Lower back pain

Lower back pain is one of the most common reasons adults seek GP advice. It can range from mild stiffness to more severe pain that affects movement, sleep, or work. In most cases, back pain improves with time and conservative management.

This page explains common causes of lower back pain, how it is assessed in general practice, and when to seek further review.

These articles are intended as educational sources, not diagnostic nor taking place of a proper medical assessment. If you need help with ongoing joint concerns, please book a GP appointment.

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How musculoskeletal back pain commonly presents

Lower back pain may present as:

Dull or aching pain in the lower back
Stiffness, especially in the morning or after rest
Pain that worsens with movement or prolonged sitting
Muscle spasm or tightness
Reduced range of movement
Pain that may spread into the buttocks or upper legs

Symptoms can develop suddenly or build up gradually.

Seek urgent medical advice if you develop:

Loss of bladder or bowel control
Numbness around the genitals or inner thighs
Progressive leg weakness
Severe pain following trauma
Back pain with fever or unexplained weight loss

Common causes of lower back pain

Mechanical back pain

This is the most common cause and relates to muscles, joints, or ligaments. It may follow lifting, twisting, prolonged sitting, or poor posture.

Muscle strain or ligament injury

Often occurs after sudden movement or overuse.

Disc related pain

Bulging or irritated discs can cause back pain and sometimes nerve symptoms.

Degenerative changes

Age related wear and tear of the spine can lead to stiffness and recurrent pain.

Inflammatory causes

Less common, but important to identify, especially if pain is worse at night or associated with stiffness lasting over 30 minutes in the morning.

How a GP assesses back pain

A GP assessment focuses on identifying serious causes and guiding appropriate management. This usually includes:

Duration and pattern of pain
Triggering events or injuries
Impact on daily activities and sleep
Presence of leg pain, numbness, or weakness
Red flag symptoms

Most back pain can be assessed without examination in an initial remote consultation.

Investigations

Most people with lower back pain do not need tests initially.

Investigations such as blood tests or imaging may be considered if:

Pain is severe or persistent
Symptoms suggest nerve involvement
There are red flag features
Inflammatory or underlying conditions are suspected

Unnecessary imaging is usually avoided early on.

Self-care and early management

Simple measures are often effective:

Keep moving and avoid prolonged bed rest
Gentle stretching and activity as tolerated
Heat or cold packs
Good posture and ergonomic support
Over the counter pain relief if appropriate

Most episodes improve within a few weeks.

Medical treatments a GP may recommend

Depending on symptoms, a GP may recommend:

Short term pain relief
Advice on activity modification
Referral for physiotherapy
Further assessment if symptoms persist

The focus is on restoring function rather than complete rest.

Expert physio insights by AccessGP Lead Physiotherapist, Sonali Talwar

Sonali is an experienced physiotherapist working with AccessGP. In her clinical practice, lower back pain is most commonly related to mechanical strain, prolonged sitting, reduced spinal mobility, and weakness in the deep core and hip muscles that support the lumbar spine.

Many patients are understandably worried that movement may cause damage, but in most cases of lower back pain, gentle movement and gradual loading are key to recovery. Staying active within comfort, avoiding prolonged rest, and following a structured exercise programme can help reduce pain, restore confidence, and prevent recurrence.

Physiotherapy focuses on improving spinal mobility, rebuilding strength, and addressing movement patterns that contribute to repeated flare ups, rather than simply treating pain in isolation.