Low back pain is very common. According to the World Health Organization, around 90% of cases are non-specific low back pain, meaning no single disease or clear structural injury can fully explain the symptoms.
Most acute low back pain improves gradually. Therefore, X-rays, CT scans or MRI scans are not always needed. Imaging may show disc degeneration, bone spurs or age-related changes, but these may not be the actual cause of pain.
The need for imaging should be assessed by healthcare professionals based on medical history, physical examination and red flags.
Should I rest more when I have low back pain?
It is acceptable to briefly avoid movements that cause severe pain. However, prolonged bed rest may reduce muscle strength, increase joint stiffness and lead to fear of movement.
In general, staying active within tolerance and gradually returning to walking, work and suitable exercise is recommended. Exercise therapy, health education, psychosocial support, sleep improvement and lifestyle modification are important parts of recovery.
Chronic low back pain usually requires comprehensive management, not painkillers, massage or one single treatment alone. WHO recommends a holistic and person-centred approach, taking into account mobility, work environment, sleep, emotions and personal goals.
When should I seek medical attention promptly?
Please seek medical assessment as soon as possible if you have:
- Low back pain after a serious fall, traffic accident or impact
- Significant weakness in both legs or rapidly worsening numbness
- Loss of sensation around the perineum or inner buttocks
- Sudden loss of bladder or bowel control
- Low back pain with fever, persistent night pain or unexplained weight loss
- History of cancer, severe osteoporosis, long-term steroid use or immunosuppression
Daily Care Tips
- Stay active within tolerance and avoid prolonged bed rest.
- Change posture regularly and take short walks when sitting for long periods.
- Gradually strengthen the lower back, abdominal, hip and lower limb muscles.
- Maintain a healthy weight, get adequate sleep and avoid smoking.
- Seek professional assessment if pain persists, recurs or affects work and sleep.
Source
World Health Organization. (2023). WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings.
World Health Organization. (2023). WHO guideline for non-surgical management of chronic primary low back pain: Executive summary.
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