Low back pain is a frequent complaint that can arise from the spine, the supporting muscles and ligaments, or surrounding tissues. Presentations range from brief, mild episodes to persistent pain with functional impact; the duration, severity and any accompanying symptoms guide next steps.
Low back pain has many causes. Mechanical strain of muscles or ligaments, degeneration of spinal discs and facet joints, and nerve irritation from a herniated disc are among the most frequent. Posture problems and imbalances in the body’s mechanics also contribute. Less commonly, infection, inflammatory conditions, fractures or systemic disease can present with lumbar pain. The suspected cause helps determine which investigations and referrals are appropriate.
Initial assessment is usually done by a primary care physician or a Physical Medicine and Rehabilitation specialist. If there are signs suggesting structural spine problems that may require surgery, Orthopaedics or Neurosurgery provide further evaluation. Pain clinics and physiotherapy services support chronic pain management and functional rehabilitation. If infection or systemic disease is suspected, Infectious Diseases or other relevant specialties may be involved.
Certain symptoms require prompt medical attention: sudden severe back pain with high fever, new weakness in the legs, loss of bladder or bowel control, numbness in the groin or saddle area, or rapidly worsening neurological deficits, and severe pain after trauma. In these cases, contact emergency services or go to an emergency department for rapid evaluation.
To reduce risk and support recovery, keep active within comfortable limits, practise safe lifting and work ergonomics, and avoid prolonged static postures. Gradual conditioning and core-strengthening exercises can help maintain spinal support; discuss starting any new exercise program with a clinician if pain is new or severe. Sleep position, a supportive mattress and workplace adjustments can also make a difference.
Assessment typically begins with a clinical history and physical examination to identify red flags and likely mechanical contributors. Imaging or other tests are considered when symptoms are severe, persistent, or suggestive of specific conditions. The choice of investigations and timing of referrals depend on clinical findings.
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