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The Causes of Acute Lower Back Pain

This article explores the key causes of acute lower back pain, from muscle strain to poor posture, and provides guidance on when to seek professional help.

By Melissa Folly and Jennifer BarrLast edited/reviewed 1st April 2025

Acute lower back pain is often caused by strain, injury, or underlying conditions. Here are some of the most common causes: 

1. Muscle or Ligament Strain

• Lifting heavy objects improperly. 
• Sudden movements or twisting motions. 
• Overuse or repetitive activities. 

2. Herniated or Bulging Disc

• Discs in the spine can protrude, bulge or press on nerves, causing sharp pain that can travel into the buttock and or the legs. 

3. Injuries

• Falls, accidents, or sports-related impacts. 
• Compression fractures in the spine, especially in older adults. 

4. Poor Posture or Prolonged Sitting

• Slouching or sitting for long periods without proper support. 
• Sleeping in an awkward position. 

5. Sciatica

• Pressure on the sciatic nerve, leading to pain radiating down the leg. 

6. Infections or Inflammation

• Kidney infections, which can cause referred pain in the lower back. 
• Localised infections or abscesses in the spine. 

7. Medical Conditions

• Ankylosing spondylitis or other inflammatory conditions. 
• Flare up of Osteoarthritis or age-related wear and tear. 

If the pain is severe, lasts longer than a few days, or is accompanied by symptoms like fever, numbness, or loss of bowel/bladder control, it’s critical to seek medical attention promptly.  

Management Tips

1. Ice and heat – Alternate between the two on and off for 15-20 minutes at a time. Give yourself a short break in between the two to ensure your skin does not get too irritated. 
2. Movement variability – Do not sit or stay in one position for too long. Keep varying positions or get up to move around every 20 minutes.
3. No bed rest – Avoid prolonged bed rest and follow the advice above. When you do go to bed at night, to prevent discomfort, perhaps try a pillow under the knees when lying on your back or in between your knees when on your side.
4. Continue with daily activities where possible – As per the National Institute of Health and Care Excellence guidelines for back pain, it is encouraged to continue with your day-to-day activities, within your tolerance levels.
5. Be kind to yourself – Despite the advice to continue with your daily activities, ensure that you spread the load and do not overexert yourself whilst you are recovering. We understand that it can be difficult to strike the right balance.
6. Relief positions – Lie on your back with your hips and knees bent and feet flat on the floor. This is known as the crook position. Whilst lying on your back, you can also gently bring one or both knees up to your chest and hold for approximately 20 seconds.
7. Do something you enjoy – Back pain is not pleasant, so why not try to do something you enjoy such as a hobby of yours. This can help take your mind off the pain, act as stress relief and if the hobby is relatively active, this movement could help your back.
8. Visit a chiropractor – National guidelines suggest that manual therapy in the presence of education and exercise, such as the treatment provided by our chiropractors, can be beneficial for acute low back pain. If you are experiencing back pain, our chiropractors will be able to discuss and assess your back pain, then provide the relevant treatment and referrals if necessary.

When to see your doctor or go to A&E:

Although only 1% of back pain is sinister, you should still look out for certain symptoms and seek the relevant medical attention.

Here is the guidance as per the NHS website:

• Ergonomic Advice
• Chiropractic
• Book Appointment