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Understanding Low Back Pain
Understanding what low back pain is, what may be contributing to it, and what current research tells us can help guide more effective management and recovery.
1. What Is Low Back Pain?
Low back pain refers to pain, stiffness, or discomfort felt between the lower ribs and the buttocks. It can affect everyday activities such as sitting, standing, walking, lifting, exercise, work, and sleep.
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Non-Specific Low Back Pain (90–95%)
No single structure can be reliably identified as the sole source of symptoms.
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Low Back Pain With Nerve Involvement (5-10%)
Symptoms may include pain travelling into the leg, numbness, tingling, or weakness.
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Serious Spinal Conditions (<1%)
A very small proportion of people may have symptoms related to fracture, infection, cancer, cauda equina syndrome, or inflammatory spinal disorders.
2. Is My Back Serious Damaged?
Not necessarily. Pain is not always a reliable measure of injury. While pain can sometimes reflect tissue damage, it is also influenced by how sensitive the nervous system has become and by many factors occurring within your body and daily life.
Current research suggests that low back pain is rarely explained by one disc, joint, muscle, or tissue alone. Pain is influenced by many interacting factors including physical health, activity levels, sleep quality, stress, beliefs, expectations, work, and lifestyle demands.
At Motion Wellness Chiropractic, we use a Bio-Psycho-Social approach to better understand what may be contributing to your low back pain, which helps guide more effective management.
3. Do I Need An X-ray or MRI?
In most cases, routine imaging is not required. Many findings commonly seen on scans, such as disc degeneration, disc bulges, arthritis, and other age-related changes, are also frequently found in people who have no back pain at all.
Age-specific prevalence estimates of degenerative spine imaging findings in patients asymptomatic for low back pain
Source: ACSQHC (2022); Brinjikji et al., (2015)
Scans can sometimes provide useful information, but they rarely tell the whole story. The most important information often comes from understanding your symptoms, medical history, lifestyle, goals, and how your body responds to movement.
4. Should I Avoid Bending, Lifting, Or Exercise?
For most people, no. Your spine is strong, adaptable, and designed to move. Bending, lifting, twisting, and physical activity are normal parts of everyday life and are generally safe when introduced gradually and appropriately. While some movements may temporarily feel uncomfortable, pain during movement does not necessarily mean damage is occurring. Gradually returning to normal movement and activity is often an important part of recovery and helps build confidence, strength, and resilience over time.
5. Should I Rest Until The Pain Goes Away?
Prolonged bed rest is generally not recommended.
While a short period of rest may be helpful during severe flare-ups, remaining active and gradually returning to normal activities is associated with better outcomes for most people.
Long periods of inactivity can contribute to stiffness, reduced fitness, loss of confidence, and slower recovery.
As much as possible, it is usually beneficial to keep moving within your tolerance and continue participating in meaningful daily activities.
7. Do I Need Surgery?
Most people with low back pain do not require surgery. Surgical treatment is typically reserved for specific situations involving significant neurological compromise, serious structural pathology, or symptoms that have not responded to appropriate conservative management. For most people, non-surgical approaches remain the recommended first option.
When Should I Seek Medical Attention?
Although most low back pain is not serious, medical assessment may be recommended if you experience:
Significant trauma
Progressive leg weakness
Numbness around the saddle area
Loss of bladder or bowel control
Unexplained weight loss
Fever or infection symptoms
A history of cancer with new onset back pain
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These symptoms do not necessarily indicate serious disease but should be assessed without delay
How Can We Help?
At Motion Wellness Chiropractic, we take an evidence-informed and individualised approach to low back pain care. Recovery from low back pain is rarely about finding a single cause or a quick fix. For most people, successful recovery involves understanding their condition, staying active, improving strength and fitness, managing stress, sleeping well, maintaining healthy habits, and gradually returning to meaningful activities.
Depending on your individual needs, your care may include:
Chiropractic Care
Making neurophysiological changes, helping pain relief and improving movement
Rehabilitation Exercise
Facilitating recovery and building strength and confidence in movement with long-term resilience
Pain Science Education
Helping you better understand your pain and recovery process
Lifestyle Guidance
Addressing sleep, stress, diet, misbelief, and daily habits that help recovery
Reference
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Clinical Guidelines
Australian Commission on Safety and Quality in Health Care (ACSQHC) (2022) Low Back Pain Clinical Care Standard. Sydney: ACSQHC.
George, S.Z., Fritz, J.M., Silfies, S.P., Schneider, M.J., Beneciuk, J.M., Lentz, T.A., Gilliam, J.R., Hendren, S. and Norman, K.S. (2021) ‘Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021’, Journal of Orthopaedic & Sports Physical Therapy, 51(11), pp. CPG1–CPG60.
National Institute for Health and Care Excellence (NICE) (2020) Low Back Pain and Sciatica in Over 16s: Assessment and Management (NG59). London: NICE.
World Health Organization (WHO) (2023) WHO Guideline for Non-Surgical Management of Chronic Primary Low Back Pain in Adults in Primary and Community Care Settings. Geneva: World Health Organization.
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Major Reviews & Lacet Series
Buchbinder, R., Underwood, M., Hartvigsen, J. and Maher, C.G. (2020) ‘The Lancet Series call to action to reduce low-value care for low back pain: an update’, Pain, 161(Suppl 1), pp. S57–S64.
Foster, N.E., Anema, J.R., Cherkin, D., Chou, R., Cohen, S.P., Gross, D.P., Ferreira, P.H., Fritz, J.M., Koes, B.W., Peul, W., Turner, J.A. and Maher, C.G. (2018) ‘Prevention and treatment of low back pain: evidence, challenges, and promising directions’, The Lancet, 391(10137), pp. 2368–2383.
Hartvigsen, J., Hancock, M.J., Kongsted, A., Louw, Q., Ferreira, M.L., Genevay, S., Hoy, D., Karppinen, J., Pransky, G., Sieper, J. and Smeets, R.J. (2018) ‘What low back pain is and why we need to pay attention’, The Lancet, 391(10137), pp. 2356–2367.
Maher, C., Underwood, M. and Buchbinder, R. (2017) ‘Non-specific low back pain’, The Lancet, 389(10070), pp. 736–747.
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Imaging & Diagnosis
Brinjikji, W., Luetmer, P.H., Comstock, B., Bresnahan, B.W., Chen, L.E., Deyo, R.A., Halabi, S., Turner, J.A., Avins, A.L., James, K., Wald, J.T., Kallmes, D.F. and Jarvik, J.G. (2015) ‘Systematic literature review of imaging features of spinal degeneration in asymptomatic populations’, American Journal of Neuroradiology, 36(4), pp. 811–816.
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Recent Research
Pinto, R.Z., Kongsted, A., Silva, S., Hayden, J.A., Downie, A. and Saragiotto, B.T. (2026) ‘Recent highlights in low back pain research, Part I: Diagnosis and Prognosis’, Journal of Physiotherapy, 72, pp. 23–32.
Saragiotto, B.T., Abdel Shaheed, C., Overton, M., Hayden, J.A., Hartvigsen, J. and Pinto, R.Z. (2026) ‘Recent highlights in low back pain research, Part II: Prevention and Management’, Journal of Physiotherapy, 72, pp. 106–115.
Ammendolia, C. (2025) ‘Ten myths of back pain in older adults that can lead to ineffective and harmful care’, Chiropractic & Manual Therapies, 33(45).
O’Sullivan, P.B., Caneiro, J.P., O’Sullivan, K., Lin, I., Bunzli, S., Wernli, K. and O’Keeffe, M. (2020) ‘Back to basics: 10 facts every person should know about back pain’, British Journal of Sports Medicine, 54(12), pp. 698–699.
