Rehabify
In brief
Most low back pain is not caused by serious damage, and most people improve within a few weeks by staying active and avoiding long bed rest. A small number of people have warning signs that need urgent care. At Rehabify in Bengaluru, Dr. Dharshan N A, a physiatrist trained in interventional pain management, helps people with back pain that is not settling, and checks for the signs that need faster action.
Why backs hurt
The lower back is made of bones (vertebrae), discs, small joints, ligaments, muscles and nerves. Pain can come from any of these. In most people, no single damaged structure is found. Doctors call this "non-specific" back pain. It is real pain, but it is usually not dangerous.
Common triggers include lifting or twisting, long hours of sitting, poor sleep, stress and low fitness. Scans often show disc bulges or "wear and tear", but these are common in people without any pain, so they do not always explain the problem.
What helps
- Keep moving. Walk, do your normal tasks as much as pain allows, and increase step by step. Movement helps the back recover faster than rest.
- Avoid long bed rest. A day or two of taking it easy during a bad flare is fine, but staying in bed longer tends to slow recovery.
- Exercise. A programme of strengthening, stretching and general fitness, ideally guided by a physiotherapist, helps both pain and future flare-ups. Yoga or Pilates can help some people.
- Heat. A warm pack can ease muscle spasm.
- Pain relief for comfort. Short-term medicines may help you move. Ask a doctor or pharmacist which is safe for you.
- Stay at work if you can, with changes such as breaks from sitting and lighter tasks for a while.
- Sleep and stress. Both affect how strongly you feel pain.
What usually does not help
- Long bed rest
- Routine X-rays or MRI in the first weeks without warning signs
- Belts or braces worn all day for a long time
- Treatments that promise a quick fix or a "permanent cure"
When to see a doctor
Book a consultation if:
- Pain lasts more than 2 to 3 weeks, or keeps coming back
- Pain spreads below the knee, or there is tingling or numbness in the leg (this may be sciatica)
- Pain wakes you at night, or there is morning stiffness lasting over 30 minutes
- You have osteoporosis, a history of cancer, or take steroid medicines
- Pain stops you working, sleeping or caring for family
How Rehabify helps with back pain
- Examination of how your back moves, nerve tests, strength and the hips and pelvis.
- Review of scans, with new ones only if they will change your treatment.
- A plan that starts with movement: a graded exercise programme, work and posture advice, and medicines for comfort.
- Image-guided injections or nerve blocks when pain clearly comes from a specific joint or nerve and has not settled. These are used to calm pain so rehab can work, not as the only treatment.
- Prevention: a home programme to lower the chance of the next flare.
The warning signs to act on now
Medical emergency
Go to an emergency department or call 108 or 112 if back pain comes with:
- numbness around the private parts, buttocks or inner thighs
- new difficulty passing urine, or loss of bladder or bowel control
- weakness in both legs, or a leg that is getting weaker quickly
- fever, or feeling very unwell
- a fall or accident
These can be signs of nerve compression (cauda equina syndrome), infection or a fracture, which need care within hours.
Also see a doctor soon if you have unexplained weight loss with back pain, or you are over 50 with new back pain for the first time.
Common questions
How long does low back pain last?
Many episodes improve within 2 to 6 weeks. Some people have pain that lasts longer or returns, and they benefit from a planned exercise programme.
Do I need an MRI for back pain?
Not usually at first. An MRI helps if warning signs are present, there is leg weakness or numbness, or pain has not improved after 4 to 6 weeks of treatment.
Is it safe to exercise with back pain?
Yes, for most people. Start gently and build up. Some discomfort is normal; sharp or spreading pain means slow down and ask your doctor.
When is an injection useful?
When pain comes from a specific joint or nerve and has not settled with exercise and medicines. Results vary from person to person.
Will I need surgery?
Most people with back pain do not. Surgery is considered for specific problems, such as severe nerve compression, and the doctor will refer you to a spine surgeon if needed.
Sources
- [1]
National Institute for Health and Care Excellence (NICE) guideline NG59. Low back pain and sciatica in over 16s
- [2]
American College of Physicians guideline on non-invasive treatment of low back pain. 2017
- [3]
WHO guideline on management of chronic primary low back pain in adults. 2023
This guide is for general education and does not replace a consultation. Read how we write and review guides in our editorial policy.
