Lower back pain is one of the most common musculoskeletal problems affecting adults in the UK. Whether it develops suddenly after lifting something heavy or gradually from long hours sitting at a desk, back pain can impact everything from work and exercise to sleep and everyday movement. 

For many people, lower back pain improves within a few weeks. However, recurring or persistent pain should never be ignored. Understanding the cause of your symptoms is the first step towards effective treatment and long-term recovery. 

In this article, we’ll explore five of the most common causes of lower back pain, the symptoms to look out for, and when it may be time to see a physiotherapist. 

What Is Lower Back Pain? 

Lower back pain refers to discomfort, stiffness, or tension felt in the lumbar spine the area between the bottom of the ribs and the pelvis. Pain can range from mild and annoying to severe and debilitating. 
Some people experience: 

• A dull ache  
• Sharp pain when moving  
• Muscle tightness or spasms  
• Pain that travels into the legs  
• Difficulty standing upright  
• Stiffness first thing in the morning  

Lower back pain can affect people of all ages, but it is particularly common in adults who: 

• Sit for long periods  
• Perform physical labour  
• Exercise intensely  
• Have poor posture  
• Experience stress or lack of sleep  

1. Muscle or Ligament Strain 

One of the most common causes of lower back pain is a strain to the muscles or ligaments supporting the spine. This often happens after: 

• Heavy lifting  
• Sudden twisting movements  
• Gym injuries  
• Poor lifting technique  
• Repetitive bending  
• Sudden increases in activity  

A strain can cause inflammation and muscle spasms, leading to pain and stiffness in the lower back. 

Common Symptoms 

• Pain after movement or exercise  
• Muscle tightness  
• Difficulty bending forward  
• Pain when standing up from sitting  
• Tenderness around the lower back muscles  

In many cases, symptoms improve within a few days to weeks. However, complete rest is usually not recommended. Gentle movement and gradual activity are often more beneficial than staying inactive. 

How Physiotherapy Helps 

A physiotherapist can: 

• Assess the injured tissues  
• Reduce muscle tension  
• Improve mobility  
• Provide hands-on treatment  
• Prescribe exercises for recovery  
• Help prevent the problem returning  

Early treatment can also reduce the likelihood of acute pain becoming chronic. 

2. Poor Posture and Sedentary Lifestyle 

Modern lifestyles are a major contributor to lower back pain. Many people spend hours sitting at desks, driving, or looking down at phones without realising the stress this places on the spine. Poor posture can lead to: 

• Increased pressure on spinal joints  
• Weak core muscles  
• Tight hip flexors  
• Reduced spinal mobility  
• Muscle imbalances  

Over time, these changes can create persistent tension and discomfort in the lower back. 

Signs Your Posture May Be Contributing to Back Pain 

• Pain after sitting for long periods  
• Stiffness at the end of the day  
• Rounded shoulders and slouched posture  
• Tight hips or hamstrings  
• Relief when walking or stretching  

Why Sitting Too Much Matters 

When we sit for prolonged periods, certain muscles become weak while others become overactive. The glutes and core often lose strength, while the hip flexors and lower back muscles become tight and overloaded. This imbalance can make the lower back work harder than it should during everyday activities. 

How Physiotherapy Helps 

Physiotherapy treatment may include: 

• Postural assessment  
• Workplace ergonomic advice  
• Mobility exercises  
• Core strengthening  
• Stretching programmes  
• Education on movement habits  

Simple changes to your daily routine can make a significant difference in reducing pain and preventing flare-ups. 

3. Herniated or “Slipped” Disc 

A disc sits between each vertebra in the spine and acts as a shock absorber. Sometimes, part of the disc can bulge or herniate, irritating nearby nerves. 

Although often referred to as a “slipped disc,” the disc does not actually slip out of place. 

Disc-related back pain can develop from: 

• Heavy lifting  
• Repetitive strain  
• Sudden bending or twisting  
• Degenerative changes over time  

Common Symptoms of a Herniated Disc 

• Lower back pain  
• Pain shooting into the leg  
• Numbness or tingling  
• Weakness in the leg or foot  
• Pain worse when coughing or sneezing  

When the sciatic nerve becomes irritated, this is commonly known as sciatica. 

Does a Herniated Disc Always Need Surgery? 

Not necessarily. In fact, many disc injuries improve with conservative treatment such as physiotherapy. Research shows that movement, exercise, and gradual rehabilitation are often highly effective for managing symptoms and restoring function. 

How Physiotherapy Helps 

A physiotherapist can help by: 

• Assessing nerve involvement  
• Improving spinal mobility  
• Reducing pain sensitivity  
• Prescribing targeted exercises  
• Improving movement patterns  
• Supporting a safe return to activity  

Treatment is tailored to the individual and based on symptom behaviour, movement limitations, and functional goals. 

4. Arthritis and Age-Related Changes 

As we age, the structures in the spine naturally change over time. Some people develop wear-and-tear changes in the joints of the spine, commonly referred to as osteoarthritis or spinal degeneration. These changes are very common and do not always cause pain. However, for some people they can contribute to: 

• Stiffness  
• Reduced mobility  
• Aching pain  
• Difficulty standing or walking for long periods  

Symptoms of Arthritic Back Pain 

• Morning stiffness  
• Pain that eases with gentle movement  
• Reduced flexibility  
• Pain after inactivity  
• Discomfort during prolonged standing  

It’s important to understand that scans showing “degeneration” are often normal age-related findings. Pain is complex and cannot always be explained by imaging alone. 

Staying Active Is Key 

Many people assume rest is best for arthritic back pain, but regular movement is one of the most effective ways to manage symptoms. Strength training, walking, mobility work, and physiotherapy-guided exercise can all help maintain spinal function and reduce discomfort. 

How Physiotherapy Helps 

Treatment may include: 

• Joint mobility exercises  
• Strengthening programmes  
• Manual therapy  
• Walking and activity advice  
• Balance and flexibility training  
• Pain management strategies  

The goal is to help patients stay active, independent, and confident in movement. 

5. Stress and Tension 

Many people are surprised to learn that stress can contribute significantly to lower back pain. When we are stressed or anxious, the body often responds by increasing muscle tension and sensitivity within the nervous system. This can lead to persistent tightness and discomfort, particularly around the neck, shoulders, and lower back. Stress-related back pain is especially common in people who: 

• Work high-pressure jobs  
• Sleep poorly  
• Feel anxious about movement  
• Have persistent or recurring pain  
• Spend long hours sitting  

Signs Stress May Be Contributing to Your Pain 

• Pain fluctuates depending on stress levels  
• Increased tension during busy periods  
• Poor sleep quality  
• Pain without a clear injury  
• Symptoms that move around or vary day to day  

Understanding Persistent Pain 

Pain is influenced by many factors, including: 

• Sleep  
• Stress  
• Activity levels  
• Mood  
• Recovery  
• General health  

Addressing these factors is often an important part of long-term recovery. 

How Physiotherapy Helps 

A physiotherapist can help you: 

• Understand your pain better  
• Build confidence in movement  
• Reduce fear around activity  
• Improve strength and mobility  
• Develop healthy movement habits  
• Create realistic recovery goals  
• Education and reassurance can play a major role in reducing persistent pain. 

When Should You See a Physio for Lower Back Pain? 

Many cases of lower back pain improve within a few weeks, but there are times when professional assessment is recommended. You should consider seeing a physiotherapist if: 

• Pain lasts longer than 2–3 weeks  
• Symptoms keep returning  
• Pain affects work or sleep  
• You struggle with daily activities  
• You experience pain during exercise  
• You have numbness or tingling  
• You feel stiff or restricted regularly  

Early treatment can help identify the cause of the problem and prevent symptoms becoming long term. 

Red Flags: When to Seek Urgent Medical Attention 

Although most lower back pain is not serious, certain symptoms require urgent medical assessment. Seek immediate medical attention if you experience: 

• Loss of bladder or bowel control  
• Severe weakness in the legs  
• Numbness around the groin or saddle area  
• Unexplained weight loss  
• Fever with back pain  
• History of cancer with new back pain  
• Significant trauma or injury  

These symptoms are uncommon but should not be ignored. 

What Happens During a Physiotherapy Assessment? 

At your first appointment, a physiotherapist will assess: 

• Your symptoms  
• Medical history  
• Movement and mobility  
• Strength and flexibility  
• Posture and movement patterns  

The goal is to understand not just where the pain is, but why it is happening. You’ll then receive a personalised treatment plan which may include: 

• Hands-on therapy  
• Exercise rehabilitation  
• Mobility work  
• Strengthening  
• Advice on activity and posture  
• Education about pain and recovery  

Treatment should always be tailored to your goals, lifestyle, and activity levels. 

Can Lower Back Pain Be Prevented? 

Although not all back pain can be avoided, there are several ways to reduce your risk: 

Stay Active 

Regular movement helps keep the spine healthy and strong. 

Strengthen Your Core 

Strong abdominal, glute, and hip muscles support the lower back. 

Avoid Long Periods of Sitting 

Take movement breaks throughout the day. 

Lift Properly 

Use your legs and avoid twisting under load. 

Manage Stress and Sleep 

Recovery and nervous system health matter more than many people realise. 

Build Exercise Gradually 

Sudden spikes in activity often increase injury risk. Consistency is more important than perfection when it comes to spinal health. 

Final Thoughts 

Lower back pain is extremely common, but it should not stop you from living an active and healthy life. 

Whether your symptoms are caused by muscle strain, poor posture, disc irritation, arthritis, or stress, understanding the root cause is an important first step towards recovery. 

Physiotherapy can help reduce pain, improve movement, and give you the tools to manage your symptoms effectively long term. 

If your lower back pain is persistent, recurring, or affecting your daily life, seeking professional advice early can help you recover faster and prevent future problems. 

Frequently Asked Questions 

How long does lower back pain take to heal? 

Many episodes improve within a few weeks, although recovery time depends on the cause and severity of symptoms. 

Should I rest with lower back pain? 

Short periods of rest may help initially, but prolonged inactivity can often make symptoms worse. Gentle movement is usually beneficial. 

Can physiotherapy help sciatica? 

Yes. Physiotherapy is commonly used to treat sciatica and can help reduce nerve irritation, improve mobility, and restore strength. 

Is walking good for lower back pain? 

In many cases, yes. Walking is a low-impact activity that helps maintain mobility and circulation. 

Do I need a scan for lower back pain? 

Most people do not need imaging initially. A physiotherapist or healthcare professional can advise if further investigation is necessary.