Lower Back Pain
Very common and usually not serious. Most people improve within 6 weeks. Scans aren’t needed unless there are warning signs.
Treatment options
Ratings show how strong the research is.
- Strong evidenceStay activeKeep walking and doing normal activities as able. Faster recovery than bed rest.
- Moderate evidenceHeatA heat pack or wrap gives modest short-term relief.
- Moderate evidenceAnti-inflammatoriesSuch as ibuprofen, for a few days. Small benefit. Not suitable for everyone, so check with your pharmacist.
- Moderate evidenceExercise and physioHelps recovery and is the best way to prevent it coming back.
- Limited evidenceMassage, manipulation, acupunctureMay give small short-term relief.
- Not recommendedParacetamol aloneLarge trials (including the Australian PACE trial) found it works no better than placebo for acute back pain.
- Not recommendedOpioidsThe Australian OPAL trial found they work no better than placebo, with more side effects and risk of dependence.
- Not recommendedBed rest and early scansSlow recovery and rarely change treatment. Scans often show disc bulges in people with no pain at all.
What you can do
- Move little and often. Hurt doesn’t mean harm.
- Return to work and activities early, even if not 100%.
- Regular exercise, a healthy weight and not smoking reduce future episodes.
See your GP if
- Not improving after 4 to 6 weeks
- Pain or numbness below the knee
- Over 50 with new pain, a history of cancer, fever, weight loss or pain worse at night
Go to the emergency department or call 000 for numbness around the bottom or genitals, new trouble controlling your bladder or bowels, or leg weakness.
Evidence and more information
maladywise.com/back-pain/