Most lower back pain gets better on its own within a few weeks. Here is what helps most:
- Keep moving. Stay as active as you can and avoid long bed rest.
- Use heat or cold for comfort.
- Take an anti-inflammatory painkiller such as ibuprofen if it is safe for you.
- Do gentle exercises and stretches. Over time, build up regular exercise such as walking, swimming, yoga or Pilates.
You should see a doctor if the pain lasts more than a few weeks, stops you doing daily activities, or comes with warning signs such as numbness around the genitals or buttocks, problems controlling your bladder or bowel, weakness in both legs, fever or unexplained weight loss. This guide explains the causes, home relief, exercises and the red flags you shouldn't ignore.
How common is lower back pain?
Extremely common. According to the World Health Organization:
- Low back pain affected about 619 million people worldwide in 2020, and the number of cases is projected to reach about 843 million by 2050.
- It is the single leading cause of disability worldwide.
- Most people have it at least once in their life.
- The number of cases peaks between the ages of 50 and 55, and it is more common in women.
The reassuring part is that in about 90% of cases the pain is "non-specific". That means no serious disease or structural problem explains it. It is real pain, but it is usually not a sign of damage.
Common causes of lower back pain
| Type | What it means | Typical features |
|---|---|---|
| Non-specific low back pain | No single identifiable cause; often linked to muscles, ligaments and joints | Ache or stiffness in the lower back; often eases with movement |
| Muscle strain | A pulled or overloaded muscle, often after lifting, twisting or unusual activity | Sudden onset, sometimes with muscle spasm |
| Sciatica | Irritation of the sciatic nerve, often from a slipped (herniated) disc | Pain, tingling or numbness travelling down one leg, often below the knee |
| Inflammatory back pain (e.g. ankylosing spondylitis) | A long-term inflammatory condition | Usually starts before age 45; stiffness worse in the morning that improves with exercise |
| Serious causes (rare) | Fracture, infection, cancer or cauda equina syndrome | See the red flags below |
Things that can make back pain more likely or slower to settle include:
- low physical activity;
- long periods of sitting;
- carrying extra weight;
- smoking;
- poor sleep;
- stress and low mood.
Pain is influenced by the nervous system as well as by tissues, which is why sleep and stress matter.
Red flags: when to get help urgently
The NHS advises getting emergency care (an emergency department or ambulance) if you have back pain with any of these:
- Pain, tingling, weakness or numbness in both legs
- Loss of feeling around the genitals or anus
- New difficulty peeing, or loss of control of your bladder or bowels
- Changes in sexual sensation or function
- Chest pain
- Pain that started after a serious accident, such as a car crash
These can be signs of serious nerve compression (cauda equina syndrome) or another emergency. The NHS also advises getting an urgent appointment if you feel hot, shivery or generally unwell, or if severe pain starts suddenly or worsens quickly.
See a doctor soon (non-urgently) if:
- the pain does not improve after a few weeks of home treatment;
- it stops you doing day-to-day activities;
- you have lost weight without trying;
- there is a lump, swelling or change in the shape of your back;
- the pain is worse at night or does not ease with rest;
- it is worse when you sneeze, cough or pass stools;
- the pain is between your shoulder blades rather than low down.
Lower back pain relief at home
1. Stay active, and avoid bed rest
This is the single most important message. The NHS advises staying active, continuing your daily activities as much as you can, and not staying in bed for long periods. UK guidance from NICE likewise encourages people to continue normal activities and promotes returning to work. Gentle movement helps stiffness and speeds recovery. Long rest tends to make things worse.
2. Heat or cold
- Cold: an ice pack or a bag of frozen peas wrapped in a towel can reduce pain and swelling, especially after a strain.
- Heat: a heat pack or hot-water bottle wrapped in a towel can ease stiffness and muscle spasm.
- Use either for 15–20 minutes at a time. Never apply heat or ice directly to the skin.
3. Painkillers: use them wisely
- The NHS suggests anti-inflammatory medicines like ibuprofen if they are suitable for you. NICE advises the lowest effective dose for the shortest time. They aren't safe for everyone, for example people with some stomach, kidney or heart conditions, or in pregnancy.
- Paracetamol on its own is not recommended for low back pain (NICE and NHS), though it may be combined with another painkiller.
- NICE advises against opioids for chronic low back pain. Ask a pharmacist or doctor if you are unsure what is safe for you.
4. Sleep and sitting
- Find a comfortable sleeping position. Some people find a pillow between the knees (on their side) or under the knees (on their back) helps.
- If you work at a desk, get up and move every 30–45 minutes. Set your screen at eye level and keep your feet flat on the floor. No single "perfect posture" prevents back pain, but changing position often helps.
Gentle exercises for lower back pain
The NHS recommends exercises and stretches, and says activities like walking, swimming, yoga and Pilates may also help. Stop any exercise that makes the pain clearly worse, and see a doctor or physiotherapist for advice.
- Knee-to-chest stretch: lie on your back with your knees bent. Gently pull one knee towards your chest and hold for 10–20 seconds. Repeat on the other side, 3–5 times each.
- Pelvic tilt: lie on your back with your knees bent. Tighten your stomach and gently flatten your lower back into the floor. Hold for 5 seconds and repeat 10 times.
- Knee rolls: lie on your back with your knees bent together. Slowly roll both knees to one side, then the other, keeping your shoulders on the floor. Repeat 8–10 times.
- Cat–cow: on your hands and knees, slowly round your back towards the ceiling, then let it gently sag. Move within a comfortable range, 8–10 times.
- Bridge: lie on your back with your knees bent. Squeeze your buttocks and lift your hips until your body forms a straight line from shoulders to knees. Hold for 3–5 seconds and repeat 8–10 times.
- Walking: short, frequent walks, increased gradually. See our beginner's walking plan.
Over the longer term, regular exercise that you enjoy, including strength, aerobic or mind–body exercise, is one of the best ways to reduce flare-ups. NICE suggests group exercise programmes for people with an episode or flare-up of low back pain.
What treatments do doctors and physiotherapists use?
If pain is severe or not getting better, the NHS lists:
- group exercise classes and physiotherapy;
- manual therapy (massage and manipulation by a trained therapist). NICE says this should only be part of a package that includes exercise.
- cognitive behavioural therapy (CBT) to help you cope with pain;
- for some people with long-term pain, a procedure called radiofrequency denervation.
Surgery is an option only for specific problems, such as a slipped disc that has not responded to other treatments.
Do I need an X-ray or MRI?
Usually not. NICE advises against routine imaging for low back pain in a non-specialist setting. Scans are considered in specialist care only if the result is likely to change treatment. Scans often show age-related "wear" that is common in people without pain, so the findings can be misleading.
Treatments NICE advises against
NICE recommends not offering these for low back pain:
- belts or corsets;
- foot orthotics;
- traction;
- acupuncture;
- ultrasound therapy;
- TENS.
Their reviews found too little benefit. You don't need to pay for these to recover.
How to prevent back pain from coming back
- Stay regularly active. Aim for the WHO target of 150–300 minutes of moderate activity a week, plus strength work on two days.
- Build core and hip strength gradually, for example with bridges, squats and planks as tolerated.
- Lift with a stable stance, keep the load close to your body and avoid twisting while lifting heavy items.
- Break up long periods of sitting.
- Look after your sleep and stress, as both affect how much pain you feel. See our stress management guide.
- If you smoke, quitting helps your overall health and recovery.
Frequently asked questions
How long does lower back pain usually last?
The NHS says back pain usually improves within a few weeks. Some people have pain that lasts longer or keeps coming back. If it hasn't improved after a few weeks of self-care, see a doctor or physiotherapist.
Should I rest or exercise with lower back pain?
Keep moving. The NHS advises against staying in bed for long periods. Gentle activity and stretches within your comfort level help you recover faster than rest.
Is heat or ice better for back pain?
Both can help. Ice may ease pain and swelling after a strain, and heat can relax stiff muscles and spasm. Use whichever feels better, wrapped in a towel, for short periods.
When is back pain an emergency?
Get emergency help if you have numbness around the genitals or anus, new bladder or bowel problems, weakness or numbness in both legs, chest pain, or back pain after a serious accident.
Can a new mattress or back belt fix back pain?
There's no single best mattress; choose one that is comfortable for you. NICE recommends against belts and corsets for managing low back pain. Staying active and exercising regularly have the strongest evidence.
Disclaimer: This article is for general information only and is not medical advice. It does not replace a diagnosis or treatment plan from a qualified professional. Please consult your doctor before changing your diet, exercise, medicines or supplements, and seek urgent care for any warning signs mentioned above.
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