The Three Main Low Back Pain Symptoms

Everyone has a slightly different experience but these are the most common low back pain symptoms.

1.Pain is the number one symptom

  • More often than not the ache is felt in the middle of the low back area and can spread out to the tops of the buttocks or the back of the thighs. The diagram below shows a really common pattern.

diagram showing the normal pattern of simple back pain symptoms

  • It is often described as dull or aching and it can be a bit vague and hard to pin point.
  • Sometimes there is a definite spot of sharp soreness with a more generalised aching spreading away from it.
  • Usually there is more pain in the back then in the leg or buttock (unlike sciatica which is often felt more in one leg).
  • It often varies with different activities - it may get better or worse if you change your position or if you have a rest. This is why it is also sometimes called mechanical (the opposite of this is inflammatory)
  • It often feels better in the morning (but not always) and gets worse as the day goes on.

Glossary = mechanical v inflammatory

Mechanical = Symptoms that change when you change position or do something differently. An example would be an ache when you are gardening that goes away when you stand up.

Inflammatory = Symptoms caused by inflammation of the tissues. This is often more constant and is better when you are moving and worse when you rest. An example is sciatica where sleep is difficult as the ache worsens the more you keep still.

2. Stiffness is a very common low back pain symptom

Stiffness that goes on for an hour or more in the morning may be caused by a problem that is not mechanical non-specific low back ache - it may a symptom of an inflammatory joint problem like ankylosing spondylitis. You need to tell your doctor about these symptoms.
You may feel stiff and sore when you get up from a rest or in the mornings. Usually this stiffness eases quite quickly with gentle movement or just getting up and about. For many people the stiff area feels better after 10-15 minutes.

3. Muscle spasm

This spasm is your bodies attempt to 'splint' or protect a sore area. If you have a sudden injury or strain this muscle spasm may be a good thing to start with.It reminds you to take it easy. After a day or two though this muscle spasm may become a bigger problem than the original injury.

  • The muscle may feel very tense and solid when you touch it.
  • It may be unpleasantly sore to touch.
  • It will feel stiff and uncomfortable when you stretch it.

All these symptoms can occur in a muscle that has no injury at all, it may just be trying to protect a little underlying joint strain or something similar.

How Does This Back Ache Normally Start?

  • Non-specific back problems can start suddenly and unexpectedly:
  • You may be going about your normal day to day business when perhaps you lift or carry awkwardly, or bend or twist - and then you feel a sudden, sharp stab of soreness that spreads across your back and feels worse as the day goes on.

  • Or it can start much more slowly and gradually and build up over months

    Maybe you felt a bit of back ache after housework, or a slight soreness after a day sitting on front of the computer, maybe some aching after walking round the shops for a few hours. This noticeable soreness usually just goes away of its own accord - but before you know it, it creeps up you again another day. Gradually your back aches for longer and it gets harder to get comfortable pain relief

From years spent helping people with this problem I have recognised some typical patterns:

  • It often comes and goes to start with - you may have months without any problems at all
  • It can start with a single episode, often 2-5 days in duration.
  • It often comes back (estimates suggest that up to 75% of people who have had this once will get it again).
  • The number of days you have symptoms may increase and the time between the episodes may get less.
  • Eventually, some people with this problem feel pain most of the time.

How Long Will it Take to Go Away?

The good news is that for most people the problem is 'self-limiting' which means it normally goes away on it's own. The sudden, sharp soreness usually settles within 1-6 weeks, and most people feel much better before this.

Some people have to manage the problem for longer, maybe a year or more, and for others they have to learn to live with it because it never quite goes away. For an unlucky few, the problem interferes with their lives in a serious way.

  • 80% of us will get this type of back problem at some point in our lives
  • 1 in 4 of us will never get rid of it
  • 1 in 10 of us will struggle to get back to our normal day to day lives



Non-Specific or Simple Lower Back Pain Guidelines

Balagué, F. et al., 2012. Non-specific low back pain. The Lancet, 379(9814), pp.482–91.





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