Common questions about back pain

Usually not. A back spasm is a sudden, painful tightening of the muscles that can make bending or getting up hard for a few days, but it does not usually mean damage to the spine, and it tends to ease with gentle movement and heat. See a doctor the same day if it comes with a fever, started after a fall, or appears in someone with osteoporosis, as it may be a fracture. Go to the emergency department straight away if it comes with chest pain or breathlessness, weakness or numbness in the legs, numbness around the buttocks or genitals, difficulty peeing or loss of bladder or bowel control, or after a serious accident.

Read more: Muscle knots and tension, Back pain · Source: NHS — Back pain · Royal Osteoporosis Society — Osteoporosis symptoms

Keep moving as much as the pain allows, because long rest in bed usually slows recovery. Short, gentle walks spread through the day help, and a warm pack wrapped in a towel may relax the tight muscles. Try gentle exercises and stretches that do not make the pain worse, and change position often. Ask a pharmacist or doctor about painkillers. If it comes with weakness or numbness in the legs, difficulty peeing or chest pain, go to the emergency department first; with a fever, see a doctor the same day. If it is not improving within a few days, or getting to the clinic is hard, Revibe can arrange a home visit in Amman to assess and treat you.

Read more: Muscle knots and tension, Home physiotherapy · Source: NHS — Back pain

In most cases no. Low back pain is common, usually comes from muscles and joints and improves within a few weeks if you stay active, and only rarely is it caused by something serious, such as a broken bone, an infection or cancer. See a doctor if it is not improving after a few weeks, is worse at night and not eased by rest, or comes with unexplained weight loss, and the same day if it comes with fever or shivering or you have osteoporosis. Go to the emergency department straight away if it started after a serious accident, or for weakness or numbness in the legs, numbness around the buttocks or genitals, difficulty peeing, or loss of bladder or bowel control.

Read more: Back pain · Source: NHS — Back pain · NICE NG59 — Low back pain and sciatica in over 16s

The most important step is to stay active and keep up your daily activities as much as you can, because long rest in bed often slows recovery. A warm pack may ease stiffness, and walking, gentle exercises and stretches help. Guidelines recommend exercise therapy, and manual therapy as part of a plan that includes exercise, not on its own. Medicines are for your doctor or pharmacist to advise on. If the pain lasts more than a few weeks or keeps coming back, at Revibe we start with an assessment to find what keeps it going.

Read more: Back pain, Manual therapy · Source: NICE NG59 — Low back pain and sciatica in over 16s · NHS — Back pain

A muscle knot is a tight spot or band in a muscle that hurts when pressed, and the pain may spread to a nearby area. It is not a build-up of salts or deposits; knots are often linked with long sitting in one position, overloading a muscle, stress and poor sleep. Movement, stretching, gradual strengthening and breaks to change position usually help. Manual therapy, muscle-knot release and dry needling may ease the pain in the short term, but the quality of the evidence varies and their long-term benefit is unclear, so they are used as part of a plan that includes exercise.

Read more: Muscle knots and tension, Dry needling · Source: Dua A, Chang KV (2025). Myofascial Pain Syndrome. StatPearls, NCBI Bookshelf · Gattie E, Cleland JA, Snodgrass S (2017). The effectiveness of trigger point dry needling for musculoskeletal conditions by physical therapists: a systematic review and meta-analysis. J Orthop Sports Phys Ther 47(3):133–149

Usually not. A Cochrane review found that traction does not ease low back pain more than a sham (pretend) treatment, with or without sciatica, and NICE guidelines advise against it. Staying active and doing movement and strengthening exercises, with manual therapy as part of an exercise plan, usually help more. If your back pain comes with numbness or weakness in one leg, get an assessment before buying any device; if both legs are affected, or you have difficulty peeing or loss of bladder or bowel control, go to the emergency department straight away.

Read more: Back pain, Disc herniation · Source: NICE NG59 — Low back pain and sciatica in over 16s · Wegner I et al. (2013). Traction for low-back pain with or without sciatica. Cochrane Database Syst Rev (8):CD003010

Sitting itself does not harm your back: the spine is strong, and there is no single correct sitting posture for everyone. But staying still for a long time can add to tightness and stiffness. So change position often and get up and move from time to time, because the best posture is the next one. Regular stretches help ease stiffness, and strengthening exercises may lower the chance of the pain coming back.

Read more: Posture and stretching · Source: Leeds Community Healthcare NHS Trust — Mid and upper back problems

In most cases no: pain between the shoulder blades usually comes from muscles and joints, and tends to change with movement and posture. But heart attack pain can sometimes spread to the upper back. So call an ambulance straight away if the pain comes with chest pain or pressure, shortness of breath, sweating, feeling sick or light-headed, or spreads to the arm, neck or jaw, or is a sudden, severe pain that feels like tearing: 911 in Jordan or 122 in Iraq and Kurdistan. Do not drive yourself to hospital.

Read more: Upper back pain · Source: British Heart Foundation — Heart attack · NHS — Back pain

A back muscle spasm does not harm the heart or lungs. Tight upper back muscles can make some movements or a deep breath uncomfortable, but new pain when you breathe in, or real shortness of breath, needs a doctor the same day, because lung and heart problems can feel similar. Go to the emergency department or call an ambulance if breathlessness comes on suddenly, or comes with pain in the chest or upper back, coughing up blood, a very fast heartbeat or fainting, sweating, or pain spreading to the arm or jaw: 911 in Jordan or 122 in Iraq and Kurdistan.

Read more: Upper back pain, Muscle knots and tension · Source: NHS — Pulmonary embolism · British Heart Foundation — Heart attack

Usually not. Upper back pain is very common, mostly comes from muscles and joints, usually improves within weeks with movement and exercise, and most of it does not need scans. Even so, the UK's NHS lists pain between the shoulders among the non-urgent reasons to see a doctor, as it occasionally has another cause. Also see a doctor if it is not improving, is worse at night or comes with weight loss, and the same day if you have a fever, it started after a minor fall or you have osteoporosis. Chest pain, breathlessness, a sudden severe pain that feels like tearing, weakness in the legs or pain after a serious accident needs the emergency department straight away.

Read more: Upper back pain · Source: NHS — Back pain · Leeds Community Healthcare NHS Trust — Mid and upper back problems

It may contribute. Stress and poor sleep are linked with upper back pain and may make it last longer, but they are usually not the only cause: long sitting, too little movement and carrying heavy bags play a part too. Regular physical activity, mobility and strengthening exercises, good sleep and ways of managing stress usually help. Be careful: if you have chest pain, breathlessness or sweating, do not assume it is anxiety; go to the emergency department or call an ambulance: 911 in Jordan or 122 in Iraq and Kurdistan.

Read more: Upper back pain, Muscle knots and tension · Source: Leeds Community Healthcare NHS Trust — Mid and upper back problems · Berkshire Healthcare NHS Foundation Trust — Physiotherapy advice for mid-back pain

It often improves within weeks with simple steps: stay active, change position often with short movement breaks during desk work, and try gentle exercises such as arching and rounding your back, turning and bending to each side. Heat may ease muscle tightness, and strengthening exercises may reduce the chance of the pain returning. If it is not improving, at Revibe we combine manual therapy, joint mobilisation, muscle-knot release and exercise. Chest pain or breathlessness needs the emergency department, not exercises.

Read more: Upper back pain, Posture and stretching · Source: Berkshire Healthcare NHS Foundation Trust — Physiotherapy advice for mid-back pain · Leeds Community Healthcare NHS Trust — Mid and upper back problems

Not necessarily. In a large study, the shape of the foot arch was not linked with low back pain, but the way the foot moved when walking, rolling inwards, was linked with it in women. So the feet may contribute for some people, but they are not a proven cause. NICE guidelines do not recommend foot orthotics (insoles) to treat low back pain. That is why our assessment looks at the back, hips, feet and walking together.

Read more: Inner ankle pain and flat foot, Back pain · Source: Menz HB, Dufour AB, Riskowski JL, Hillstrom HJ, Hannan MT (2013). Foot posture, foot function and low back pain: the Framingham Foot Study. Rheumatology (Oxford) 52(12):2275–2282 · NICE NG59 — Low back pain and sciatica in over 16s

Sometimes. Irritable bowel syndrome (IBS), with its gas, bloating and constipation or diarrhoea, can come with backache. This pain is usually tied to tummy symptoms: cramps tend to get worse after eating and ease after a bowel movement, while muscle and joint pain changes with movement and posture. See a doctor if tummy symptoms persist, and promptly if you notice blood in your stool or unexplained weight loss. Go to the emergency department for sudden, severe tummy pain that spreads to your back. If upper back pain comes with chest pressure or pain, breathlessness or sweating, do not assume it is gas: call an ambulance straight away on 911 in Jordan or 122 in Iraq and Kurdistan.

Source: NHS — Symptoms of IBS (irritable bowel syndrome) · NHS — Acute pancreatitis

Sometimes, but it is less common than muscle and joint pain. A stomach ulcer, including one caused by H. pylori, usually hurts in the upper tummy, while pain from gallstones or an inflamed pancreas may start in the upper tummy and spread to the back, often with feeling sick or vomiting. Go to the emergency department straight away for sudden, severe tummy pain, pain spreading to the back with vomiting, a high temperature or shivering, yellow skin or eyes, or vomiting blood or black poo. Heart attack pain can feel like indigestion, so call an ambulance if it comes with chest pressure, breathlessness or sweating: 911 in Jordan or 122 in Iraq and Kurdistan.

Read more: Upper back pain · Source: NHS — Gallstones · NHS — Stomach ulcer

Osteoporosis itself is not usually painful until a bone breaks, but it can lead to a break or partial collapse of one of the bones of the spine, sometimes after a minor fall or even a cough or sneeze. This may show up as unexplained back pain with muscle spasms, loss of height or a curving back, and it can be mistaken for arthritis. So if someone with osteoporosis, or who takes steroid tablets long-term, gets new back pain, they should see a doctor the same day.

Read more: Back pain · Source: NHS — Osteoporosis · Royal Osteoporosis Society — Osteoporosis symptoms

Kidney pain is usually felt in the side or the lower back just under the ribs. Kidney stone pain may come and go in severe waves and spread to the groin, and a kidney infection often brings a high temperature or shivering, burning when you pee, blood in your pee or feeling sick. Muscle and joint pain usually changes with movement and posture, without these symptoms. If you have pain in your side with a fever, shivering or urinary symptoms, see a doctor the same day; go to the emergency department straight away if the pain is sudden and very severe, or you become confused, very drowsy or have difficulty speaking.

Read more: Back pain · Source: NHS — Kidney infection · NHS — Kidney stones

In most cases no. Spondylosis means wear-and-tear changes in the discs and the small joints between the vertebrae that come with age, and they are often seen on scans of people who have no pain at all. So the word on your report does not mean your back is damaged, and the scan does not always match how much it hurts. See a doctor if you get numbness or weakness in a leg or severe pain that gets worse at night, and go to the emergency department straight away if both legs are affected, or for numbness around the buttocks or genitals or new problems controlling your bladder or bowels.

Read more: Back pain, Spinal stenosis · Source: Brinjikji W et al. (2015). Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol 36(4):811–816 · NHS — Back pain

Yes. Even if the changes stay on the scan, pain can often be eased and movement improved. Treatment is mainly non-surgical: staying active, strengthening and flexibility exercises, keeping a healthy weight, and manual therapy as part of a plan that includes exercise. Medicines, injections and surgery are for your doctor to decide. At Revibe we start by assessing your movement, strength and what makes the pain worse, then build an exercise programme with you that suits your age and daily activities.

Read more: Back pain, Manual therapy · Source: American Association of Neurological Surgeons (AANS) — Osteoarthritis · NICE NG59 — Low back pain and sciatica in over 16s

What people call calcification of the vertebrae is usually small bony spurs (osteophytes) at the edges of the vertebrae seen on X-rays. They are part of age-related spinal wear (spondylosis): bone growth, not a deposit that herbs or massage can dissolve. These wear changes are often seen in people with no pain. Treatment is usually the same as for spondylosis: movement, strengthening and flexibility exercises, and keeping a healthy weight. If a spur presses on a nerve and causes numbness or weakness, your doctor decides what is needed; weakness in both legs or loss of bladder or bowel control needs the emergency department straight away.

Read more: Back pain, Spinal stenosis · Source: American Association of Neurological Surgeons (AANS) — Osteoarthritis · Brinjikji W et al. (2015). Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol 36(4):811–816

Usually not. The most common type of rounded upper back is postural kyphosis, which comes from sitting and standing habits, often appears in teenagers and is not usually inherited. Scheuermann's disease, in which the vertebrae grow wedge-shaped so the spine curves, is different: a twin study suggests genes play a large part in it. There is also a rare type that a baby is born with. So if you notice a clear, increasing curve in your child or teenager, especially if others in the family have it, see a doctor.

Read more: Posture and stretching, Children's physiotherapy · Source: NHS — Kyphosis · Damborg F et al. (2011). Genetic epidemiology of Scheuermann's disease: heritability and prevalence over a 50-year period. Acta Orthop 82(5):602–605

A rounded back can make you look a little shorter, but postural rounding does not shorten the bones themselves; better posture helps you stand at your full height without adding new height. Clear height loss with a new curve in the back in an older person, though, can be a sign of spinal fractures from osteoporosis and deserves a doctor's visit, on the same day if it comes with new back pain.

Read more: Posture and stretching · Source: Royal Osteoporosis Society — Osteoporosis symptoms · NHS — Kyphosis

Usually not much. NICE guidelines advise against belts and corsets for treating low back pain, with or without sciatica. A Cochrane review found that back supports do not seem to prevent back pain, and that the results for treating it are conflicting and the evidence weak. Staying active and exercise therapy usually help more. If a doctor advises a belt for a specific reason, follow their instructions on how and for how long to wear it.

Read more: Back pain · Source: NICE NG59 — Low back pain and sciatica in over 16s · van Duijvenbode I, Jellema P, van Poppel M, van Tulder MW (2008). Lumbar supports for prevention and treatment of low back pain. Cochrane Database Syst Rev (2):CD001823

Yes, and treatment depends on the type and size of the curve. For a postural rounded back, strengthening exercises for the back and trunk, mobility exercises for the upper back and chest, and changes to sitting habits may improve posture and ease pain and stiffness, even after eighteen. Exercise is not expected to straighten a structural curve, such as Scheuermann's, or stop it getting worse, but it may ease pain and stiffness. A brace is decided by an orthopaedic specialist for children who are still growing, and surgery is considered for severe or worsening curves. At Revibe we assess your posture and movement and build a suitable exercise programme.

Read more: Posture and stretching · Source: NHS — Kyphosis

There is little evidence on the posture-corrector belts sold in shops, and they are not expected to fix a habit-related rounded back on their own; they may simply remind you to straighten up while you wear them. Better posture depends more on strengthening, movement and changing sitting habits. Medical braces have specific uses decided by a doctor, such as some children with Scheuermann's disease while they are still growing, and a few studies suggest a special brace may reduce the curve in women with osteoporosis.

Read more: Posture and stretching · Source: NHS — Kyphosis · Sánchez-Pinto-Pinto B et al. (2022). Efficacy of Bracing on Thoracic Kyphotic Angle and Functionality in Women with Osteoporosis: A Systematic Review. Medicina 58(6):693

Usually not. A slight curve may cause no symptoms, while a more noticeable or worsening one can cause back pain and stiffness, and in severe cases very bad pain or difficulty breathing. Physiotherapy can help improve posture and ease pain and stiffness. See a doctor if the curve is getting worse quickly in a child or teenager, and the same day if it appears suddenly with pain in an older person. Numbness or weakness in the legs, or loss of bladder or bowel control, needs the emergency department straight away.

Read more: Posture and stretching · Source: NHS — Kyphosis · Royal Osteoporosis Society — Osteoporosis symptoms

This is not known precisely, because studies have rarely recorded the side effects of back belts, so we cannot say for sure that they weaken the muscles. But relying on one for long periods may make you move less, while movement and exercise are what usually help back pain. A belt can also be uncomfortable if it is too tight. If a doctor has advised one for a specific reason, follow their instructions and ask which activity and exercises suit you alongside it; otherwise, staying active and strengthening exercises for your back and trunk usually help more.

Read more: Back pain · Source: van Duijvenbode I, Jellema P, van Poppel M, van Tulder MW (2008). Lumbar supports for prevention and treatment of low back pain. Cochrane Database Syst Rev (2):CD001823 · NICE NG59 — Low back pain and sciatica in over 16s

In most cases no. Mild scoliosis is not usually a sign of anything serious, does not usually cause significant pain or other health problems, and does not always need treatment. A long-term follow-up of people with the common type that starts around adolescence, who were never treated, found that most lived productive, active lives and their survival was close to that of others, though some had more back pain, and some with large curves had shortness of breath. What matters is that an orthopaedic doctor monitors the curve, especially in growing teenagers. Severe breathlessness or chest pain needs the emergency department.

Read more: Scoliosis · Source: NHS — Scoliosis · Weinstein SL, Dolan LA, Spratt KF, Peterson KK, Spoonamore MJ, Ponseti IV (2003). Health and function of patients with untreated idiopathic scoliosis: a 50-year natural history study. JAMA 289(5):559–567

Genes may play a part. In most cases scoliosis has no clear cause, but your genes may make you more likely to get it, as it sometimes runs in families. Less often it comes from a problem with the spinal bones from birth, nerve or muscle conditions, or age-related wear and tear. So if a parent, brother or sister has it, look out for signs such as uneven shoulders or waist, or the body leaning to one side, and take your child to a doctor if you notice them.

Read more: Scoliosis, Children's physiotherapy · Source: NHS — Scoliosis

Sometimes. Scoliosis does not cause significant pain for most people, but back pain is more common in adults with the condition. Activities that strengthen and stretch the back may help reduce the pain; the type of exercise matters less than keeping your back moving. Painkillers and injections are for your doctor to decide. If the pain comes with numbness or weakness in the legs, or loss of bladder or bowel control, go to the emergency department; if it is severe and wakes you at night, see a doctor before physiotherapy.

Read more: Scoliosis · Source: NHS — Scoliosis · NHS — Scoliosis: treatment in adults

Yes, and treatment depends on age and the size of the curve: many mild cases only need monitoring, an orthopaedic doctor may recommend a brace for children who are still growing to help stop the curve getting worse, and surgery is considered if it keeps worsening. Physiotherapy may help with pain, strength and movement, but the evidence is unclear that exercises alone straighten the curve or stop it progressing. At Revibe we work alongside your doctor's plan and X-ray follow-up, and we do not promise to straighten the curve.

Read more: Scoliosis · Source: NHS — Scoliosis: treatment in children · Romano M et al. (2024). Therapeutic exercises for idiopathic scoliosis in adolescents. Cochrane Database Syst Rev (2):CD007837