Lower back pain? Here's what to do

“One of the most helpful questions to ask is not ‘how intense is the pain?’ but ‘how much is the pain impacting my life?’ says Lead Physiotherapist at More Good Days, Kelly Parbery. “Even relatively mild pain can be worth addressing if it’s becoming a recurring barrier to things you value.”

Most aches and pains aren’t dangerous and often improve with time, movement and self-care. “It’s worth seeking advice if pain persists for 6 weeks or more, if it’s becoming more severe, limiting your daily activities, or causing significant worry or distress,” says Kelly.

She adds, “You should be seeking prompt medical attention if your pain is associated with other symptoms, such as unexplained weight loss, significant fevers, weakness or numbness in your arms or legs, if you're experiencing loss of bladder or bowel control, or if it follows a major injury.”

“The intensity of pain doesn't always reflect the amount of damage in the body,” explains Kelly. “Pain is your body's protective alarm system. As with any alarm, it can sometimes become overprotective. If pain is lingering or repeatedly coming back, it's often worth looking beyond a single body part and exploring the bigger picture.”

Pain reflects many influences and isn’t just about what's happening in people's muscles, joints, or discs. “More often it's a sign there might be ongoing contributors that haven't been addressed,” says Kelly. “These might include poor sleep, stress or reduced physical conditioning.”

“Rather than focusing solely on the painful body part, it's helpful to step back and look at the whole picture,” says Kelly. “Someone's physical health, sleep, activity levels, emotions, previous pain experiences, and daily life all influence pain. Understanding that can often be the first step towards breaking a recurring cycle of persistent pain.”

Other tools that may help manage lower back pain include:

• Heat or cold. Heat and cold therapies are widely recommended for back pain.³
• Movement. Staying physically active is proven to help keep recurring back pain at bay.⁴
• Modify your activity. Adjusting, pacing and temporarily reducing load while still moving your body and listening to it.
• Over the counter medications. Temporary use of Ibuprofen and paracetamol can be a good way to get through a flare-up and allow you to keep moving. Speak with your pharmacist or doctor about which options may be right for you.

If you’re experiencing back pain for the first time, it can be good to get advice from an expert. “Your GP or a physiotherapist are both great options,” says Kelly. “Physios in Australia are first contact practitioners. They're trained to diagnose and manage problems such as back pain without a referral.”

MoreGoodDays^® at home back pain program provides weekly one-on-one sessions with experienced chronic pain clinicians, such as a physiotherapist and a psychologist who work together to guide you through your recovery. “Pain psychology approaches such as cognitive behavioural therapy (CBT) or mindfulness-based approaches for pain can be really beneficial,” says Kelly. “It helps people develop strategies to reduce the impact of pain and stress.”

In the case of ongoing, persistent or severe pain it’s important to see a healthcare professional to understand the cause. But there are some things you can do at home to help manage your pain if it’s becoming more persistent.

“Gone are the days of suggesting complete bed rest, apart from a serious medical reason,” says Kelly. “Instead, it can be a good idea to pace activities; break tasks up into manageable chunks instead of pushing through until that pain actually becomes severe. It’s important to try and avoid ‘boom or bust’ pain cycles where you push yourself on days you feel good then can’t do anything the next day. This can further sensitise the nervous system.”

“Instead of asking ‘how do I get rid of this pain immediately?’, it can be more helpful to ask, ‘what's something I can do today to help?’”

Taking a holistic approach is important. This might include:

• Calming strategies. “Slow breathing, mindfulness or guided relaxation can be very helpful.”
• Prioritising sleep. “This is a wonderful way to regulate and get your body to recover. Poor sleep can increase pain sensitivity.”
• Staying connected. “Even when you’re having a flare-up, stay connected with the people who mean the most to you, and continue meaningful activities where possible.”
• Being curious. “Noticing patterns can be really helpful. When you’re having pain, do you completely avoid a task altogether? Are you thinking that this will never get better? Identifying what these patterns are doing for you can be helpful.

“These strategies don't mean the pain is all in your head,” says Kelly. “Pain is 100% real. It is unique to the individual. Someone’s personal experiences influence whether things are going to be threatening or non-threatening. These work because the nervous system responds to many influences, including movement, sleep, stress, emotions, and confidence.”

My Back Pain has online resources on back pain and how to manage it.