Condition information
Understanding your pathway
What is back pain?
Back pain may involve the spine or surrounding tissues and can be short-lived, recurrent or persistent. Pain continuing beyond three months is generally described as chronic. Its effect on walking, work and sleep matters as much as its location. Often there is no single identifiable structural cause. [1][2]
What can contribute?
Muscle strain, disc-related problems, osteoarthritis and nerve irritation are possible contributors. Less common causes include fracture, inflammatory disease or infection. Age-related changes on a scan do not necessarily explain symptoms. A diagnosis should bring together the history and examination rather than rely on an imaging label alone. [1][3][4]
Common presentations and symptoms
Symptoms can include an ache, stiffness, pain with particular movements or pain travelling into a leg. Leg pain with tingling or weakness may need a nerve assessment. Persistent pain can also interrupt sleep and confidence with movement; these effects deserve attention even when a scan is reassuring. [1][3][4]
Assessment and diagnosis
Assessment starts with a history, examination and a check for serious causes. Routine imaging is not needed for uncomplicated low back pain. A scan or specialist investigation is considered when its result could change management, particularly with significant neurological findings or another specific clinical concern. [1][3][4]
Management options
Education, remaining active within an agreed plan and exercise-based rehabilitation are central options. A procedure is not routine treatment for nonspecific low back pain. An epidural or radiofrequency procedure requires a separate, suitable indication; neither a painful back nor an abnormal scan alone establishes that indication. [1][3][4][5]
When should I seek urgent care?
Call 000 or attend an emergency department for back pain with new bladder or bowel dysfunction, loss of feeling around the genitals or buttocks, or rapidly worsening limb weakness. Severe pain following major injury, fever with significant back pain or inability to walk also needs urgent assessment. [1][3][4]
Multidisciplinary care and self-management
Persistent pain can affect more than one part of life. Physiotherapy, psychological support and medical care may be combined according to your needs. Psychological care addresses the effects of pain and ways of coping; it does not imply that pain is imagined. Discuss an activity plan you can sustain rather than alternating between doing too much and stopping completely. [5][2]
Preparing for your consultation
Bring a current medicine list, relevant scan reports and details of treatments you have tried. Describe what each treatment changed, any adverse effects and the activities you most want to regain. You may wish to bring a support person. Ask what the assessment can clarify, what remains uncertain and which decisions can reasonably wait.
Follow-up and questions to ask
Agree how progress will be judged: for example, walking tolerance, sleep, work participation or confidence with a daily task. Ask when to review the plan and what changes should prompt earlier contact. Discuss potential benefits, limitations, costs and alternatives before starting treatment. If a plan is not helping, review its purpose instead of assuming that more of the same treatment is always needed. [6]
Sources and further reading
Sources support the statements cited above. Overseas guidance may describe different services or eligibility rules. A procedure leaflet explains a technique and its risks; it does not establish that the treatment is effective for every condition.
- Back pain — Healthdirect Australia
- Chronic pain — Healthdirect Australia
- Low back pain and sciatica: recommendations — NICE
- Sciatica — Healthdirect Australia
- Options for chronic pain management — Healthdirect Australia
- Procedures in pain medicine clinical care standard — Faculty of Pain Medicine, ANZCA