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Health education · Back painMusculoskeletal health
Pain in the lower back can be intense and limit movement. It can stay in one place or travel down a leg. These symptoms do not all point to the same problem.
In most cases, without warning signs, low back pain improves within a few weeks with appropriate care and without imaging.2
The terms
| Term | What it means |
|---|---|
| Low back pain | Pain in the lower back, with or without pain in a leg.2 |
| Sciatica | Pain caused by involvement of a nerve root that is part of the sciatic nerve. It follows the nerve and can travel down the leg, sometimes to the lower leg.2,5 |
| Herniated disc | A tear in the outer layer of a disc between the vertebrae, letting part of its contents push out. It can irritate a nerve root, but it often causes no symptoms.5 |
Pain that travels down the leg is not enough, on its own, to confirm sciatica or a herniated disc. The exam helps tell the causes apart.
Causes
Pain can start after an effort, a movement, a fall or a long time in the same position. It can also appear with no obvious trigger.
Non-specific low back pain is when no underlying disease is found to explain the pain. It is the most common situation, and the outlook is usually good.2
The assessment mainly aims to understand how the back is working, the limitations and the signs that would call for specific tests.
A herniated disc or a narrowing of the spinal canal, called stenosis, can irritate or compress a nerve root.5,4
The pain may then come with tingling, numbness or weakness in the leg.5
Symptoms
Low back pain can cause pain, stiffness or difficulty moving.
New or worsening weakness, loss of sensation or numbness deserve a prompt assessment. This is all the more important if the weakness is getting worse.2
According to Santé Québec, see a professional in particular if:1
Go to the hospital without waiting if back pain comes with, among other things:1
Severe nerve compression, such as cauda equina syndrome, or serious or progressive neurological involvement needs urgent care.2,4
In immediate danger, call 911. For guidance based on your symptoms, call Info-Santé at 811, option 1.1
Assessment
The professional looks at how the pain started, where it travels, the movements that change it and its impact on activities. Medical history, treatments already tried and warning signs guide the next steps.2
The exam may include assessing:
Imaging
Not routinely. Without warning signs, imaging is not recommended for low back pain, even when pain travels down the leg.2,4
It becomes relevant if a serious condition is suspected (fracture, infection, cancer, cauda equina syndrome), if neurological involvement is significant or progressing, or if a herniated disc or stenosis persists after at least six weeks of treatment and a procedure is being considered.4
Images often show changes in the spine that cause no symptoms, such as a bulging disc. This is even more common with age.5
A visible abnormality should therefore not be interpreted on its own. It must match the symptoms and the exam. Without a reason, imaging changes neither the care nor the outlook, and it can reveal findings with no clinical meaning.2
Recovery
Strict bed rest does not help relieve low back pain.2,5 Suitable exercise is at the heart of recovery.2
Short walks, cycling or swimming, and a gradual return to daily tasks, as pain allows. Lie down only to sleep.1
Keep the same position for no more than 20 to 50 minutes at a time. Lying down, pillows under the knees or between the legs can help.1
Heat can relieve the back.6,5 So can cold: 15 to 20 minutes every 2 to 3 hours.1 Always protect the skin with a cloth.
A suitable exercise program, with a physiotherapist’s help if needed, helps you regain movement and progress.2,5
Do not lift objects that are too heavy for your current abilities.1
If an exercise causes or worsens pain, stop and ask for advice rather than forcing it.5
Medications
Medications can complement physical measures and the return to activity. Acetaminophen or ibuprofen can reduce pain.1 Anti-inflammatories are often offered first for low back pain.2,6
Anti-inflammatories are not suitable for everyone, however: they can cause digestive side effects (such as bleeding), affect kidney function and, at high doses over long periods, increase cardiovascular risk.7 The lowest possible dose for the shortest possible time is recommended.7
Ask your pharmacist or a professional before starting or combining medications.1,7 The choice depends on the type of pain, medical history and risks, and the treatment should be reassessed.3
Duration
The outlook is usually good: most low back pain resolves in about six weeks.2,5 Recovery varies with the situation, however, and symptoms can fluctuate.
Symptoms of a herniated disc also tend to decrease over time. After one to two years, people treated with or without surgery recover to about the same degree.5
Having a herniated disc therefore does not automatically mean surgery is needed.5
Persistent pain
Pain lasting more than 12 weeks is considered persistent or chronic; between 6 and 12 weeks, it is called subacute.2 It can affect activities, work, sleep and social life.
Care may then require several approaches and coordinated follow-up.3 It is still possible to work on function, independence and quality of life.
A musculoskeletal health consultation makes it possible to assess your pain and suggest a suitable plan: advice for temporarily adapting some activities, exercises and referral to physiotherapy, medication when relevant, an injection for certain indications or referral to a specialist.
If you have warning signs, such as loss of control of urine or stool, go to the emergency room without waiting.
This sheet provides general information and does not replace an assessment by a health professional. Published October 29, 2026.
