Enable Recite

Persistent Back Pain

Back Pain

Back pain is very common and up to 80% of the population will experience back pain in their life.  70% of people who get back pain will greatly recover despite some recurrences. For a small group of people (up to 30%) it may become persistent (lasting beyond 6-12 weeks) and can disrupt many aspects of a person’s life. Even if the pain is very bad, it is very rare for back pain to be a sign of something serious.

What are the symptoms?

Most people experience back pain in the middle or on one or both sides of their backs, but may also feel it around their hips and buttocks and occasionally into one or both thighs. Persistent back pain is typically back pain that has been going on for longer than 12 weeks.

Back pain may limit your willingness or ability to do certain activities, movements, or tasks. For some people this may affect their work, sleep, and social activities as well. These limitations often lead to people experiencing low mood, anxiety, and depression.

What are the causes?

Back pain can appear with no clear trigger, or some people can describe a movement that started the symptoms. This may be sports injury or a fall, but it can also be a simple movement we do a lot, usually with no issues, like picking up a towel.

The back has lots of muscles, joints and discs that might be involved in a pain episode. These structures can heal and repair if they have been injured or inflamed. It is not essential to identify the structures involved, as this will not usually change the advice you are given. The spine is a strong and resilient structure.

It can often be contributed by a combination of the factors below:

  • Being inactive
  • Doing too much
  • Doing activities that we are not fit or strong enough for
  • Being overweight or obese
  • Poor fitness levels
  • High stress levels
  • Low mood
  • Poor sleep
  • Smoking

The good news is that many of these things can be modified as part of an effective treatment plan.

For more information to help support your general health and well-being, please click here to access our "Healthy You" page. This includes information on exercise, mental health, smoking and weight management.

How long will it last?

In many cases, with some simple advice, keeping active, and some lifestyle modifications, you may see a good improvement within 2-12 weeks. For some – pain can persist much longer because people adapt and cope in different ways. It important to know that for some people, life-long self-management is needed.

What can I do to help myself?

new onset of back pain help

What else can I do?

Look to gradually increase what you can tolerate in terms of movement, activity, and exercises you can manage. Below you will find some resources/exercises to get you started with regards to your back pain. Start with the easiest and gradually work through them over time.

Persistent back pain exercises - EASY

Persistent back pain exercises - MODERATE

Persistent back pain exercises - ADVANCED 

You may prefer to increase your activity levels in other ways, such as simply walking, swimming, or joining an exercise class like Pilates, Thai chi, aquafit, or yoga.

The important thing is you find something you enjoy doing that you can do regularly to stay active.

Do I need an x-ray or a scan?

In most cases, no. A good history and physical examination of your sciatica alone provides enough information to diagnose your problem. Scans and x-rays are not always useful for diagnosing back pain. While a scan or x-ray may provide information it rarely alters the treatment plan. 

Imaging findings are very poorly linked with pain and often people with no pain have very similar findings on their scans/x-rays to those that do. X-rays and scans can help for a small number of people in certain situations and will be recommended by a healthcare professional if required.

Is back pain caused by bad posture?

posture infograph

Symptoms to check

Click the plus sign to see a list of problems that could be a sign you may need to be checked urgently

When to get immediate medical advice

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

  • numbness or tingling around your genitals or buttocks/inner thighs
  • loss of bladder or bowel control or difficulty urinating, leaking of urine or bowel movements.
  • Changes in sexual function, including loss of sensation during intercourse, inability to achieve an erection or ejaculate
  • sudden, significant weakness in your arms or legs
  • lack of coordination or heaviness to your arms and legs that is affecting your walking
  • severe arm pain with accompanying tingling or numbness
  • chest pain
  • a high temperature (fever) of 38C (100.4F) or above
  • a swelling or a deformity in your back
  • it does not improve with or at rest or is worse at night
  • it started after a serious accident, such as after a car accident

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

Click here to find out more about the warning signs of cauda equina

Immediate medical advice is available by contacting NHS 111

Referral Information

If your back pain persists or you are not sure what to do, you can self-refer to see a local physiotherapist who can help you with your problem.

Refer