sensation, and they’re treated differently from non-specific back pain.

It’s difficult to prevent back pain, but the following tips may help reduce your risk:

You should contact a GP or NHS 111 immediately if you have back pain and:

  • numbness or tingling around your genitals or buttocks
  • difficulty peeing
  • loss of bladder or bowel control – peeing or pooing yourself
  • chest pain
  • a high temperature
  • unintentional weight loss
  • a swelling or a deformity in your back
  • it does not improve after resting or is worse at night
  • it started after a serious accident, such as after a car accident
  • the pain is so bad you’re having problems sleeping
  • pain is made worse when sneezing, coughing or pooing
  • the pain is coming from the top of your back, between your shoulders, rather than your lower back

These problems could be a sign of something more serious and need to be checked urgently.

It’s not always possible to identify the cause of back pain but it’s rarely anything serious. Most back pain is what’s known as “non-specific” (there’s no obvious cause) or “mechanical” (the pain originates from the joints, bones or soft tissues in and around the spine). This type of back pain:
  • tends to get better or worse depending on your position – for example, it may feel better when sitting or lying down
  • typically feels worse when moving – but it’s not a good idea to avoid moving your back completely, as this can make things worse
  • can develop suddenly or gradually
  • might sometimes be the result of poor posture or lifting something awkwardly, but often occurs for no apparent reason
  • may be due to a minor injury such as sprain (pulled ligament) or strain (pulled muscle)
  • can be associated with feeling stressed or run down
  • will usually start to get better within a few weeks
MEDICAL CONDITIONS THAT CAUSE BACK PAIN
Conditions that can cause back pain include:
  • a slipped (prolapsed) disc (a disc of cartilage in the spine pressing on a nerve) – this can cause back pain and numbness, tingling and weakness in other parts of the body
  • sciatica (irritation of the nerve that runs from the lower back to the feet) – this can cause pain, numbness, tingling and weakness in the lower back, buttocks, legs and feet
  • ankylosing spondylitis (swelling of the joints in the spine) – this causes pain and stiffness that’s usually worse in the morning and improves with movement
  • spondylolisthesis (a bone in the spine slipping out of position) – this can cause lower back pain and stiffness, as well as numbness and a tingling sensation
These conditions are treated differently to non-specific back pain. Very rarely, back pain can be a sign of a serious problem such as:
  • a broken bone in the spine
  • an infection
  • cauda equina syndrome (where the nerves in the lower back become severely compressed)
  • cancer
If you see your GP with back pain, they will look for signs of these.
Back pain will usually improve within a few weeks or months. There are several things you can try to help reduce your pain in the meantime. There are also some specialist treatments that may be recommended if it’s thought simple measures aren’t likely to be effective on their own. See your GP or a physiotherapist if your pain isn’t improving despite trying simple treatments. The main treatments for back pain include:
TREATMENTS YOU CAN TRY YOURSELF
STAY ACTIVE
One of the most important things you can do is to keep moving and continue with your normal activities as much as possible. It used to be thought that bed rest would help you recover from a bad back, but it’s now known that people who remain active are likely to recover more quickly. This may be difficult at first, but don’t be discouraged – your pain will start to improve eventually. Consider taking painkillers if the pain is stopping you from carrying on as normal. There’s no need to wait until you’re completely pain-free before returning to work. Going back to work will help you return to a normal pattern of activity and may distract you from the pain.
BACK EXERCISES AND STRETCHES
Simple back exercises and stretches can often help reduce back pain. These can be carried out at home as often as you need to. For information about the types of exercises and stretches that can help, see: Your GP may be able to provide information about back exercises if you’re unsure what to try, or you may want to consider seeing a physiotherapist for advice. Read about how to find a physiotherapist. Doing regular exercise alongside these stretches can also help keep your back strong and healthy. Activities such as walking, swimming, yoga and pilates are popular choices.
PAINKILLERS
Non-steroidal anti-inflammatory drug (NSAID) tablets, such as ibuprofen, can help relieve back pain. Many types are available to buy from pharmacies or supermarkets without a prescription. But NSAIDs aren’t suitable for everyone, so check the box or leaflet to see whether you can take the medicine first. Speak to a pharmacist if you’re not sure. If you can’t take NSAIDs, alternative medicines such as codeine may help. This is a stronger painkiller that should ideally only be used for a few days, as it can cause addiction if used for longer. Paracetamol on its own isn’t recommended for back pain, but it may be used alongside stronger painkillers such as codeine. Muscle relaxants may be prescribed by your GP if you have painful muscle spasms in your back.
HOT AND COLD PACKS
Some people find that heat – for example, a hot bath or a hot water bottle placed on the affected area – helps ease the pain when back pain first starts. Cold, such as an ice pack or a bag of frozen vegetables, placed on the painful area can also help in the short-term. However, don’t put the ice directly on your skin, as it might cause a cold burn. Wrap an ice pack or bag of frozen vegetables in a cloth first. Another option is to alternate between hot and cold using ice packs and a hot water bottle. Hot and cold compression packs can be bought at most pharmacies.
RELAX AND STAY POSITIVE
Trying to relax is a crucial part of easing the pain as muscle tension caused by worrying about your condition may make things worse. Read more about: Although it can be difficult, it helps if you stay optimistic and recognise that your pain should get better, as people who manage to stay positive despite their pain tend to recover quicker.
SPECIALIST TREATMENTS
EXERCISE CLASSES
Your GP may suggest attending an NHS group exercise programme if they think it might help reduce your pain. These programmes involve classes led by a qualified instructor, where you’re taught a mix of exercises to strengthen your muscles and improve your posture, as well as aerobic and stretching exercises.
MANUAL THERAPY
Manual therapy is the name for a group of treatments where a therapist uses their hands to move, massage and apply careful force to the muscles, bones and joints in and around your spine. It’s usually carried out by chiropractors, osteopaths or physiotherapists, although chiropractic and osteopathy aren’t widely available on the NHS. Manual therapy can help reduce back pain, but it should only be used alongside other measures such as exercise. There’s also some evidence that a therapy called the Alexander technique may help with long-term back pain, although the National Institute for Health and Care Excellence (NICE) doesn’t currently recommend this treatment specifically.
PSYCHOLOGICAL SUPPORT
Your GP may suggest psychological therapy, in addition to other treatments such as exercise and manual therapy. Therapies such as cognitive behavioural therapy (CBT) can help you manage your back pain better by changing how you think about your condition. While the pain in your back is very real, how you think and feel about your condition can make it worse. If you’ve been in pain for a long time, a specialist treatment programme that involves a combination of group therapy, exercises, relaxation, and education about pain and the psychology of pain may be offered.
SURGERY AND PROCEDURES
Surgery for back pain is usually only recommended if there’s a specific medical reason for your pain, such as sciatica or a slipped (prolapsed) disc, and other treatments haven’t helped. But a procedure called radiofrequency denervation may sometimes be used if:
  • you’ve had back pain for a long time
  • your pain is moderate or severe
  • your pain is thought to originate from the joints in your spine
This procedure involves inserting needles into the nerves that supply the affected joints. Radio waves are sent through the needles to heat the nerves, which stops them from sending pain signals. You’re awake while the treatment is carried out and local anaesthetic is used to numb your back. You won’t need to stay in hospital overnight. As with all procedures, radiofrequency denervation carries a risk of complications, including bleeding, bruising, infection and accidental nerve damage. Discuss the risks with your surgeon before agreeing to treatment.
TREATMENTS NOT RECOMMENDED
A number of other treatments have sometimes been used for non-specific back pain (back pain with no identified cause), but aren’t recommended by the National Institute for Health and Care Excellence (NICE) because of a lack of evidence. These include:
  • belts, corsets, foot orthotics and shoes with “rocker” soles
  • traction – the use of weights, ropes and pulleys to apply force to tissues around the spine
  • acupuncture – a treatment where fine needles are inserted at different points in the body
  • therapeutic ultrasound – where sound waves are directed at your back to accelerate healing and encourage tissue repair
  • transcutaneous electrical nerve stimulation (TENS) – where a machine is used to deliver small electrical pulses to your back through electrodes (small sticky patches) attached to your skin
  • percutaneous electrical nerve stimulation (PENS) – electrical pulses are passed along needles inserted  near the nerves in the back
  • interferential therapy (IFT) – where a device is used to pass an electrical current through your back to try to accelerate healing
  • painkilling spinal injections (although these can help if you have sciatica)
  • spinal fusion or disc replacement surgery

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