Overview
Back pain is one of the most common reasons people see a doctor. Most back pain is mechanical, meaning it arises from the muscles, ligaments, or joints of the spine rather than from a serious disease. It is usually short-lived and improves with movement and simple self-care.
How common is it?
About 8 in 10 people will experience significant back pain at some point. It is the leading cause of disability worldwide and one of the top reasons for work absence.
Causes and risk factors
Most back pain results from muscle or ligament strain, poor posture, or disc problems such as a prolapsed disc pressing on a nerve. Serious causes such as fracture or tumour are uncommon but must be excluded.
Common risk factors
- Sedentary lifestyle and prolonged sitting
- Poor lifting technique
- Being overweight
- Psychological factors including stress, anxiety, and depression
- Smoking (reduces blood supply to spinal discs)
- Previous back injury
- Physically demanding work or sport
Symptoms
- Aching or stiffness in the lower, middle, or upper back
- Pain that worsens with bending, lifting, or sitting for long periods
- Muscle spasms
- Pain radiating down the leg (sciatica) if a nerve is compressed
- Numbness or tingling in the legs or feet
- Difficulty standing straight
When to see a doctor
Call emergency services (999 in the UK) or go to an emergency department now if back pain occurs with new loss of bladder or bowel control, difficulty passing urine, numbness around the genitals or anus, or weakness or numbness in both legs. Serious trauma or associated chest pain also needs emergency assessment. Do not drive yourself. Seek urgent same-day advice for fever, feeling unwell, or rapidly worsening severe pain. Arrange a medical review for unexplained weight loss or pain that persists.
Diagnosis
Most back pain does not need imaging. X-rays and MRI are reserved for red flag symptoms, suspected fracture, or pain lasting more than 6 weeks without improvement. Blood tests rule out inflammatory causes.
Treatments
Stay active and exercise
Continuing normal activity as much as tolerable is the single most effective treatment for acute back pain. Bed rest prolongs recovery.
Pain relief
Paracetamol and topical NSAIDs are used first. Short courses of oral NSAIDs for more severe pain. Muscle relaxants occasionally used short-term.
Physiotherapy and manual therapy
Targeted exercises, manipulation, and education about posture and movement are effective for persistent back pain and for preventing recurrence.
Self-care and lifestyle
- Strengthen core muscles with exercises like pilates, yoga, or swimming
- Check your workstation setup and avoid prolonged sitting without breaks
- Lift with your legs bent and keep the load close to your body
- Sleep on a medium-firm mattress in a position that keeps the spine neutral
Prevention
Regular exercise, maintaining a healthy weight, not smoking, good posture habits, and proper lifting technique all reduce the risk of back pain episodes.
Sources for targeted updates
Updated: 11 September 2026. Emergency back-pain warning signs. This update covers the named sections; a full review of the remaining guide is pending.