Lower back pain can feel sharp, stiff, aching, or “locked”. It may stay in the lower spine or travel into your buttock or leg. It can also affect work, sleep, lifting, exercise, and confidence.

Most flare-ups settle with sensible movement and time. However, recurring or stronger symptoms need a clearer plan. A physiotherapist can assess what is driving your lower back pain, explain the likely pain pattern, and guide a step-by-step return to normal activity.

If you are unsure what is happening, start with our Back Pain guide, common causes of back pain, or sciatica guide.

Lower back pain quick summary

What is lower back pain?

Lower back pain usually comes from the lumbar spine, which is the lower part of your back. Symptoms may involve muscles, joints, discs, or sensitive nerves. More than one structure can contribute at the same time, so a focused assessment matters.

Lower back pain is common, but it is not always simple. Some people feel local stiffness. Others feel pain that spreads into the buttock or leg. Your pattern helps guide the safest treatment and exercise plan.

Hands-on lumbar mobilisation may help guide movement, reduce protective guarding, and support a clearer recovery plan when it matches your presentation.

Why does lower back pain start?

Lower back pain often starts when sensitive tissues are overloaded, irritated, or not coping with recent demands. This may happen after lifting, bending, sport, long sitting, or a change in workload. Sometimes symptoms start suddenly. In other cases, they build over days or weeks.

• Muscle or ligament strain: a sudden lift, twist, or spike in activity can overload the tissues. See pulled back muscle.
• Disc irritation: disc-related symptoms often feel worse with bending, sitting, or coughing. See bulging disc.
• Joint pain: lumbar facet or sacroiliac joint irritation can refer pain into the buttock or hip. See lumbar facet joint pain and sacroiliac joint pain (SIJ).
• Nerve irritation: pain, pins and needles, or numbness into the leg may relate to nerve sensitivity. See sciatica.
• Load and recovery mismatch: doing too much too soon, or recovering poorly between demanding days, can keep symptoms going.

Should I rest or keep moving with lower back pain?

For most people, gentle movement is better than bed rest. Walking, changing positions, and light mobility can help reduce stiffness while keeping your back moving.

However, do not force painful movement. If walking, bending, or lifting rapidly worsens leg pain, numbness, or weakness, book an assessment promptly. If you notice red flags, seek urgent medical care.

How do you investigate lower back pain?

A physiotherapist will assess how you move, how your back and hips tolerate load, and how your symptoms behave with specific tests. They also screen for signs that suggest you should see a GP or specialist for further assessment.

Sometimes physiotherapists use real-time ultrasound to help you learn how to activate key stabilising muscles. Read more about ultrasound physiotherapy for lower back pain.

When does lower back pain need prompt medical review?

What helps lower back pain?

Most lower back pain plans work best when they combine education, movement, and graded strengthening. The right mix depends on your symptoms, irritability, goals, and how long the problem has been there.

The WHO guideline for chronic primary low back pain supports non-surgical care that includes education and exercise-based management.

1) Physiotherapy treatment and education

A physiotherapist may use hands-on treatment, targeted exercise, and advice on pacing, lifting, and daily movement habits. Many people improve when they understand what is driving symptoms and build confidence gradually. Start here: back pain relief with physiotherapy.

2) Strength and core control

Trunk and hip strength can improve confidence with daily tasks and sport. A good plan usually starts with movement quality, then builds load over time. See core stability training.

3) Posture and load management

Posture alone rarely causes pain, but repeated habits can load sensitive tissues. Small changes to sitting time, lifting technique, training load, and recovery habits may help. See good back posture tips.

4) Pain tools you can use at home

Heat, pacing, gentle walking, and short movement breaks may help during a flare-up. Some people use TENS as a short-term symptom tool. It should support movement and exercise, not replace assessment when symptoms are worsening.

5) Other treatment options and when they fit

Massage, dry needling, injections, imaging, or medical review may fit some presentations. The best choice depends on your symptoms, diagnosis, irritability, general health, and goals. Surgery is uncommon for simple lower back pain, but urgent review matters when red flags or progressive neurological signs are present.

Related back pain guides

These related guides explain common lower back pain patterns, linked conditions, and practical treatment pathways.

Lower back pain FAQs

When should I see a physiotherapist for lower back pain?

Book an assessment if pain lasts more than a few days, keeps returning, limits walking or work, travels into the leg, or leaves you unsure about the cause. Early assessment can help you understand the main driver and choose the right next step.

What exercises help lower back pain?

Many people do well with a mix of mobility and progressive strengthening for the trunk and hips. The best exercises depend on whether your back feels stiff, irritable, load-sensitive, or linked to leg symptoms, so exercise choice should match your presentation.

Is walking good for lower back pain?

For many people, yes. Short walks can help reduce stiffness, maintain confidence, and reduce inactivity during a flare-up. However, if walking clearly increases leg pain, numbness, or weakness, it is sensible to get your symptoms assessed.

Can lower back pain cause leg pain?

Yes. Lower back pain can sometimes travel into the buttock, thigh, calf, or foot when nearby nerves become irritated. Sciatica is one common example, but not all leg pain comes from the same cause, so symptom pattern and assessment still matter.

What are red flags for lower back pain?

Urgent medical review is important if you develop new bladder or bowel changes, saddle numbness, progressive leg weakness, fever, unexplained weight loss, or severe pain after major trauma. These signs are uncommon, but they should not be ignored.

With the right plan, many people regain confidence in daily movement, work tasks, lifting, and exercise.

What to do next

If your symptoms are new, start with light movement, avoid long periods of sitting, and keep loads sensible for a few days. If lower back pain keeps returning, travels down the leg, or limits normal life, book an assessment so you can get a clear explanation and a step-by-step plan.

References

1. World Health Organization. WHO guideline for non-surgical management of chronic primary low back pain in adults. Geneva: World Health Organization; 2023.
2. George SZ, Fritz JM, Silfies SP, et al. Interventions for the management of acute and chronic low back pain: revision 2021. J Orthop Sports Phys Ther. 2021;51(11):CPG1-CPG60. doi:10.2519/jospt.2021.0304.
3. Hayden JA, Ellis J, Ogilvie R, Malmivaara A, van Tulder MW. Exercise therapy for chronic low back pain. Cochrane Database Syst Rev. 2021;9:CD009790. doi:10.1002/14651858.CD009790.pub2.
4. Lara-Palomo IC, Gil-Martínez E, López-Fernández MD, González LM, Querol-Zaldívar MLÁ, Castro-Sánchez AM. Efficacy of dry needling for chronic low back pain: a systematic review and meta-analysis of randomized controlled trials. Altern Ther Health Med. 2023;29(8):110-120.
5. Brotis AG, Tsaousi G, Boboridis KG, et al. Epidural steroid injections in lumbar disc herniation. World Neurosurg. 2025.