Low Back Pain: Everything You Need to Know
- staystrongtherapy
- Jun 27
- 8 min read
All information in this blog is supported by NICE guidelines and peer-reviewed research. Reference numbers appear throughout, the full list can be found at the bottom of the page.
What Is Lower Back Pain?
Lower back pain is one of the most common health complaints in the world, affecting people of all ages and lifestyles. It refers to pain, stiffness, or discomfort felt anywhere in the lower part of the spine, roughly between the bottom of your ribcage and the top of your buttocks. The good news is that the majority of lower back pain cases are not caused by anything serious, and with the right support, most people recover well. ¹
Common Signs & Symptoms
Lower back pain can feel different from person to person, but common experiences include:
A dull, aching pain in the lower back that may come and go
Stiffness, particularly first thing in the morning or after sitting for long periods
Sharp or shooting pain that may travel into the buttocks or down one or both legs
Muscle spasms or tightness in the lower back or hips
Difficulty standing up straight or changing position
Pain that worsens with certain movements such as bending, lifting, or twisting
If your pain travels down your leg below the knee, causes tingling or numbness, or is accompanied by weakness in the legs, this may suggest nerve involvement such as sciatica, which is covered in its own blog. ¹
What Is Actually Happening in Your Back?
Your lower back, known medically as the lumbar spine, is made up of five vertebrae (the bones that stack to form your spine), separated by discs that act like shock absorbers. Surrounding these structures are muscles, ligaments, tendons, nerves, and small joints called facet joints that allow your spine to move.
Lower back pain most commonly occurs when one or more of these structures becomes irritated, strained, or compressed. This can happen due to:
Muscle or ligament strain: the most common cause. Overstretching or overloading the muscles and soft tissues of the back, often through heavy lifting, a sudden awkward movement, or prolonged poor posture.
Disc irritation or herniation: the soft discs between your vertebrae can bulge or press on nearby nerves, causing pain, numbness, or tingling. Think of the disc like a jam doughnut, if squeezed, the filling can push outward and irritate nearby structures.
Facet joint syndrome: the small joints along the back of your spine can become inflamed or worn, causing localised pain and stiffness, often worse when leaning backwards or twisting.
Postural back pain: long periods of sitting, standing, or working in awkward positions can place uneven load on the spine, gradually causing pain and tension to build up.
In most cases of lower back pain there is no serious structural damage, the back is simply overloaded, irritated, or weakened through lack of movement. ¹ ²
Symptoms to Look Out For:
Certain symptoms should always be assessed by a medical professional to rule out a more serious underlying cause. ¹ These symptoms are uncommon but important to rule out as they may indicate conditions such as spinal cord compression, fracture, or infection. ¹Please seek urgent medical attention or contact your GP if you experience any of the following:
Loss of bladder or bowel control
Numbness or tingling in your groin or inner thighs (saddle area)
Severe pain that is constant and not relieved by any position, particularly at night
Unexplained weight loss alongside back pain
Back pain following a significant fall, accident, or trauma
A history of cancer alongside new or worsening back pain
Myths vs Facts
"I should rest until the pain goes away.": Whilst a short period of relative rest in the very early stages can be helpful, prolonged bed rest is usually unadvised for lower back pain. UK guidelines recommend encouraging people to continue with normal activities as much as possible. ¹ ³
"Back pain means my spine is damaged.": The vast majority of lower back pain is not caused by serious structural damage. UK guidelines specifically state that routine imaging should not be offered for low back pain in most cases, as scans often show age-related changes that are entirely normal and are not always the cause of pain. ¹
"I should avoid exercise if my back hurts.": Quite the opposite. Gentle, progressive exercise is one of the most evidence-based treatments for lower back pain and plays a key role in long-term recovery. ³ ⁴
How We Can Help
Osteopathic manual techniques and spinal manipulation / mobilisation: UK guidelines recommend considering manual therapy, including spinal manipulation, mobilisation, and soft tissue techniques, for managing low back pain, delivered as part of a treatment package that includes exercise. ¹ Once consultation and assessment has provided a diagnosis, our hands-on osteopathic approach will be taylored to your presenting symptoms; mobilising stiff spinal joints, releasing tight muscles, and improving the way your back moves and functions. Research supports manual therapy as an effective approach for both acute and chronic low back pain. ⁵
Deep tissue and sports massage: Massage is explicitly recognised by UK guidelines as a component of manual therapy for low back pain. ¹ Targeted massage helps release chronic muscle tension, reduce inflammation, and improve circulation to the affected area.
Medical acupuncture: We use medical acupuncture as part of a broader, multimodal treatment plan alongside exercise and manual therapy. Whilst current UK guidance does not recommend acupuncture as a standalone treatment for low back pain, a substantial and growing body of research supports its use, particularly for chronic presentations. It has found acupuncture to be effective in reducing pain and disability in people with chronic low back pain compared to usual care, ⁷ and has also been found to be effective for chronic non-specific low back pain. ⁸ We are transparent about this distinction and always discuss your options openly.
Cupping and gua sha: We use cupping and gua sha as complementary tools within a broader treatment plan. Cupping has been seen to significantly improve pain and disability in people with low back pain, with effects that were superior to medication and usual care in several measures. ⁹ These therapies are not currently addressed by UK guidelines, however the research evidence supports their use as part of a multimodal approach.
Exercise & Rehabilitation
Exercise is one of the most powerful and well-evidenced tools for recovering from lower back pain. Exercise has been found to significantly reduced pain and improved function, quality of life, and disability in people with non-specific low back pain. ⁴
In the early stages (first few days):
Stay as mobile as possible: short, gentle walks are excellent
Avoid prolonged sitting or lying down where possible
Try gentle knee-to-chest stretches lying on your back, slowly pulling one knee at a time toward your chest
As you begin to recover:
Cat-cow stretch: on all fours, slowly arch and round your back in a gentle flowing movement. This mobilises the lumbar spine and relieves stiffness.
Pelvic tilts: lying on your back with knees bent, gently flatten your lower back into the floor and hold for a few seconds. Activates the deep stabilising muscles of the spine.
Glute bridges: lying on your back with knees bent, slowly lift your hips off the floor, hold briefly, and lower. Builds strength in the glutes and lower back.
Bird-dog: on all fours, slowly extend one arm and the opposite leg, hold, and return. Excellent for core stability and spinal control.
In the longer term:
Build up to regular low-impact exercise such as walking, swimming, or cycling ⁴
Pilates and yoga have good evidence for reducing recurrence of lower back pain ⁴
Strengthening your core: the deep muscles around your spine and abdomen, is key to long-term back health ³
Always work within a comfortable range and stop any exercise that significantly worsens your pain. Your practitioner will guide you on what is appropriate for your specific situation.
Living With Lower Back Pain: Practical Day-to-Day Tips
Here are some practical tips to help you manage day to day:
Sitting: Avoid sitting for more than 30 to 40 minutes without getting up and moving. Use a supportive chair with your feet flat on the floor and hips and knees at roughly 90 degrees.
Sleeping: Lying on your side with a pillow between your knees, or on your back with a pillow under your knees, helps reduce pressure on the lower spine overnight.
Lifting: Bend at the knees rather than the waist, keep the load close to your body, and avoid twisting while lifting.
Driving: Adjust your seat so your knees are roughly level with your hips, and take regular breaks on long journeys.
At work: Ensure your screen is at eye level and consider alternating between sitting and standing throughout the day.
Heat: A warm heat pack applied to the lower back can help relax muscle spasm and ease stiffness, particularly in the mornings.
What to Expect at Your First Appointment
At your first appointment, we will take a full case history to understand your pain, how it started, what makes it better or worse, and how it is affecting your daily life. In line with NICE guidelines, we will carry out a thorough assessment and discuss a personalised, evidence-based treatment plan with you. ¹ You will never be rushed, and everything will be explained clearly so you feel fully informed and comfortable throughout.
Frequently Asked Questions
How many sessions will I need?
This varies depending on how long you have had the pain, the underlying cause, and how your body responds to treatment. Many people notice significant improvement within two to four sessions, though longer-standing or more complex conditions may require more time.
Can lower back pain come back?
Yes, recurrence is common, particularly if the underlying causes such as posture, movement habits, or weakness are not addressed. This is why rehabilitation exercises and lifestyle advice form a central part of your treatment plan. ³
Should I get a scan?
In most cases, scans are not necessary. UK guidelines advise against routine imaging for low back pain as scans frequently show age-related changes that are not the cause of pain. Your practitioner will advise you if a referral for imaging or to another specialist is appropriate. ¹
Ready to take the first step? Get in touch with us today using the contact form and we will help you find the right treatment for your lower back pain. Or simply book an appointment by clicking the button below
References
National Institute for Health and Care Excellence (NICE). Low Back Pain and Sciatica in Over 16s: Assessment and Management. NICE Guideline [NG59]. Published November 2016, last updated December 2020. Available at: https://www.nice.org.uk/guidance/ng59
Corp N, et al. Evidence-based treatment recommendations for neck and low back pain across Europe: A systematic review of guidelines. European Journal of Pain. 2020. DOI: 10.1002/ejp.1679. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7839780/
Li Y, et al. Exercise intervention for patients with chronic low back pain: a systematic review and network meta-analysis. Frontiers in Public Health. 2023. Available at: https://pubmed.ncbi.nlm.nih.gov/38035307/
Zhai H, et al. Effectiveness of Physical Activity in the Management of Nonspecific Low Back Pain: A Systematic Review. 2024. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11678838/
Rubinstein SM, et al. Exercise Therapy Versus Manual Therapy for the Management of Pain Intensity, Disability, and Physical Function in People With Chronic Low Back Pain: A Systematic Review With Meta-Analysis and Meta-Regression. 2024–2025. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314856/
Mak S, et al. Use of Massage Therapy for Pain, 2018–2023: A Systematic Review. JAMA Network Open. 2024. DOI: 10.1001/jamanetworkopen.2024.22259. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11250267/
Acupuncture vs Usual Care for Chronic Low Back Pain: A Systematic Review and Meta-Analysis of Immediate and Intermediate Effects. PMC. 2025. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12867475/
Comparative Efficacy of Acupuncture for Chronic Low Back Pain: A Network Meta-Analysis. Heliyon. 2025. Available at: https://www.cell.com/heliyon/fulltext/S2405-8440(25)01513-0
Zhang Z, et al. The effectiveness of cupping therapy on low back pain: A systematic review and meta-analysis of randomized control trials. Complementary Therapies in Medicine. 2024. Available at: https://www.sciencedirect.com/science/article/pii/S0965229924000013
Comments