Back Pain

Back pain is extremely common and affects most adults at some point in their lives. In most cases, it is not caused by a serious condition and improves with simple self-care. 

Pain may be in the lower back, middle back, or neck, and can sometimes spread to the legs or arms. 

Most back pain is musculoskeletal, meaning it is related to the joints, muscles or ligaments in your spine. Common causes include: 

• Muscle or ligament strain 

• Poor posture or prolonged sitting 

• Lifting heavy objects incorrectly 

• Spinal wear and tear (osteoarthritis or spondylosis) 

• Disc problems – such as slipped or bulging discs 

• Stress or tension – which can increase muscle tightness 

Most causes do not require scans or hospital treatment and settle in days to weeks. 

• Stay active – Gentle movement and walking are better than bed rest 

• Pain relief – Use regular paracetamol or ibuprofen if suitable 

• Apply heat or ice – Heat packs often relieve muscle stiffness 

• Improve posture – Avoid slumping when sitting or standing 

• Sleep support – Use a firm mattress and try sleeping on your side with a pillow between your knees 

• Physiotherapy – You may be referred for exercises to strengthen and support your back 

Most back pain improves within 6–8 weeks. 

Cauda Equina Syndrome is a rare but serious condition that needs emergency treatment. It occurs when nerves at the base of the spine are compressed. 

 Call 999 or go to A&E immediately if you experience: 

• Loss of control of bladder or bowel 

• Numbness or tingling in the saddle area (genitals, buttocks, inner thighs) 

• Weakness or numbness in both legs 

• Sudden severe back pain with leg symptoms 

• Recent onset of erectile dysfunction 

These symptoms require urgent MRI  

You should go to A&E if: 

• You have any red flag symptoms (see above) 

• Back pain follows a major trauma (e.g. fall or car crash) 

• Pain is sudden and severe and doesn’t improve with pain relief 

• You have a history of cancer, weight loss, or fever with back pain 

• You are feeling very unwell or unable to walk 

For other back pain, please speak to your GP or call NHS 24 on 111. 

• Most back pain is not caused by serious illness 

• Keeping active is key – avoid prolonged bed rest 

• Stay positive – symptoms usually settle 

• Don’t ignore warning signs – seek help if symptoms worsen