Lower back pain: causes, when to see a physiotherapist and what to do at home
Most adults experience lower back pain at some point. It often comes out of nowhere – lifting a bag, after a long day of sitting or first thing in the morning. The good news is that most lower back pain is not serious and responds well to movement and physiotherapy. What should you do when your back hurts, and when should you pay closer attention?
Most common causes of lower back pain
- muscle overload and tension – long hours of sitting, one-sided strain, unusual physical work,
- joint restrictions in the spine and pelvis – reduced joint mobility causing pain and protective muscle tension,
- a weak deep stabilising system – the muscles that should support your spine are not doing their job,
- disc problems – a herniated or bulging disc, sometimes with pain radiating into the leg,
- poor posture and muscle imbalances.
Causes often combine. That is why an examination that shows where the pain really comes from is so important.
Red flags – when to see a doctor straight away
See a doctor as soon as possible if your back pain comes with:
- problems passing urine or stool, or numbness around the genitals or back passage,
- weakness in a leg (for example you cannot stand on your toes or heels),
- fever or unexplained weight loss,
- pain after a fall or injury,
- very severe pain that does not change with position or at night.
What helps in the acute phase
- Keep moving. Bed rest is no longer recommended – reasonable movement (walking, everyday activities) speeds up recovery.
- Find a position of relief, for example lying on your back with your lower legs resting on a chair.
- Heat or cold – whichever feels better. Heat usually eases muscle tension.
- Avoid heavy lifting and sitting in one position for long periods.
Safe exercises for relief
Exercise slowly and only within a pain-free range. If the pain gets worse or shoots into your leg, stop.
- Knee rocking – lie on your back, pull your bent knees towards your belly and gently rock from side to side. 30–60 seconds.
- Cat–cow – on all fours, slowly alternate between rounding your back and gently arching it. 8–10 repetitions.
- Belly breathing – lying with your knees bent, breathe slowly into your belly and lower ribs, with a long exhale. 2–3 minutes.
- Pelvic tilts – lying on your back, gently press your lower back into the floor and release. 10 repetitions.
These exercises are general. For lasting improvement, a tailored exercise programme after an examination works best.
How physiotherapy helps
At your first visit we carry out an initial examination – how you move, where mobility is restricted, which muscles are overloaded and which are not working. Based on that we choose the therapy, for example:
- soft tissue techniques and trigger point release,
- mobilisation of the spine and pelvis,
- the McKenzie method for disc-related pain,
- activation of the deep stabilising system,
- kinesio taping,
- back school – how to sit, lift and work so the pain does not come back.
The aim is not just to dull the pain but to remove its cause and teach you how to help yourself.
Prevention for desk workers
Most of us sit for hours every day. It helps to change positions, stand up and walk every 30–45 minutes and set up your workstation well. See our guide to setting up your office chair.
Frequently asked questions
Should I lie down when my back hurts? No. A short rest in a comfortable position is fine, but get back to normal movement as soon as you can.
Do I need a referral for physiotherapy? You can come to us without a doctor’s referral as a self-paying client. With any red flags (see above), always see a doctor first.
How long until the pain improves? For most people, acute lower back pain improves significantly within days to weeks. If the pain keeps returning or lasts longer, it is time to address the cause with a physiotherapist.
This article is for general information only and does not replace a medical examination or an individual consultation with a physiotherapist.