Low back pain is usually not caused by a serious disease. Current guidelines recommend carrying on with daily activities as far as the pain allows, rather than bed rest.
Low back pain is a complaint that almost everyone experiences at some point in their life. It is usually not caused by a serious disease, and most cases ease markedly within a few weeks. So what should you do while you are in pain?
Bed rest is not recommended
In the past, lying in bed for days was recommended for low back pain. Today, guidelines say the opposite: walking and carrying on with work and daily tasks as far as the pain allows supports recovery. Staying inactive for a long time can lead to weaker muscles, stiff joints and longer-lasting pain.
This does not mean pushing through everything despite the pain. Taking a short break from heavy tasks that clearly increase the pain, and building up activity step by step, is the most balanced way forward.
Does pain mean damage?
The severity of low back pain does not always reflect the extent of tissue damage. Disc changes and herniations seen on MRI are also found in many people who have no pain at all. Poor sleep, stress and fear of movement can also increase pain. This is why imaging is not needed for every case of low back pain; the doctor decides based on the examination findings.
Why is exercise important?
Exercise is one of the approaches with the strongest evidence for low back pain. There is no single "right exercise"; programmes such as walking, strengthening, flexibility or clinical Pilates are chosen according to the person's situation and preferences. Methods such as manual therapy are most beneficial when combined with exercise. Passive supports such as corsets and back belts are not recommended.
When should you seek help straight away?
- Being unable to control or pass urine or stools
- Numbness in the groin and around the bottom
- Progressive weakness in the legs
- Low back pain accompanied by fever, unexplained weight loss or a history of cancer
- Pain that started after a serious fall or accident
If any of these apply, go to the emergency department without delay. If your pain does not ease within a few weeks or spreads down your leg, see a doctor.
More information: Low back and neck pain assessment · Exercise therapy
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