Lower back pain: common causes and what to do
A plain-English guide to lower back pain: why it happens, what usually helps in general, and the warning signs that mean you should seek medical help.
Lower back pain is one of the most common reasons people seek help with their health. Most episodes are not caused by serious damage, even when they feel alarming, and many settle over days to weeks. Understanding what tends to contribute can help you decide what to do next.
When to get urgent help
Call 999 or go to A&E straight away if you have back pain together with any of these. They can be signs of a rare but serious condition such as cauda equina syndrome. Do not drive yourself.
- Numbness or tingling around your genitals, buttocks or inner thighs (the saddle area)
- Difficulty passing urine, loss of bladder or bowel control, or being unable to feel when you are passing urine or stool
- Pain, tingling, weakness or numbness in both legs, or sciatica on both sides, or weakness in a leg that is getting worse
- New changes to sexual sensation or function alongside back or leg pain
- Chest pain, or back pain that started after a serious accident such as a car crash
What it can feel like
- An ache, stiffness or sharp catch across the lower back, sometimes to one side
- Pain that changes with position, such as bending forward, sitting for long periods or getting out of a chair
- Muscle tightness or spasm around the lower back
- Pain that eases once you get moving, or that feels worse first thing in the morning
Common contributors
- Strain of the muscles or ligaments after lifting, twisting or an unaccustomed activity
- Irritation of the small joints or discs of the spine
- Long periods of sitting or standing in one position
- Sudden changes in activity, such as a big increase in training or a spell of inactivity
- Poor sleep, stress and tiredness, which can make pain feel stronger and last longer
General self-care
These are general comfort measures many people find reasonable. They are not a treatment plan, and what suits one person may not suit another.
- Keep moving as comfortably as you can. Gentle walking and normal daily activity usually help more than long periods of bed rest
- Change position often, and take short breaks from sitting
- Heat, such as a warm shower or heat pack, can help muscles feel less tense for some people
- If you use over-the-counter pain relief, follow the packet instructions and ask a pharmacist if you are unsure what is suitable for you
- Return to normal activity and exercise gradually as things settle
When to see your GP
See your GP promptly, or call NHS 111, if you have any of the following:
- Feeling hot, cold, shivery or generally unwell, or severe pain that starts suddenly or quickly gets worse
- Unexplained weight loss, or a lump, swelling or change in the shape of your back
- Pain that is worse at night or does not ease with rest, or is worse when you cough, sneeze or open your bowels
- A history of cancer and new, persistent back pain
Consider seeing your GP if:
- Your pain has not improved after a few weeks of home care
- The pain stops you doing your daily activities, or you are struggling to cope or are worried
- You have lost weight without trying, or there is a lump, swelling or change in the shape of your back
- The pain is worse at night, does not ease with rest, or is worse when you sneeze, cough or open your bowels
- The pain is between your shoulder blades rather than in your lower back
How osteopathy may help
Osteopaths regularly see people with lower back pain. After taking a full history and examining you, treatment typically combines hands-on techniques (such as soft-tissue work, joint mobilisation and, where suitable, manipulation) with advice and exercises you can do yourself. For some people this may help ease pain and stiffness and make movement more comfortable.
NICE guidance for low back pain says manual therapy (spinal manipulation, mobilisation or soft-tissue techniques) can be considered, but only as part of a treatment package that includes exercise. A 2026 Cochrane review found that spinal manipulation may give a small improvement in chronic low back pain compared with sham treatment and similar results to other conservative treatments, but the certainty of that evidence is low to very low.
Results vary from person to person, some people feel a little sore for a day or two afterwards, and osteopathic care is not right for everyone. It sits alongside, not instead of, medical care, and staying active and doing your exercises remain central.
If you would like your symptoms assessed, you are welcome to book an appointment. Osteopathic care is not right for everyone, and if something needs medical attention first, I will tell you.
Common questions
How long does lower back pain last?
The NHS says back pain usually improves within a few weeks, but it can sometimes last longer or keep coming back. If it has not improved after a few weeks of home care, see your GP.
Should I rest or keep moving if I have a bad back?
The NHS advises staying active and carrying on with your daily activities as far as you can, and not staying in bed for long periods. Movement may be uncomfortable at first, but it is generally helpful.
Is heat or ice better for back pain?
The NHS suggests either can be used. An ice pack wrapped in a tea towel may ease pain and swelling, and a heat pack or hot water bottle wrapped in a tea towel may help with stiffness and muscle spasm. Use whichever feels better and protect your skin.
Is paracetamol good for back pain?
The NHS says paracetamol on its own is not recommended for back pain, though it can be taken alongside another painkiller. Anti-inflammatories such as ibuprofen may help but are not suitable for everyone, so check with a pharmacist or GP.
Free 5-minute exercise sheet
A simple, printable sheet of gentle exercises and stretches, about five minutes a day, based on NHS physiotherapy leaflets. It is general information, not a personal treatment plan, and it is not suitable if you have any of the urgent signs listed above.
Sources and further reading
Links open in a new tab. Sources were checked in October 2026.
- NHS: Back pain
- NICE guideline NG59: Low back pain and sciatica in over 16s
- Cochrane review (2026): Spinal manipulative therapy for adults with chronic low back pain
- Rubinstein et al., BMJ 2019: Benefits and harms of spinal manipulative therapy for chronic low back pain
Related guides
This page is general information to help you understand common aches and pains. It is not medical advice and cannot diagnose your problem. If you are worried about your symptoms, please speak to your GP or call NHS 111.