Back pain is incredibly common. It is estimated around 80 per cent of adults will experience it at some point in their lives. Although you shouldn’t have to tolerate any pain, there will be some signs when a back pain is more than just a passing niggle.
We spoke to a sports injury specialist and an osteopath, both experts in treating muscle and joint pain, but with different foundational philosophies and methods, about the most common issues they see in clinic, and how to know your pain deserves further attention.
“Back pain can stem from muscles, joints, discs, nerves, or occasionally be referred from elsewhere in the body, such as the kidneys, gallbladder – or in women, it is sometimes linked to the reproductive system – and each type of back pain tends to respond to a slightly different approach,” explains osteopath Anisha Joshi (@osteoanisha).
“Pain is really just information. It’s your body’s way of flagging that something would benefit from a bit of attention, whether that’s a movement pattern, a new load you’re not used to, or tension in the shoulders and lower back”.
The nervous system and the musculoskeletal system are more closely linked than many realise. “Stress and emotional load can influence how the back feels,” Joshi continues. “I see this often in patients who notice their back becomes more sensitive during demanding weeks, not necessarily their most physically active ones.”
Back discomfort and lower back symptoms can be linked to things such as footwear, vision or breathing patterns, she adds. “Looking more broadly, rather than solely at the area that feels sore, often supports longer-lasting improvements.”
David Vrettos, sports injury specialist, and founder of Reverse Chronic Pain, adds that one of the least understood aspects of chronic back pain is the relationship between pain and the nervous system. “We know from extensive research that pain is produced by the brain as a protective response, and that in chronic pain this response can become over-sensitised, generating pain that persists long after any injury has healed. This doesn’t mean the pain isn’t real, it is, but it does mean that understanding what’s driving it influences what helps”.
Back pain can be categorised in different ways. “Acute pain is typically mechanical ( i.e. through movement), recent, and often has a clear cause (lifting, sudden movement, trauma),” Vrettos explains. “It usually resolves in six to 12 weeks or less. Chronic, meanwhile, is persistent, lasts beyond three months, and is where it gets more complex.”
It is either “specific” – “When a clear structural cause can be identified (fracture or nerve root compression, for example)” – or “non-specific”. A significant proportion of back pain is “non-specific”, meaning the cause is unclear, even with imaging. Here, the experts describe different kinds of back pain they commonly see among patients and when to seek help.
Acute mechanical back pain
Sudden onset, often after a specific movement or lift, localised, sharp or achey, worse with movement. “This typically signals muscle strain, facet joint irritation or minor disc irritation,” Vrettos says. “It’s generally managed by staying active with gentle movement, short-term over-the-counter pain relief and avoiding prolonged bed rest. Seek help if it hasn’t improved after two to three weeks, or if radiating into the leg.”
Muscular back pain
“The one I see most often in clinic,” Joshi says. “It tends to feel like a dull ache or tightness, often more noticeable with certain movements and easing with rest. It’s generally linked to muscle strain, movement patterns, or joints not moving quite as freely as they could. It’s very common, and tends to respond fairly quickly to treatment. Left too long, the body may start compensating, which can sometimes lead to discomfort in other areas.”
‘Back pain can stem from muscles, joints, discs, nerves, or occasionally be referred from elsewhere in the body,’ says osteopath Anisha JoshiDisc-related back pain
“This often shows up as a deeper, more central ache that can feel more noticeable with bending, lifting or longer periods of sitting,” Joshi says. “It relates to the discs between the vertebrae and how they’re being loaded day to day. It’s common, particularly from the mid-thirties onwards, and sits on a wide spectrum from very mild to more noticeable.”
It can feel like pain radiating into the buttock and/or down the leg, often below the knee, and may include pins and needles, numbness, or weakness in the leg, Vrettos adds. “This can signal nerve root irritation, usually from a disc bulge pressing on a nerve. Seek help relatively promptly, especially if you have weakness or bladder/bowel changes. It usually resolves with time (in most cases, within three months) with physio, and specific nerve mobilisation exercises. Avoiding prolonged sitting.”
Inflammatory back pain
“This tends to be less common,” Joshi says. “It’s usually more noticeable first thing in the morning or after rest, and often eases with movement, which is the opposite pattern to most other types of back pain.” If your back genuinely feels better the more you move and less comfortable the longer you’re still, it’s worth mentioning this to a professional, she advises.
Vrettos adds: “Seeking help is important. Early diagnosis and treatment significantly improves outcomes. Exercise is key, but specialist input is essential.”
‘Avoid anyone who tells you that you’ll need treatment indefinitely, shows you frightening images of your spine, or discourages other forms of care,’ says sports injury specialist David VrettosChronic non-specific lower back pain
Chronic back pain persists for more than three months, it can be constant or episodic, is often disproportionate to any identified structural cause, and frequently worse with stress and better on holiday or when distracted, Vrettos explains. “This is where pain has outlasted tissue healing, often driven by central nervous system sensitisation.”
“Look for someone who understands persistent pain, not just structural diagnosis. Pain neuroscience education and psychological approaches addressing fear and avoidance will be helpful, along with graded activity, building trust and resilience in the brain and body.”
Compression fracture
“This typically presents as a sudden onset, often in post-menopausal women, after minimal trauma or even spontaneously,” Vrettos explains. “It is usually localised to a specific vertebral level and can be a sign of a fracture, most commonly related to osteoporosis. It requires urgent imaging, medical pain management; bracing sometimes, and addressing underlying bone health.”
Postural and desk-related back discomfort
This tends to feel like a tight or achy sensation that builds through the day and eases once you move, Joshi says. “It’s extremely common in anyone who spends long periods of time in one position, particularly while seated, with limited movement through the day. On its own, it’s rarely a sign of anything to worry about, but it’s a helpful early nudge.”
When to see a specialist
Interestingly, Vrettos says, for non-specific back pain, evidence suggests that aggressive investigation early on (such as scanning and multiple specialist appointments) can actually reinforce the idea that something is seriously wrong and maintain pain. “Early reassurance and staying active is often more beneficial.”
That said, there are certain red flags which may suggest a serious underlying health condition that require urgent medical attention.
As a general guide, “if your discomfort is mild, comes and goes, and feels a little better with gentle movement, that’s probably just the body’s way of communicating”, Joshi says. “So giving it a week or so to settle down is reasonable.”
It’s worth being assessed by a professional if your discomfort feels more intense or seems to be building rather than settling over weeks of self-management; if pain travels down a leg or radiates below the knee, particularly alongside tingling, numbness or weakness; if it is consistently disturbing your sleep, or feels more noticeable first thing and eases with movement; or if it follows a fall, accident or specific injury, the experts agree.
Red flags, which require urgent care and being seen by a doctor, include if you experience back pain alongside things like changes in, or loss of, control of bladder or bowel function; numbness in the inner thighs or groin; sudden or progressive leg weakness; back pain that is progressively worsening with no periods of relief; back pain with sudden unexplained weight loss, or persistent back pain in someone with a history of cancer, Vrettos says.
Who to see
When it comes to back pain specialists, physiotherapists, osteopaths and chiropractors can all be effective in addressing musculoskeletal back pain. While they each have different philosophical foundations, in modern practice there is typically overlap in their approaches.
Vrettos says: “Avoid anyone who tells you that you’ll need treatment indefinitely, shows you frightening images of your spine, or discourages other forms of care.”
Five tips for managing everyday back pain, from osteopath Anisha Joshi
Gentle movement. Regular, comfortable movement can support the area, whereas long periods of complete rest aren’t always a helpful approach. Change position regularly. Rather than waiting until you feel the need to move, build in regular breaks, standing for even a minute every 30-45 minutes. A strong, supported core is helpful. This isn’t just about the abdominals, it’s the deeper stabilising muscles that support the spine. Sleep position can make a difference. For side sleepers, a pillow between the knees may help keep things a little more aligned overnight. Look at the wider picture, not just the sore spot. A tight area often feels better with a stretch in the short term, but understanding what’s contributing to it tends to make that improvement last longer.Hence then, the article about the seven types of back pain and which ones not to ignore was published today ( ) and is available on inews ( Middle East ) The editorial team at PressBee has edited and verified it, and it may have been modified, fully republished, or quoted. You can read and follow the updates of this news or article from its original source.
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