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MSK Physiotherapy - Lower back

Important Facts About Your Back Pain- Please Read

Please read the following information and then use the links at the bottom of the page if you are looking for further information or exercise.

 

Here is a list of the main problems and concerns we would recommend you get checked out by a health professional before commencing self-management exercises. These are called Red Flags and may indicate a more serious problem that requires medical assessment.

WARNING: Cauda Equina Syndrome (CES): This a rare but extremely serious spinal condition that requires immediate assessment. 

If you are experiencing the symptoms described in (1) or (2) below, then please have these checked out URGENTLY – usually your GP if within normal hours (8:30-6pm) or call NHS24 on 111 at other times.

(1) Significant changes in your bowel or bladder habits and/or sexual function. This includes difficulty passing or controlling your urine flow/ signs of recent bowel incontinence.

(2) Changes to sensation in between your legs e.g. difficulty feeling the toilet paper when you are wiping your bottom.

For further information on CES:

Click for CES info card

Click here for CES short video

Click here for CES information in other languages

 

Symptoms That Are Present After Trauma

If symptoms are caused by a traumatic incident to your back (e.g. a fall, car accident), please have this checked out by a health professional before commencing with an exercise program.

NOTE: If you have underlying low bone density (e.g. osteoporosis) or long-term steroid use then smaller amounts of force may cause problems that require medical assessment.

 

Symptoms Where No Trauma Was Involved

If you feel any of the following signs develop rapidly or over a longer period of time please have these checked out by a health professional.

  • Severe restriction in the movement of your lower back and legs.
  • Sudden or newly worsening leg pain which extends below the knee
  • Changes in your balance and the way you are walking e.g. tripping, falling
  • Weakness and/ or altered sensation into both arms and/ or legs at the same time
  • If one or both feet are feeling very floppy or feel very weak on walking
  • Problems with coordination of upper and/ or lower limbs e.g. writing, getting dressed, walking.
  • Pain or altered sensation around your trunk e.g. can be described as a band of pain/ numbness around the chest
  • Pain and/ or stiffness in other joints at same time as low back pain developed
  • Fever and generally feeling unwell at same time as low back pain developed
  • Unexplained lumps and bumps that appear or are changing/ growing
  • Constant pain that does not change with rest or activity
  • Significant worsening night pain, unable to lie flat
  • Night sweats
  • Unexplained weight loss and/or previous history of cancer
  • Increasing number of joints that are painful and/or stiff

NOTE: Special attention should be taken if you have a history of long-term steroid/ immunosuppressive drug use, recent joint replacement, dental surgery or steroid injection. Rheumatoid arthritis or other joint disease, recent infection, previous history of tuberculosis, intravenous drug use or alcoholism

Last Updated: 11 June 2021