Back Pain
Understand back symptoms, nerve-related pain and the role of an active rehabilitation plan.
Call 000 for back pain with new loss of limb movement or feeling, or trouble controlling your bladder or bowels. Seek urgent assessment for severe sudden pain, fever or feeling unwell, or new weakness or numbness.
Back pain is a symptom, not a single diagnosis
Pain may be felt in the lower back, upper back or nearby areas. It can begin after an event or develop without an obvious injury. Muscles, joints and other structures may be involved, but it is often not possible to identify one precise source.
A helpful assessment considers symptoms and function together. The intensity of pain alone cannot identify the structure involved or determine which treatment is appropriate.
Local pain, referred pain and sciatica
Pain that spreads into a leg needs to be described carefully. A clinician will ask where it travels and whether there is tingling, numbness or weakness. Sciatica describes a pattern of nerve-related leg symptoms; it should not be used as a label for every ache in the buttock or thigh.
Tell your clinician about any change in walking, strength or sensation. New or worsening neurological symptoms need reassessment rather than simply more of the same exercises or manual treatment.
Assessment and imaging
The history and examination help identify whether a serious cause needs investigation. Imaging is not routinely required for uncomplicated low back pain. Ask what question a proposed scan would answer and how its result would change management.
Building activity and confidence
Australia’s Low Back Pain Clinical Care Standard supports remaining active and returning to usual activities as feasible. Prolonged bed rest can delay recovery. The plan should be adjusted to your current situation and explain how to manage changes in symptoms.
Education, exercise and self-management are central parts of care. Hands-on treatment may be considered as part of a broader plan. Agree on meaningful goals, such as walking, working or lifting with more confidence, and a review point.
When pain persists
Ongoing pain can affect sleep, mood, work and confidence. Discuss these effects openly. A plan can consider these factors alongside physical rehabilitation, with other clinicians involved where appropriate. Persistent pain is real even when a scan does not provide a complete explanation.
Prepare for an assessment
Write down when the problem started, what brings it on, what eases it and what has changed. Bring relevant reports and a medicines list. Describe the activities you want to regain, rather than only giving a pain score.
- What is the working diagnosis, and what remains uncertain?
- What findings would change the plan or need medical review?
- What can I do between appointments?
- How will we measure progress and decide whether to change treatment?
Care in Melbourne’s northern suburbs
For people in Epping, Mill Park, Lalor, Reservoir and surrounding suburbs, the Muscle Joint Bone team can help arrange an appropriate starting appointment. Confirm current services, practitioner availability and any referral or funding requirements.
Sources and further reading
- Northern Spinal: original back-pain resource
- Northern Spinal: original sciatica resource
- Australian Low Back Pain Clinical Care Standard
- Healthdirect: low back pain
General education only. An assessment is needed to determine what applies to you.
