About back pain

How common is back pain?

Back pain is very common. About 80% of people will get it at some point.

You might feel pain only in your back, or it might spread down one or both legs. Some people also get tingling, pins and needles, or numbness.

Most back pain gets better within 2–3 months, although it may not go away completely. A small number of people (about 1 in 100) need extra help from specialists like physiotherapists or pain clinics. Very few people (less than 1 in 1,000) need surgery.

Why does my back hurt?

Back pain can happen for many reasons, including:

These include slips, trips, falls, or car accidents. If you get back pain after this, it is often called whiplash. It usually gets better with gentle movement, pain relief, and time.

  • Disuse: Sitting or staying in one position for too long, like working at a computer without breaks.
  • Misuse: Doing a sudden activity without warming up, such as driving for hours then lifting something heavy straight away.
  • Overuse: Doing more than your body is used to, like lifting too much weight at the gym or suddenly increasing your activity level.

  • Stress or anxiety: These don’t cause pain on their own, but they can make pain feel worse.

  • Tiredness (fatigue): When your body or mind is tired, everything feels more sensitive, including pain.

Some painkillers can actually make pain worse if used for a long time. One group, called opioids, can increase back pain when taken for too long.

Is it dangerous?

Usually no. Most back pain improves within 12–14 weeks.

If your pain hasn’t improved after 6–8 weeks, it’s worth speaking to a professional such as a First Contact Physiotherapist at your GP surgery. You can also self‑refer to the CDDiMSK service.

Self-referral service

Very rarely, back pain can be a sign of something more serious, such as:

  • Cauda equina syndrome (about 3 in 100,000 people)

  • A serious illness (0.4–2 in 100,000 people)

What is cauda equina syndrome?

It is when important nerves at the bottom of your spine get squashed. These nerves help you move your legs, feel around your bottom and private parts, and know when you need the toilet.

Warning signs you should not ignore

Contact your GP as soon as possible if you have:

  • Pain that never changes — it doesn’t get better or worse no matter what you do.

  • Back pain with sudden weight loss without trying.

  • Sudden pain in both legs at the same time, even though nothing happened. Or if long‑term pain in one leg suddenly starts in the other leg too.

  • Weakness in both legs at the same time.

  • Pins and needles, numbness, or tingling in your genitals, anus, or the skin between them (the perineum). This may happen with or without changes to your bladder or bowel.

If these symptoms started or got worse in the last 2 weeks, go to A&E today.

Do I need a scan or Xray?

Probably not.

An MRI scan shows a still picture of your body while you lie down. It cannot show how your back moves, so it often doesn’t explain why you have pain.

For most people:

  • An MRI does not change the treatment plan.

  • It can sometimes delay recovery or even make symptoms feel worse.

MRI scans are mainly useful for:

  • Ruling out serious problems.
  • Helping surgeons decide what to operate on if other treatments haven’t worked.

Surgery is not usually a good way to treat back pain. About 3 out of 10 people who have back surgery end up with worse pain or new pain afterwards.

Male holding back in pain

What can I do to help my back pain?

The best treatment for back pain is movement.

This could be:

  • Walking

  • Gentle exercise

  • Gym classes

  • Anything that feels comfortable for you

Even during a bad flare‑up, try to move as much as your pain allows

You can also:

  • Ask your GP or First Contact Physiotherapist about exercises and suitable pain relief

  • Self‑refer to CDDiMSK if things haven’t improved after 6 weeks

Exercises

Pelvic tilt in sitting
Lumbar rotation
Assisted hip flexion

What should I not do?

  • Don’t blame yourself or “fight” the pain. Pain is not a sign of weakness.

  • Don’t assume long‑lasting pain means damage. You can be sore but still safe to move.

  • Don’t panic if you have a flare‑up. Good and bad days are normal.

  • Don’t believe everything you read online. Many treatments have no evidence behind them.

  • Don’t rely on scans. Many people with no pain at all have changes on MRI scans. For example, disc bulges are found in:

    • 40% of people over 30

    • 50% of people over 40

In summary

  • Back pain is very common

  • It is almost never caused by something serious

  • Keep moving as much as you can

  • MRI scans rarely explain back pain

  • Surgery is almost never needed for low back pain

  • If your pain hasn’t improved after 6–8 weeks, contact your GP or use the self‑referral link