When is Lower Back Pain Serious?

By Principal Physiotherapist, Sam Davison


One question we get asked a lot in our clinic is “when is lower back pain serious?” or when should we “worry about back pain?” The good news is that a sinister cause for back pain is exceedingly rare. For most people, pain can be attributed to factors in daily life. By completing a thorough history and examination, our team at Barangaroo Physio can ascertain if the cause is a mechanical (movement) problem for example sitting too long, or because of a limp, or a structural problem for example the joints / discs which may become aggravated when lifting something heavy, or following a fall.

Sadly, but reassuringly, low back pain is common, and statistics tell us that up to 80% adults will experience some form of it in our lives.

So when shouldn’t we be worried about lower back pain?

If back pain can be associated with a particular activity or movement, the pain changes during times of the day and settles within 48-72 hours then it’s likely something less serious. That doesn’t mean to say that it’s not incredibly painful and debilitating. However, as Physiotherapists, it’s important that for any injury we screen for more concerning symptoms.

When do we need to ask more questions?

Whilst this is not an exhaustive list, specifically to low back pain we ask a lot about the following:

  • Mechanism of Injury -We can tell a lot about your pain from the information you tell us. If you have back pain as a result of a trauma e.g. fall from a height, car accident – there maybe an indication to send you for further investigations.
  • Night Pain – Constant pain that doesn’t ease or is worse at night. We will always ask if your pain wakes you up.
  • Referred Pain – When pain / numbness or any other sensation is felt down the front or back of the leg, it tells us the nerve might be irritated as a result of the pain.
  • Weight Loss – We are less concerned by gradual planned weight loss and more inquisitive if there was been a recent, unexplained weight loss.
  • Bladder / Bowel Symptoms – Back pain paired with the inability to pass urine, or control bowel movements is often a more concerning symptom and one where we would seek a specialist review and further investigations.
  • Past medical history – Your medical history can tell us a lot of important information about your overall wellbeing, particularly if you have a history of back pain. But also, if any other illnesses / medications may increase your risk of back trouble
  • High Temperature or Feeling Generally Unwell – If there is a fever present at the same time your pain started – this could be a sign of an infection.

What if you’re not sure about your lower back pain?

There is a wide ranging list of conditions that can bring about more severe back pain so if you are ever concerned about any pain or problem, please seek medical advice from a registered healthcare professional. Whether that’s your GP, Physiotherapist, Sports Doctor or Specialist – an individual assessment is always appropriate, even for peace of mind. If any of your practitioners are concerned they will seek investigations as appropriate.

If you feel as though you need to see a physiotherapist to have your pain treated, then be sure to book in HERE

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