Lower back pain: what you can do yourself

Lower back pain most often appears without a single event that could be blamed for it. In the great majority of people it settles within a few weeks and there is no serious cause behind it. This is not a consolation but a starting point that changes the decisions you make in the first days.

The first change concerns rest. Lying down for more than a day or two does not speed up recovery and often slows it down. The muscles along the spine weaken, the joints stiffen, so the pain with the first movement is greater and the fear of moving grows. Stay upright and moving as much as the pain allows.

Walk. In the first week, short and frequent walks are usually better tolerated than one long one. Adapt your work rather than stopping it: change positions, get up every twenty to thirty minutes, and leave heavy loads to someone else for a while. Heat helps many people relax their muscles, and cold helps some with a fresh injury; both are safe to try. Introduce exercises for the abdominal and back muscles gradually once the worst pain has eased; in the first week it matters more that you move at all than which exercise you choose.

For sleep, find the position that hurts least, for example on your side with a pillow between your knees or on your back with a pillow under your knees. Ask a pharmacist or doctor about painkillers. It makes sense to take them regularly for a few days so that movement becomes possible at all, rather than waiting for the worst moment.

In the first weeks, imaging mostly does not change treatment. Degenerative changes show up on scans in people without pain too, so the report often raises more worries than it resolves. X-rays are available at the centre, but whether one is needed is decided by the doctor based on the findings of the examination.

A few signs change this picture. Inability to hold urine or stool, numbness in the area between the legs and on the inner thighs, and rapidly worsening weakness of one or both legs need immediate help – call 112 and do not wait for an appointment. Get help immediately also with severe pain after a fall from a height or after a road accident.

Book an appointment if the pain does not ease after four to six weeks, if it travels down the leg below the knee, if it comes with pins and needles or weakness in the leg, if it regularly wakes you at night, or if it comes with fever and unexplained weight loss. The orthopaedics clinic and physiotherapy at the centre are self-pay, so you do not need a referral; booking is with the provider that runs the clinic.

At the examination, the orthopaedic specialist links the course of the pain to the load that triggers it and assesses mobility, walking and stability. The proposed treatment follows the findings: often guided physiotherapy and adjusted exercise, sometimes additional imaging. Bring previous reports and scans, and say which exercises you have already done in physiotherapy.