What is back pain and when should you worry about it?

What is back pain?

Back pain is discomfort, stiffness, aching or pain felt anywhere along the spine. It can affect the lower back, middle back, upper back, neck area, or the muscles and soft tissues around the spine.

For many people, back pain occurs after a sudden movement, strain, or injury. For others, it builds gradually over a period of time. It may feel like a dull ache, sharp pain, muscle spasm, burning sensation, or stiffness. Some people also get pain that travels into the buttocks, hips, or legs, which can happen when nerves are irritated.

Back pain is very common. Most cases are not caused by anything serious and will improve with time, movement, and the right support. However, it can still be painful, frustrating, and limiting, especially if it affects everyday activities.

Common causes of back pain

Back pain can have many different causes. Sometimes there is no single clear reason, and the pain may be linked to a combination of muscles, joints, discs, nerves, posture, lifestyle, and general health.

Among the most common causes of back pain are:

• muscle strain or ligament sprain
• lifting heavy objects with poor technique
• sudden twisting or awkward movement
• sitting or standing for long periods
• poor posture or reduced movement during the day
• spinal wear and tear
• slipped disc or nerve irritation
• sciatica
• arthritis
• previous injury
• stress, tension, or poor sleep
• being less active over a long time.

Back pain can also be linked to existing medical conditions. These include ankylosing spondylitis and fibromyalgia.

When to worry about back pain

The good news is that the majority of back pain isn’t serious. However, there are certain symptoms that shouldn’t be ignored.

You should seek urgent medical help if you have back pain and any of the following symptoms:

• numbness, tingling, weakness, or pain in both legs
• loss of feeling around your genitals, buttocks, or anus
• changes in bladder or bowel control
• difficulty peeing or loss of bladder control
• chest pain
• back pain after a serious accident, fall or injury
• a high temperature
• unexplained weight loss
• swelling or a deformity in your back
• pain that is getting worse, not better
• pain that is severe at night or stops you sleeping
• pain made worse by coughing, sneezing, or going to the toilet.

You should also speak to a healthcare professional if your back pain:

• hasn’t improved after a few weeks
• keeps returning
• is affecting your daily life
• is associated with symptoms such as leg pain, pins and needles, weakness, stiffness, or fatigue.

When back pain may be linked to sciatica

Sciatica is pain caused by irritation or compression of the sciatic nerve. It often starts in the lower back or buttock and travels down the back of the leg.

Symptoms of sciatica can include:

• pain in the buttock, leg, or foot
• tingling or pins and needles
• numbness
• weakness
• pain that feels worse when sitting, coughing, or sneezing.

Sciatica can improve over time, but you should seek advice if symptoms are severe, getting worse, or lasting for a long time. If sciatica is linked to bladder or bowel changes, numbness around the genitals or buttocks, or weakness in both legs, this needs urgent medical attention.

When back pain may be inflammatory

Some types of back pain are caused by inflammation rather than strain or wear and tear. One example is ankylosing spondylitis. While it may sound a bit like a dance, it’s actually a long-term inflammatory condition that can affect the spine and other joints.

Back pain linked to ankylosing spondylitis may:

• start gradually
• be worse in the morning or during the night
• improve with exercise
• feel worse after rest
• cause stiffness that lasts a long time
• be associated with pain around the buttocks
• occur alongside fatigue or pain and swelling in other joints.

This type of pain can be different from a typical pulled muscle. If you have back pain and stiffness that has lasted for more than three months – especially if it improves with movement but not rest – it’s worth speaking to a healthcare professional.

Long-term back pain

Back pain becomes more complicated when it lasts for a long time. Some people continue to feel pain even after the original injury or cause has settled. This is often described as persistent or chronic pain.

Chronic back pain can affect more than just the back itself. If you’re constantly in pain, it’s likely going to affect your mood, sleep, confidence, work, relationships, and your overall quality of life. People with back pain may also become less active because they’re worried about making the pain worse. Over time, this can lead to stiffness, weakness, and reduced confidence with movement.

Pain management is not just about reducing pain. It is also about helping people understand their symptoms, improve function, and feel more in control. Treatment may include physiotherapy, exercise, reviewing any medication you’re currently taking, practising relaxation techniques, pacing strategies, and even psychological support such as cognitive behavioural therapy CBT.

Practice Plus Group has a new specialist starting soon in Birmingham with expertise in fibromyalgia and chronic pain. This may be particularly helpful for patients whose pain:

• has lasted a long time
• has not improved with standard treatment
• is affecting daily life, sleep, or general wellbeing.

Fibromyalgia and back pain

Fibromyalgia is a long-term condition that can cause widespread pain across the body. It can also cause tiredness, poor sleep, brain fog, headaches, and increased sensitivity to pain.

Back pain may be one of several symptoms for people with fibromyalgia. The pain is not always linked to a single injury or visible problem on a scan. Instead, the nervous system may become more sensitive. This means pain signals feel stronger or last longer than expected.

Fibromyalgia can be difficult to live with. This is especially true when symptoms come and go or affect many areas of the body. Treatment usually focuses on improving quality of life and helping people manage symptoms. These may include:

• gentle exercise and movement
• group exercise programmes
• pacing activity to avoid overdoing things
• improving sleep routines
• stress management
• relaxation techniques
• medicines (if needed)
• talking therapies such as cognitive behavioural therapy (CBT)
• support from a pain or musculoskeletal specialist.

There is no single treatment that works for everyone with fibromyalgia. A personalised approach is often best, especially when symptoms have been present for a long time.

What can increase the risk of back pain?

Back pain can happen to anyone, but some factors may increase the risk. These include:

• heavy lifting
• repetitive bending or twisting
• long periods of sitting
• low levels of physical activity
• poor sleep
• stress or anxiety
• previous back injury
• being overweight
• smoking
• certain jobs or hobbies
• inflammatory or musculoskeletal conditions.

With all that said, back pain isn’t always caused by one specific thing. Many people with back pain have a mix of physical, lifestyle, and emotional factors that all play a role.

Preventing back pain

Preventing back pain is not about avoiding movement. In many cases, staying active is one of the most helpful things you can do for your back.

Some of the ways to reduce the risk of back pain include:

• moving regularly during the day
• avoiding long periods in one position
• building strength gradually
• stretching and maintaining flexibility
• using good lifting technique
• taking breaks from sitting
• keeping active by walking, swimming, or cycling
• maintaining a healthy weight
• managing stress
• getting enough sleep.

If you already have back pain, try not to rest in bed for long periods. Unless you’re experiencing ‘red flag’ symptoms, gentle activity can actually be better than complete rest.

How is back pain treated?

Treatment depends on your symptoms, how long you’ve had pain, and whether there’s an underlying cause.

Back pain treatment may include:

• advice and reassurance
• gentle movement and staying active
• physiotherapy
• pain relief medication
• anti-inflammatory medication (if needed)
• guided exercises
• group exercise
• manual therapy (such as mobilisation or soft tissue techniques)
• pain management support
• CBT or other psychological therapies
• scans or further investigations (if needed)
• referral to a specialist if symptoms are severe, complex, or long-lasting.

For many people, the most helpful treatment plan combines physical support with education and confidence-building. This is especially important for long-term pain where fear of movement can sometimes make symptoms harder to manage.

Do you always need a scan for back pain?

Not always. Many cases of back pain improve without the need for an X-ray, MRI scan, or CT scan. Scans are usually recommended when the results are likely to change your treatment plan or when symptoms suggest something more serious may be happening.

A healthcare professional can assess your symptoms and advise whether imaging is needed. In some cases, a scan can help identify problems such as disc changes, nerve compression, arthritis or other spinal conditions. In other cases, symptoms can be managed safely without imaging.

When to see a specialist

You may benefit from a pain clinic or physiotherapy if:

• symptoms are getting worse
• pain is affecting your sleep, work, or everyday life
• you have leg pain, numbness, pins and needles, or weakness
• you have recurring flare-ups
• you have symptoms of chronic pain or fibromyalgia
• you are worried about an underlying medical condition
• previous treatment has not helped.

Specialist assessment can help identify the likely cause of your symptoms and recommend a treatment plan that suits your needs.

Getting help for back pain at Practice Plus Group

At Practice Plus Group, we support patients with a wide range of musculoskeletal symptoms. These include back pain, joint pain, and other long-term pain conditions.

If your back pain has been affecting your daily life, or you are worried about persistent symptoms, our team can help assess your needs and talk you through your options.

Want to access back treatment via private medical insurance?

Simply type in the name of your insurance provider below to see if you can access healthcare with us.

James Wood, Content Specialist