Have you ever been going about your day and then suddenly a sharp pain in your lower back? What about that small ache that started a week ago and has been steadily getting worse? You may be experiencing low back pain. It is estimated that 50 to 80% of the global population will experience a bout of low back pain in their life. What many people don't understand is what it actually is.
Low back pain affects the lumbar region of the spine. It can result from many different injuries and conditions, but the main reason is injury to the muscles and tendons surrounding the lower back. For most people, symptoms are temporary. However, chronic low back pain affects up to 23% of adults, making it difficult to work, participate in hobbies, or even complete everyday activities such as washing and getting dressed.
Low back pain can present in many different ways. It may come on suddenly after a specific movement or it could gradually build over many days or weeks. There may be a pop, crack or flicking sound associated with a specific incident. The pain itself can range from very localised and sharp to a dull ache over a larger area. It is also quite common for pain to radiate into the hips or glutes. On some occasions pain may radiate down the back of the leg, indicating some sciatic nerve involvement. Pain may be present all the time, or may come and go depending on aggravating activities. Other symptoms include stiffness after prolonged positions such as sitting, lying down or standing, and muscle spasms, especially in the acute phase.
There has been a move away from diagnosing low back pain through pathoanatomical means. Recent literature and research has shown it is not necessary to identify a specific tissue contributing to the pain for effective treatment. Upon initial screening from a physiotherapist, the aim is to rule out any serious causes including fractures, cancer, infection, inflammatory conditions or specific neurological deficits such as radiculopathy and cauda equina syndrome. Once those causes have been ruled out, individuals are classified as having non-specific mechanical low back pain.
Over 90% of low back pain cases fall into mechanical non-specific low back pain. This can be triggered by many reasons, including physical factors such as lifting or bending awkwardly, or being stuck in a certain position for too long. It can also be triggered psychosocially, such as being fatigued or stressed at work. In some cases, both factors contribute. Most cases of acute non-specific low back pain make a complete recovery within 4 to 6 weeks if treated correctly.
X-rays and MRIs are usually not needed for low back pain. Only when clinicians suspect a specific disease or pathology would imaging be considered. Studies have shown that imaging does not show consistent associations with future episodes of low back pain, nor does it provide better clinical outcomes. Imaging is also costly and time-consuming, so it is best to avoid if not necessary.
At your initial appointment, your physiotherapist will take a detailed history of your pain and overall story. From there, they will take you through some tests to understand what movements you are limited in and other factors that may be contributing to your pain. After testing, your physiotherapist should have enough information to make a diagnosis. You can then discuss treatment options, management strategies and an overall plan to get you back doing what you want to do.
About the author
Jordan completed a Bachelor of Sport and Exercise Science at La Trobe University before graduating from the new Masters of Physiotherapy program at the University of Tasmania in 2025. Growing up in Hobart, he was immersed in sport from an early age and has worked with Hockey Victoria, travelling to state championships across Australia, and locally with the Tassie Devils AFL program and the Taroona FC WSL team. Jordan brings a genuine passion for goal-setting and believes that physio and exercise should be something people look forward to, not just endure.
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