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Lower back pain

Lower back pain

Lower Back Pain: Causes, Treatment, and When to Seek Help

Sudden or ongoing back pain? Most cases are not serious – but some need urgent attention.

Lower back pain is one of the most common reasons people seek medical care.

In most cases, it improves with simple treatment, but it’s important to recognise when further assessment is needed.

What is lower back pain?

Lower back pain refers to pain in the area between the ribs and hips.

It is commonly caused by:

  • Muscle strain
  • Ligament injury
  • Disc irritation or bulge
  • Poor posture or sudden movement

Most cases are mechanical, meaning related to muscles, joints, or discs

Common symptoms

  • Pain in the lower back
  • Pain that may spread to the buttock or leg
  • Stiffness or reduced movement
  • Pain worse with movement or certain positions

What causes lower back pain?

Common (non-serious) causes:

  • Muscle or ligament strain
  • Disc bulge or irritation
  • Poor posture or lifting injury

These usually improve within days to weeks

Less common but important causes:

  • Nerve compression (e.g. sciatica)
  • Fracture (especially after a fall or in older patients)
  • Infection
  • Cancer (rare)

Red flags (IMPORTANT)

Seek urgent medical care if you have:

  • Loss of bladder or bowel control
  • Numbness around the groin or inner thighs
  • Progressive leg weakness (often one leg initially)
  • Severe or worsening nerve symptoms
  • Back pain with fever
  • History of long-term steroid use (risk of fracture)
  • Back pain in intravenous drug users (higher risk of serious infection)

One of the most serious conditions is cauda equina syndrome (compression of nerves in the lower spine)

 This is a medical emergency and requires urgent MRI and hospital assessment

Other concerning features:

  • Unexplained weight loss
  • History of cancer
  • Significant trauma (fall or accident)
  • Pain not improving or progressively worsening

Treatment options

1. Stay active

  • Gentle movement is important
  • Avoid prolonged bed rest
  • Avoid prolonged sitting in one position

Staying active helps speed recovery

2. Pain relief

  • Anti-inflammatory medications (NSAIDs)
  • Paracetamol
  • Short-term stronger pain relief if required

 Pain can be severe and may need appropriate medical management

3. Muscle relaxants

  • May help if muscle spasm is present

4. Heat therapy

  • Heat packs can reduce muscle stiffness

5. Physiotherapy

  • Improves strength and mobility
  • Reduces recurrence

Advanced pain management (if symptoms persist)

If symptoms continue despite treatment:

  • Nerve root (epidural) injection
  • Injection of local anaesthetic and steroid near the affected nerve
  • Performed under imaging guidance (usually CT)
  • Can reduce pain and inflammation

Effects vary:

  • Temporary relief in many patients
  • Longer-term relief in some
  • Limited effect in others
  • Your doctor or VEMSA emergency specialists can explain the benefits and risks

Surgical options (in selected cases)

If symptoms persist and imaging shows nerve compression:

  • Microdiscectomy
  • Minimally invasive (“keyhole”) surgery available
  • Removes part of the disc pressing on the nerve

Usually considered after failure of conservative treatment

Do you need a scan?

Most people do not need immediate imaging

Scans (MRI or CT) are recommended if:

  • Red flags are present
  • Symptoms persist
  • Significant nerve symptoms develop

 MRI is the preferred (gold standard) test for nerve-related problems

When to seek urgent care

Seek urgent medical help if you have:

  • Loss of bladder or bowel control
  • Numbness in the groin area
  • Progressive leg weakness
  • Severe pain after trauma
  • Fever with back pain

How VEMSA can help

We can:

  • Assess your symptoms via video consultation
  • Provide pain relief and prescriptions
  • Guide safe home management
  • Identify red flags early
  • Arrange imaging when needed
  • Refer you to physiotherapy or specialists
  • Provide follow-up until your symptoms improve

Key takeaway

  • Most lower back pain improves within a few weeks
  • Staying active is important
  • Imaging is only needed in selected cases
  • Red flag symptoms require urgent assessment

Need help now?

  • Seen within minutes
  • Available 24/7, 365 days/year
  • No booking required
  • No out-of-pocket cost

 Start your consultation with an emergency-trained clinician now

Evidence and references

This information is based on established clinical guidelines:

  • Royal Australian College of General Practitioners
  • National Institute for Health and Care Excellence
  • World Health Organisation

Key evidence (simplified):

  • Around 80% of people experience lower back pain at some point
  • Most cases improve within 2–6 weeks
  • Early imaging does not improve outcomes in most patients
  • Staying active leads to faster recovery than bed rest

Disclaimer

This information is for general education only and does not replace individual medical advice. If you are concerned or have severe symptoms, seek urgent medical care

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