About this symptom
Back pain is pain anywhere along the back, most often in the lower back. It can be a dull, steady ache or a sudden sharp jolt.
Often no clear cause is found, and it gets better on its own. The most common cause is a strain of a muscle or ligament. It usually improves within a few weeks but can last longer or come back. A serious cause is rare.
Possible causes
This is not a diagnosis. These are the causes doctors think about, with the ones that are most urgent to rule out first.
- Spinal fracture, infection or cancerRare causes. A doctor looks for them if back pain comes with a fever, weight loss you cannot explain, a past cancer, or pain that is worse at night.
- Kidney infectionPain in the side or back with a fever, or with burning or blood when passing urine.Read about it
- OsteoporosisWeak bones can collapse in the spine (compression fractures) and cause back pain.Read about it
- Slipped discA disc in the spine presses on a nearby nerve. It is the most common cause of sciatica, with pain that can spread into the leg.Read about it
- SciaticaSharp or burning pain from the buttock down the back of one leg, sometimes to the foot, with tingling, numbness or weakness. The leg pain is often worse than the back pain.Read about it
- Ankylosing spondylitisBack pain and stiffness that build up over months or years, usually starting in teenagers and young adults, with tiredness and pain in other joints.Read about it
- Low back painThe most common cause. A strain of the muscles or ligaments after lifting, a sudden movement or sitting too long in one position, though often no single cause is found.Read about it
When to get help
See a doctor the same day if back pain comes with a fever, shivering or feeling unwell, or if it is sudden and severe or getting worse quickly. See a doctor soon if you have:
- A history of cancer, weight loss you cannot explain, or a lump or swelling on the back
- Pain that is worse at night or when lying down
- Weakness or numbness in one leg, or pain that travels below the knee
- Burning or blood when passing urine
- Pain that has not eased after a few weeks, or stops you doing your daily activities
Back pain with none of these signs usually settles with time and can be managed at home.
What you can do at home
For most back pain these steps are safe to try. Stop and see a doctor if the pain gets worse.
Do
- Keep up your daily activities, with a short rest in the first day or two if you need it
- Use an ice pack for the first few days, then a heat pack, wrapped in a towel
- Walk, swim or stretch gently once the worst has passed
- Ask a pharmacist or doctor which painkiller suits you
Do not
- Do not stay in bed for long periods
- Avoid heavy lifting and twisting while the pain is settling
What the doctor will do
The doctor will ask where the pain is, how often it comes and how severe it is. They will examine your back and how you move, and ask about weakness, numbness, bladder or bowel changes, fever, weight loss and any past cancer.
Scans are usually not needed in the first few weeks unless there are warning signs. When they are, the tests may include:
- Blood tests
- An X-ray of the spine
- A or an of the lower spine
Treatment usually starts with exercise, physiotherapy and pain relief. Surgery is considered only for some causes, such as a slipped disc, when other treatment has not helped.
Myths and facts
Things people often say about this. Open each one to see what is true.
Myth“I should rest in bed until the back pain goes.”What is true?
Fact
Long periods in bed do not help. A short rest in the first day or two is fine, but staying gently active and keeping up your daily activities usually helps recovery more.
Myth“Back pain always needs an MRI to find out what is wrong.”What is true?
Fact
Most back pain gets better without a scan, and doctors usually do not order spine tests in the first few weeks unless there are warning signs such as weakness, numbness, bladder or bowel changes, fever or a past cancer.
Questions to ask your doctor
Tick the ones you want answered and take them with you.
Common questions
Should I stay in bed if my back hurts?
No. Rest for a day or two if you need to, then return to your usual activities as far as the pain allows. Long periods in bed are not recommended and can slow recovery.
How long does back pain last?
Many people feel better within a week, and the pain is usually gone within a further few weeks. It can last longer or come back. See a doctor if it has not improved after a few weeks or stops you doing your daily activities.
Do I need an MRI for back pain?
Usually not at first. The doctor decides after asking questions and examining you. Scans are usually kept for pain that does not settle, or when warning signs such as weakness, numbness or bladder and bowel changes are present.
Can back pain come from the kidneys?
Sometimes. Pain in the side or back with a fever, or with burning or blood when passing urine, can come from the kidneys, so see a doctor the same day.