Back and spine injuries
Most low back pain is not dangerous, and most of it improves. Specialist assessment is for the back pain that is not improving, has alarm features, or is happening in a young athlete where conditions like pars bone stress injury need to be considered.
Most low back pain is not dangerous and improves with time and movement. Most low back pain also benefits from a clear explanation of what is going on and sensible activity advice. Specialist sport and exercise medicine input is for the back pain that is not improving, has alarm features, or is happening in a young athlete where conditions like pars bone stress injury need to be considered.
Common back and spine problems we see
Common low back pain
The back pain that is not dangerous and improves with movement.
Read more Disc and nerveDisc pain and sciatica
Disc-related pain and leg symptoms, and when they need attention.
Read more Young athletesBack pain in young athletes
Pars bone stress injury and growing-athlete back pain that needs care.
Read more ScansImaging in back pain
When a scan helps with back pain, and when it does not.
Read more
Common patterns
Most non-specific low back pain has multiple contributors: load, posture, sleep, stress, deconditioning, and sometimes a recent injury. The picture often does not need a precise structural label to manage well, but it does need a clear plan.
Specialist input is most useful when:
- Pain has not settled over weeks despite a sensible plan
- Symptoms are limiting work, sport, or sleep
- There are leg symptoms (radicular pain, weakness, numbness)
- The picture is unusual for the person's age or activity
- You are an adolescent athlete with persistent back pain (see pars bone stress injury below)
Disc-related pain and sciatica
Lumbar disc herniation can cause back pain, leg pain, or both. Most disc-related sciatica resolves over weeks to months without surgery. A small proportion need surgical opinion, particularly where weakness is significant or symptoms are not settling. The clinical course is generally favourable, but the experience can be tough; specialist input helps with pain management, activity advice, and the decision about whether and when surgical opinion is needed.
Pars bone stress injury in young athletes
Persistent low back pain in an adolescent athlete, particularly in extension-heavy sports (cricket fast bowlers, gymnasts, dancers, divers), should be evaluated for a pars bone stress injury, also called spondylolysis (a stress fracture of the pars interarticularis). Early identification supports recovery; missed cases can progress to non-union or spondylolisthesis.
Imaging in back pain
Most acute non-specific back pain does not benefit from imaging. Imaging finds incidental changes in nearly everyone past middle age, and labels can lead to fear and reduced activity. Imaging is appropriate when there are red flags, persistent or worsening symptoms despite sensible care, or when the result will change management.
Common questions
Should I rest my back?
Brief modified activity is fine. Sustained rest is not helpful. Movement is part of recovery.
I have a "bulging disc" on my MRI. Does that mean surgery?
Imaging findings need to be correlated with your history and examination. A scan is most helpful when interpreted alongside the full clinical picture.
Can I keep playing sport with low back pain?
Most adults can. Adolescents with persistent pain in extension-heavy sports should be assessed for pars bone stress injury before continuing.
