Key Facts

✔ Lower back pain affects about 1 in 6 Australians

✔ Serious causes account for less than 1% of casesf

✔ Scans are unnecessary for most episodes

✔ Staying active leads to faster recovery than resting

✔ Most people improve signiaficantly within six weeks

✔ You do not need a GP referral to see a physiotherapist

30-Second Summary

Lower back pain is one of the most common health complaints in Australia-and in the vast majority of cases, it is not caused by anything serious. Most episodes improve within weeks, and the single most important thing you can do is stay as active as possible rather than rest. If your pain is interfering with your daily life, a physiotherapist can assess what's going on and help you recover faster.

Introduction

Almost everyone will have lower back pain at some point. It's the second most common reason Australians visit their GP, and a leading cause of emergency department presentations. It can feel alarming-especially when the pain is severe or stops you doing things you normally take for granted.

But the way back pain feels is not a reliable guide to how serious it is. In most cases, no single structural cause is ever identified, and the pain still gets better. Understanding what's actually happening-and what genuinely helps-is one of the most important steps toward recovery.

What Is Lower Back Pain?

Lower back pain refers to pain felt in the lumbar spine-the lower part of your back between your bottom rib and the top of your buttocks. It often comes with stiffness, and sometimes with pain that travels into one or both legs.

Most lower back pain is described clinically as "non-specific," meaning a precise structural cause cannot be identified on examination or imaging.

Definition: Non-specific lower back pain is pain in the lower back where no single structural cause can be identified-this is a normal finding, not a failure of diagnosis, and it still responds well to the right management.

What Causes Lower Back Pain?

Lower back pain rarely has a single clear cause. It usually develops from a combination of factors rather than one specific event.

Common physical triggers include muscle strain from lifting or sudden movement, sustained postures held for long periods (such as a full day at a desk), and cumulative load on the spine over time. A Melbourne office worker who has spent several weeks working longer hours than usual might notice a dull ache that builds gradually rather than from any single moment-this is a typical pattern, and one we see regularly at RheCore in St Kilda.

What's less obvious, but just as important, is the role that non-physical factors play. Stress, poor sleep, low mood, and dissatisfaction at work are all associated with the onset and persistence of back pain. This is not about the pain being "in your head"-it reflects how the brain and nervous system process pain signals, and how a person's circumstances influence that process. The Australian Clinical Care Standard for Low Back Pain specifically recognises this, recommending that assessment consider psychological and social factors alongside physical ones.

Lifestyle factors also play a role. Smoking, physical inactivity and excess weight are each associated with back pain, and addressing them can reduce symptoms.

What Are the Symptoms of Lower Back Pain?

The most common experience is a dull ache or stiffness in the lower back, which may be worse with certain movements, after sitting for a long period, or first thing in the morning.

Some people also experience pain that travels into the buttock, thigh or leg-this is often called sciatica or radicular pain. It happens when a nerve in the lower back is irritated or compressed, and it can produce shooting, burning or tingling sensations down the leg. For most people, leg pain of this kind is managed in the same way as lower back pain itself, and improves with time and appropriate movement.

Symptoms that need urgent attention

Most lower back pain does not need urgent medical assessment. However, seek help promptly if you experience any of the following alongside back pain:

✔ Difficulty controlling your bladder or bowel

✔ Numbness or tingling in the groin or inner thighs (saddle area)

✔ Progressive weakness in both legs

✔ Fever alongside back pain

✔ Back pain following a significant injury or fall

These are uncommon but important signs that need assessment without delay.

How Is Lower Back Pain Treated?

Staying active is the most important thing

The strongest and most consistent evidence points to the same thing: staying active leads to faster recovery than resting. The Australian Low Back Pain Clinical Care Standard is clear that prolonged bed rest is harmful and should be avoided. Continuing normal daily activities-including work, where possible-leads to better outcomes than stopping everything until the pain is gone.

This does not mean pushing through severe pain or ignoring warning signs. It means that modifying activity is usually better than stopping it entirely.

Exercise

Exercise is well-supported for lower back pain. The type matters less than the fact that you do something you can sustain. Walking, swimming, gentle stretching and strength-based exercise have all been shown to help. The Clinical Care Standard recommends exercise be individualised to the person's preferences and situation rather than prescribing one specific program for everyone.

Hands-on physiotherapy

Manual therapy-including joint mobilisation, soft tissue work and targeted pressure applied by a physiotherapist-is commonly used as part of a broader treatment plan. It is most effective when combined with exercise and active self-management, rather than used as a passive standalone treatment.

Education and reassurance

Understanding back pain is itself a treatment. People who understand that pain does not equal damage recover faster and are less likely to develop chronic symptoms. Unhelpful beliefs about back pain are associated with slower recovery and are worth addressing early.

Technology-assisted therapies

Where physiotherapy-led treatment and exercise alone are not producing the improvement a patient needs, technology-assisted therapies can be added alongside hands-on care. High-intensity laser therapy has demonstrated pain reduction and improved function in people with chronic lower back pain across multiple randomised controlled trials. Focused shockwave therapy has shown similar results in systematic reviews, particularly for persistent soft-tissue and musculoskeletal pain. These modalities are used selectively at RheCore as part of a broader treatment plan-not as standalone treatments-and only where clinically appropriate based on individual assessment.

What about imaging?

A scan is not necessary or helpful for most episodes of lower back pain. The Clinical Care Standard is explicit: routine imaging is not recommended because findings are often poorly correlated with symptoms. Disc degeneration, disc bulges and facet joint changes show up on scans in large proportions of people who have no pain at all-these are features of normal ageing, not necessarily the cause of your current symptoms.

Pain medicines

Medicines can have a role in the short term, primarily to support your ability to stay active rather than to eliminate pain entirely. The Clinical Care Standard specifically recommends against routine use of opioids, anticonvulsants and antidepressants for lower back pain-the risks generally outweigh the benefits for this condition.

What You Can Do Right Now

✔ Keep moving-avoid staying in one position for more than 30-40 minutes at a time

✔ Modify activities that aggravate your pain, but aim to keep doing as much as possible

✔ A heat pack applied to the lower back can help with muscle tension and comfort

✔ Try to maintain your normal sleep routine, even if pain disturbs it

✔ If you sit for work, stand up and move briefly every hour

✔ Avoid complete rest-the evidence consistently shows it slows recovery

When Should You See a Physiotherapist?

A physiotherapy assessment is worth having if:

✔ Your pain has lasted more than one to two weeks and is not clearly improving

✔ Pain is interfering with work, sleep or your ability to do everyday tasks

✔ You have pain travelling into your leg, or leg numbness or tingling

✔ You have had lower back pain before and it keeps recurring

✔ You are unsure what is causing your pain and want a proper assessment

A physiotherapist can assess the nature and likely cause of your pain, identify any factors that may be slowing recovery, give you an individualised exercise program, and help you understand what is happening and what to do about it.

Seek urgent medical assessment-not a physiotherapy appointment-if you have any of the red flag symptoms listed above.

Key Takeaways

✔ Lower back pain is extremely common and is rarely caused by anything serious

✔ Staying active is the most important thing you can do-rest slows recovery

✔ Imaging is not necessary or helpful for most cases

✔ Pain travelling into the leg is common and usually managed the same way as back pain

✔ Technology-assisted therapies such as high-intensity laser and focused shockwave can support recovery in persistent cases when used alongside hands-on care

✔ If pain persists beyond one to two weeks or is affecting daily life, a physiotherapy assessment is a sensible next step

References

• Australian Commission on Safety and Quality in Health Care. Low Back Pain Clinical Care Standard. Sydney: ACSQHC; 2022. safetyandquality.gov.au
• Healthdirect Australia. Low back pain-causes, symptoms, diagnosis. healthdirect.gov.au/low-back-pain (2025)
• Healthdirect Australia. Back pain-an overview. healthdirect.gov.au/back-pain (2025)
• Abdildin Y, Tapinova K, Jyeniskhan N, Viderman D. High-intensity laser therapy in low back pain management: a systematic review with meta-analysis. Lasers in Medical Science. 2023;38(1):166. PubMed PMID: 37493840
• Liu K, Zhang Q, Chen L, et al. Efficacy and safety of extracorporeal shockwave therapy in chronic low back pain: a systematic review and meta-analysis of 632 patients. Journal of Orthopaedic Surgery and Research. 2023;18:455
• Reviewed by the RheCore Physiotherapy Team, St Kilda. Last reviewed: June 2026. Joy Ju- PhD candidate ,B.Phty, BSc APA Physiotherapist

If lower back pain is affecting your daily life, work or sleep, a physiotherapy assessment can identify what's going on and get you moving in the right direction. Book an appointment with RheCore's physiotherapy team in St Kilda