Common Symptoms
- Aching, sharp pain or stiffness in the lower back
- Pain aggravated by prolonged sitting or standing
- Pain extending into the buttock or thigh
- Reduced movement or difficulty bending, lifting or changing position
What Causes It?
- Muscle or soft-tissue strain
- Age-related disc change or a disc problem
- Repeated posture or loading stress
- Irritation of the small joints of the spine
How Is It Diagnosed?
The doctor first reviews your symptoms, any injury and relevant medical history, then performs a clinical examination and arranges investigations only when appropriate. Not every patient needs imaging.
- Review of the symptom pattern, medical history and any injury
- Examination of spinal movement and areas of tenderness
- Neurological assessment when leg pain, numbness or weakness is present
- X-ray or MRI only when the findings suggest it may help guide care
Treatment Options
Treatment depends on the underlying cause, severity of symptoms, impact on function and relevant examination or investigation findings.
- Adjustment of aggravating activities and daily load
- Pain-relief or anti-inflammatory medication when appropriate
- Physiotherapy, movement retraining and progressive trunk-strengthening exercise
- Injection or a minimally invasive procedure only for selected patients after assessment
When Should You Seek Medical Attention?
Seek prompt medical assessment, or urgent care according to severity, if any of the following occurs:
- Inability to stand or bear weight after a significant injury
- Progressively worsening leg weakness or numbness
- A change in bladder or bowel control, or numbness around the saddle area
- Fever, systemic illness and persistent severe back pain
Recovery and Daily Activities
Activity is usually adjusted rather than stopped completely. Rehabilitation gradually restores movement, strength and tolerance for sitting, lifting, work or exercise. Seek prompt medical care if leg weakness, marked numbness or bladder or bowel symptoms develop.
Activities should be progressed according to symptoms, function and response to treatment. Ask a doctor or physiotherapist for advice if symptoms persist or affect work or daily activities.
Dr. Yuen Explains
Related Health Education Video
Health Education Video
Back Pain Q&A: Finding the Cause
Dr Yuen Chi Pan explains the key symptoms, assessment considerations and treatment or rehabilitation principles related to back pain q&a: finding the cause.
Watch VideoFrequently Asked Questions
Does low back pain always come from a disc problem?
No. Low back pain may involve muscles, spinal joints, discs, nerves or everyday loading. The likely source is considered from the history and examination.
Does every patient need an MRI?
No. A doctor considers the symptoms, neurological findings, injury and response to treatment before deciding whether an X-ray, MRI or another investigation is needed.
Should I rest completely when my back hurts?
Prolonged complete rest is not usually advised. Activity can be adjusted according to symptoms, with rehabilitation progressed for the individual condition.
How can physiotherapy help?
Following assessment, physiotherapy may help restore movement, strength and movement control, plan daily loading and identify findings that need medical review.
Still Unsure What May Be Causing Your Symptoms?
Similar symptoms may have different causes. If pain persists, affects activity or progressively worsens, consider an individual medical assessment.