In this guide
Back pain is one of the most common reasons to see a doctor. In the vast majority of cases it isn’t serious and gets better within a few weeks. Here is how to recognise lumbago and sciatica, what really helps, the signs that mean seeing a doctor quickly, and what a physio can do for you.
Lumbago or sciatica: what’s the difference?
Lumbago is sudden pain in the lower back, often after an effort, an awkward movement or bending over. The back feels « locked », every movement hurts, but the pain stays in the back.
Sciatica is pain that starts in the lower back or buttock and runs down the leg, sometimes to the foot, along the sciatic nerve. It sometimes comes with tingling or numbness. It is often caused by a herniated disc irritating the nerve.
In both cases the outlook is usually good: most lumbago improves within a few days to a few weeks, and sciatica within a few weeks to a few months.
What helps day to day
- Stay as active as the pain allows. Complete bed rest slows recovery: walk a little every day, even slowly.
- Apply heat (hot water bottle, warm shower) to your lower back to relax the muscles.
- For pain medication, ask your doctor or pharmacist.
- Avoid lifting heavy loads and movements that clearly trigger the pain, until it eases.
- Change position often: don’t sit for long without getting up.
- To get out of bed, roll onto your side first, then push up with your arms.
Pain can be frightening, but hurting doesn’t mean your back is being damaged. Moving gently helps you heal.
When to get urgent help
See a doctor straight away, or call emergency services (15 or 141), if the pain comes with difficulty passing urine or controlling your bladder or bowels, numbness between the thighs or around the genitals, leg weakness that is getting worse, fever, or if it started after a fall or accident.
Also see your doctor if the pain hasn’t improved after a few weeks, wakes you every night, if you are losing weight for no reason, or if you have had cancer.
What a physio can do
A physio helps when pain lasts, keeps coming back, or when sciatica disturbs walking and sleep. After an assessment, they offer a programme suited to you:
- manual techniques and mobilisation to ease pain and restore flexibility;
- progressive exercises to strengthen the back, abdominal and leg muscles;
- advice on everyday movements: bending, lifting, sitting at work;
- a gradual return to activities and sport, without fear of moving.
Physiotherapy is prescribed by a doctor. A home physio saves you car journeys, which are often painful when your back is locked.
Three gentle exercises to start
Do them slowly, lying on your back on a mat or a firm bed, 5 to 10 times each. Stop if the pain clearly increases or spreads further down the leg, and ask your physio.
- Knee to chest: bring one knee towards your chest with your hands, hold a few seconds, then switch legs.
- Pelvic tilt: knees bent, feet flat, gently draw your belly in, pressing your lower back into the floor, then relax.
- Gentle rotation: knees bent and together, slowly let them fall to one side then the other, keeping your shoulders on the floor.
These exercises don’t replace the programme your physio will tailor to you.
Preventing it coming back
- Move regularly: walking, swimming or cycling keep your back healthy.
- Strengthen your core with the exercises learned from your physio.
- To lift something, bend your knees and keep it close to your body.
- At work, get up and move at least once an hour.
This guide gives general information. It doesn’t replace the advice of your doctor or physio, who know your situation.