Low Back Pain (Mechanical)

Mechanical low back pain is pain arising from the muscles, ligaments, joints, or discs of the lower back, without a serious underlying cause. It is extremely common and, in most cases, improves significantly within a few weeks with simple management.

• Dull, aching, or sometimes sharp pain in the lower back
• Pain that may worsen with certain movements, prolonged sitting, or bending, and ease with rest or position change
• Muscle stiffness, particularly noticeable after periods of inactivity
• Pain may occasionally spread into the buttock or upper thigh
• Alarm features requiring urgent assessment include pain with numbness or weakness in the legs, loss of bladder or bowel control, unexplained weight loss, or fever

• Often results from strain or minor injury to the muscles, ligaments, or joints of the lower back, frequently related to lifting, twisting, or prolonged poor posture.
• Risk is increased by heavy manual work, prolonged sitting, poor lifting technique, obesity, and lack of regular physical activity.
• In the large majority of cases, no single specific structural cause can be identified, and this does not indicate anything is seriously wrong.

• Diagnosed clinically based on the typical pattern of pain and examination findings.
• Screening for alarm features — such as leg weakness, numbness, bladder or bowel changes, unexplained weight loss, or fever — is an essential part of every assessment, as these would prompt further urgent investigation.
• Imaging, such as X-ray or MRI, is not usually needed for typical mechanical low back pain in the absence of alarm features, since findings often do not correlate well with symptoms and rarely change initial management.

Staying as active as possible, within the limits of pain, is recommended, since prolonged bed rest tends to delay recovery rather than help it.

Simple pain relief, such as paracetamol or an NSAID, can help manage pain during the acute phase.

Applying heat to the affected area can help ease muscle tension and discomfort for some people.

Most episodes of mechanical low back pain improve substantially within a few weeks; physiotherapy can support recovery and help prevent recurrence, particularly for pain that is slow to improve.

Anyone with alarm features — leg weakness, numbness, bladder or bowel changes, or unexplained weight loss — should be assessed urgently, as this changes the management approach.

• Use proper lifting technique, bending at the knees rather than the back.
• Maintain regular physical activity and core-strengthening exercise to support the back.
• Avoid prolonged sitting without breaks, and maintain good posture.
• Maintain a healthy body weight to reduce strain on the lower back.
• Stay active during minor episodes of back pain rather than resorting to prolonged bed rest.