Condition information
Understanding your pathway
Clinically reviewed by Dr Chow Chow MBChB FANZCA FFPMANZCA FIPP MScGHP on .
What is back pain?
Back pain can make walking, work and sleep harder. It may settle after a short time, return from time to time, or persist. Pain lasting more than three months is generally described as chronic. It can involve the spine or surrounding tissues, and there is often 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
Before your visit, think about what back pain is stopping you from doing: walking to the shops, sitting at work or getting comfortable at night. Bring your medicine list, relevant scan reports and a note of treatments you have tried. Tell the specialist what helped, what did not, and what you would most like the assessment to clarify.
Follow-up and questions to ask
Ask what the assessment suggests, what remains uncertain and which options fit your situation. Agree on a practical way to review progress, such as walking or sitting tolerance, sleep or work participation. Discuss benefits, risks, costs and alternatives before deciding on treatment, and ask when the plan should be reviewed. [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