TL;DR Quick answer
Back pain that lasts longer than three months, often affecting sleep, work and movement. A pain specialist can confirm the cause and plan treatment, with non-surgical options considered first, such as medication management, physiotherapy-led rehabilitation and lifestyle and sleep guidance.
Medically reviewed by Dr. Nikhilesh Samudrala — Consultant Pain Physician View full profile →
About chronic back pain
Chronic back pain is pain in the lower or upper back that continues for more than about twelve weeks. It is one of the most common reasons people see a pain specialist, and it often has more than one contributing cause.
| Key facts | Details |
|---|---|
| Common symptoms | A constant dull ache or episodes of sharp pain; stiffness, especially in the morning or after sitting; pain that worsens with bending, lifting or standing for long periods |
| Common causes | Wear-related changes in the discs and facet joints; muscle and ligament strain; disc bulges or herniation |
| How it is diagnosed | Diagnosis starts with a detailed history and physical and neurological examination. |
| When to get help | Seek urgent medical care if back pain comes with loss of bladder or bowel control, numbness around the groin or buttocks, rapidly worsening leg weakness, fever, unexplained weight loss, or follows a significant injury |
| Treatment options | Medication Management, Physiotherapy-Led Rehabilitation, Lifestyle and Sleep Guidance, Epidural Steroid Injection, Radiofrequency Ablation |
| Who to see | Dr. Nikhilesh Samudrala, Consultant Pain Physician |
Symptoms
- A constant dull ache or episodes of sharp pain
- Stiffness, especially in the morning or after sitting
- Pain that worsens with bending, lifting or standing for long periods
- Pain that spreads into the buttocks or thighs
Causes
- Wear-related changes in the discs and facet joints
- Muscle and ligament strain
- Disc bulges or herniation
- Spinal stenosis (narrowing of the spinal canal)
- Sacroiliac joint problems
How it is diagnosed
Diagnosis starts with a detailed history and physical and neurological examination. Imaging such as X-ray or MRI is used when it is likely to change the treatment plan. In some cases, a diagnostic injection helps confirm which structure is causing the pain.
Treatment options
Treatment usually combines several approaches: medication review, guided exercise and physiotherapy, posture and activity advice, and, for selected patients, image-guided procedures such as facet joint injections or radiofrequency ablation.
When to seek help
Seek urgent medical care if back pain comes with loss of bladder or bowel control, numbness around the groin or buttocks, rapidly worsening leg weakness, fever, unexplained weight loss, or follows a significant injury.
| Option | Type | What it involves | Typical duration |
|---|---|---|---|
| Medication Management | Treatment | A careful review of pain medicines to improve relief and reduce side effects. | Ongoing / varies |
| Physiotherapy-Led Rehabilitation | Treatment | Guided exercise and movement to restore strength, flexibility and confidence. | Ongoing / varies |
| Lifestyle and Sleep Guidance | Treatment | Practical changes to sleep, activity and daily routine that support pain relief. | Ongoing / varies |
| Epidural Steroid Injection | Procedure | An injection into the epidural space to reduce nerve inflammation causing arm or leg pain. | 15–30 minutes |
| Radiofrequency Ablation | Procedure | Using controlled heat on small sensory nerves to interrupt pain signals from joints. | 45–90 minutes |
| Caudal Epidural Injection | Procedure | An epidural injection given through a natural opening at the base of the spine. | 15–20 minutes |
| Lumbar Medial Branch Block | Procedure | A test injection that shows whether the lower back facet joints are causing pain. | 20–30 minutes |
| Spinal Cord Stimulation | Procedure | An implanted device that uses mild electrical pulses to reduce long-term nerve pain. | Ongoing / varies |
| Vertebroplasty | Procedure | Injection of bone cement into a painful spinal compression fracture. | About 1 hour per level |
Patient guides
This page is for general information. Whether a treatment is suitable for you is decided after an individual consultation.
