Clinically reviewed by What is lower back pain
Lower back pain is pain between the bottom of your ribs and your hips. In Urdu it is simply kamar dard, and it is one of the commonest complaints in the world.
In most people it comes from the joints, muscles and ligaments of the back being loaded in a way they did not like. There is no single damaged structure to point at. This is called mechanical back pain.
That sounds vague, but it is good news. The back is sensitive rather than damaged. Pain travelling down the leg is a different problem, covered on our sciatica and slip disc pages.
Symptoms you might have
- Ache, stiffness or a sharp catch across the lower back, often to one side
- Worse with sitting, bending forward or standing in one place
- Stiff and sore first thing in the morning, easing after moving about
- Pain that shifts around a little day to day, which is typical
- Muscle spasm beside the spine, sometimes making you stand tilted
- Pain may spread into the buttock or thigh, but does not travel below the knee in simple mechanical back pain
- No numbness, tingling or weakness in the leg
Why it happens
- Lifting with a bent and twisted back, which is how most sudden episodes start
- Heavy manual work, loading, carrying and shifting weight all day
- Long hours on a motorbike, which combines vibration, a held posture and no back support
- Long periods sitting at a desk or driving
- Sitting on the floor or squatting for long stretches of household work
- Being weak through the trunk and hips, so ordinary loads feel heavy
- Pregnancy and the months after delivery
- Extra body weight, and poor sleep, which both make the back more sensitive to pain
When you should see a physiotherapist
Come in if the pain has not clearly improved after a week or two, if it keeps coming back, or if it is stopping you working or sleeping.
Go to a hospital the same day if you have numbness around the groin or back passage, loss of control of your bladder or bowels, or weakness in both legs. That combination suggests serious pressure on the nerves at the base of the spine and is treated as an emergency. Do not wait for an appointment.
See a doctor promptly, not a physiotherapist, if back pain comes with fever, unexplained weight loss, a history of cancer, or a bad fall. Night pain that does not change with position also needs a doctor.
Al-Shama Physiotherapy Clinic
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اپائنٹمنٹ کے بارے میں پوچھیںAppointment ke liye poochein
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یہ فارم پُر کریں؛ واٹس ایپ پر آپ کی تفصیلات کے ساتھ پیغام تیار ہو جائے گا۔Yeh form bharein, WhatsApp aap ki tafseel ke saath khul jaye ga.
How it is treated
Treatment starts with an assessment to sort out which kind of back pain this is, because mechanical pain, a disc pressing on a nerve, and pain referred from the hip need different work.
- Exercise therapy, the most useful thing by far. Movement for the stiff areas, then strengthening for the trunk, hips and legs
- Manual therapy, hands-on mobilisation to free the stiff segments and the hips, which makes the exercises easier
- Dry needling for muscles stuck in protective spasm beside the spine
- Hijama (cupping therapy) for widespread muscle tightness across the lower back
- Electrotherapy and TENS for pain control early on, so you can move enough to start exercising
- Ultrasound over a localised tender area where the assessment supports it
- Practical advice on lifting, sitting, riding and sleeping, which prevents the next episode
Surgery has no role in ordinary mechanical back pain. It is considered only for problems such as a disc compressing a nerve with worsening weakness. For the back pain most people have, the answer is movement, strength and time.
Exercises, and what to avoid
What helps
- Walking, starting with ten minutes a few times a day and building up
- Gentle movement in both directions: knee rolling, pelvic tilts, and lying face down propped on the elbows
- Glute bridges, bird dog and side planks once the sharp pain has eased
- Hip and hamstring flexibility work, because stiff hips push extra load into the lower back
What to avoid
- Bed rest beyond a day. It reliably makes recovery slower, not faster
- Sit-ups, crunches and toe touching while the back is sore
- Lifting with a rounded, twisted back, and carrying loads away from your body
- Waiting for the pain to be completely gone before you move. Gentle movement while slightly sore is part of the treatment
What you can do at home
Keep moving. The most useful thing you can do is carry on with normal activity in a modified way, rather than lying down.
Heat suits most back pain, because the muscles beside the spine tighten protectively. Fifteen to twenty minutes of a hot pack, several times a day. Use ice only in the first day or two after a sudden sharp strain, then switch to heat.
Break up sitting every 20 to 30 minutes. Riding a motorbike counts as sitting, and for many people here it is what keeps the back pain going.
Sleep on your side with a pillow between the knees, or on your back with a pillow under the knees.
How long it takes
Most episodes of simple back pain improve a great deal within two to six weeks. You should feel some change in the first week or two of proper treatment.
Back pain present more than three months takes longer, usually three to six months of consistent work. It often becomes less reactive before it becomes less frequent.
Recurrence is common. That is not failure, and not a sign your spine is wearing out. It is why the strengthening is worth continuing after the pain has gone.
Recovery is slower in people who rest completely, who return to heavy lifting with no change in technique, and who stop exercising as soon as it stops hurting.
Urdu / Roman Urdu
Choose your reading script / اپنی پسند کا رسم الخط منتخب کریں
اردوUrdu script
کمر درد بہت عام ہے اور زیادہ تر سنگین نہیں ہوتا۔ مسئلہ اکثر کمر کے جوڑ اور پٹھوں پر غلط طریقے سے زور پڑنے کا ہوتا ہے۔
ایم آر آئی میں ڈسک کا ابھار ان لوگوں میں بھی مل جاتا ہے جنہیں درد ہی نہیں ہوتا۔ اس لیے رپورٹ دیکھ کر گھبرانا نہیں چاہیے۔
آرام سے نہیں، حرکت سے ٹھیک ہوتا ہے۔ ایک دن سے زیادہ لیٹ کر آرام کرنا نقصان دیتا ہے۔ تھوڑی تھوڑی دیر چلنا، گرم پانی کی بوتل اور ورزش اصل علاج ہیں۔
فوراً ہسپتال جائیں اگر: شرمگاہ یا پاخانے کے گرد سن ہونا ہو، پیشاب یا پاخانے پر کنٹرول ختم ہو جائے، یا دونوں ٹانگیں کمزور ہو جائیں۔
Roman Urdu
Kamar dard bohat aam hai aur zyada tar sangeen nahi hota. Masla aksar kamar ke jor aur pathon par ghalat tareeqe se zor parne ka hota hai.
MRI mein disc ka ubhaar un logon mein bhi mil jata hai jinhein dard hi nahi hota. Is liye report dekh kar ghabrana nahi chahiye.
Aaram se nahi, harkat se theek hota hai. Ek din se zyada lait kar aaram karna nuqsan deta hai. Thodi thodi der chalna, garam pani ki bottle aur warzish asal ilaj hain.
Foran hospital jayen agar: sharamgah ya pakhane ke gird sun hona ho, peshab ya pakhane par control khatam ho jaye, ya dono taangein kamzor ho jayen.
Treatment at the clinic, and online
INFORMATION → INDIVIDUAL CARE
A plan built around you.
Talk with Dr. Zahra Fatima, DPT. Understand your next steps, with guidance for your own symptoms and daily routine.
Talk it through
Discuss your symptoms, what you find difficult and what you want to get back to.
Understand your next steps
Use the consultation to discuss which care and exercises fit your situation.
Take your plan with you
Your online consultation includes a written plan you can refer to afterwards.
Questions people ask
Is my back pain serious?
Do I need an MRI for my back pain?
Should I rest or keep moving?
When is back pain an emergency?
Why does my back pain keep coming back?
Further reading from the NHS
Back pain has several possible causes; the cause is not always clear from symptoms alone. NHS: back pain
Related conditions
- Slip disc treatment
- Upper back pain treatment
- Middle back pain treatment
- Scoliosis physiotherapy
- Kyphosis and rounded back