The NHS is known for its world-class healthcare provision. But with increasing waiting times, fewer staff, and ongoing disruption from the Covid-19 pandemic, it’s become more difficult for patients to access NHS care for low back pain [1-2].
But back pain is a serious issue. The NHS estimates lower back pain alone is the reason for 11% of disabilities in the UK [3]. And referral waiting times for the necessary treatment are growing year-on-year. As a result, more patients are looking to private healthcare providers like Harley Street Specialist Hospital to alleviate their back pain.
So can the NHS help with your lower back pain, and, if so, which back and spine treatments can you expect? Here, you’ll learn which treatments for low back pain are available on the NHS, and what you can do if these aren’t accessible to you.
Can the NHS help with lower back pain?
If you have sudden or severe back pain with an obvious cause (for example, you’ve been in a car accident or had a specific injury), the NHS can often provide treatment for your symptoms. And even if lower back pain doesn’t have a clear cause, they will be able to recommend some first-line treatments to help you manage your pain. These include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) — Ibuprofen is available over the counter, but your GP may be able to prescribe a higher strength NSAID if needed.
- Physiotherapy — Physiotherapy is often effective for managing low back pain, but NHS waiting lists can be very long.
- Home exercises — Stretches, Pilates, and other exercises for low back pain may be suggested to strengthen your back muscles.
However, if you have non-specific low back pain such as lower back pain when standing, there’s usually only so much the NHS can do, particularly if you’re relatively young. That’s because low back pain can sometimes resolve itself without treatment [3].
What treatments can the NHS offer for back pain?
In some cases, general or undiagnosed low back pain becomes chronic, with physiotherapy and anti-inflammatories only providing limited relief. So what can the NHS do to help in these cases?
- Group exercise sessions — You may be invited to join groups focused on rehabilitative exercise for low back pain.
- Manual therapy — Massage therapy and other types of manual manipulation can improve back pain symptoms. Massage for sciatica, for example, can be beneficial
- Cognitive behavioural therapy — CBT is a type of talking therapy that can help you cope better with pain.
- Certain types of injections for back pain — Injections to relieve pain or seal off nerve endings may be recommended for long-term back pain. NHS cortisone injections are sometimes available.
- Back surgery — A herniated disc may require surgery if it continues to cause pain after non-surgical treatments have been exhausted.
These treatments may work, but they are often difficult to get on the NHS. Waiting lists are long, treatment courses are short, and you’ll need to exhaust all previous options before advanced treatments like steroid injections or nerve sealing procedures are offered.
Lower back pain and other symptoms: what do they mean?
If you have multiple symptoms — such as low back pain alongside stomach or groin pain — your GP may be able to diagnose you with an underlying health condition. In these cases, it may be easier to get NHS treatment for low back pain.
This chart shows some of the possible diagnoses for lower back pain alongside other symptoms. Bear in mind that these aren’t the only possibilities, so get advice from a doctor to discuss your specific symptoms.
Possible condition(s) | Stomach pain | Buttock pain | Groin/testicular pain | Bloating | Diarrhoea |
---|---|---|---|---|---|
Pulled muscle (strain) | X | ||||
Sciatica | X | X | |||
Piriformis syndrome | X | ||||
Spinal stenosis | X | ||||
Cauda equina syndrome | X | ||||
Pregnancy/labour | X | ||||
Pancreatitis | X | ||||
Trapped wind | X | ||||
Irritable bowel syndrome | X | X | X | ||
Appendicitis | X | X | |||
Kidney stones | X | X | |||
Ovarian cyst | X | X |
NHS lower back pain exercises and physiotherapy
There are several exercises the NHS recommends for treating low back pain. These are normally designed to [5-6]:
- Strengthen your back and core — Muscles in the back and abdomen must be strong to support your spine and help you maintain a good posture.
- Heal tissue around the spine — Exercise promotes blood flow and encourages healing around your affected joints.
- Promote a positive mindset — Regular exercise releases endorphins to make you feel more positive about your condition, helping you cope with the pain.
- Prevent joint stiffness — Stop your spinal joints and back muscles getting stiff with regular stretches.
Here are three commonly recommended lower back pain exercises from the NHS.
1. Bridge pose
Bridge pose is a good way to strengthen your glutes, providing your low back with a stronger base. Lie on your back with your legs bent and your feet flat on the floor. Slowly lift your pelvis and spine off the ground and hold them in a diagonal line from your head to your knees. Hold for several seconds, then lower the spine and pelvis with control.
2. Knee rolling
Start in the same position as for bridge pose. Draw your stomach muscles in, then move your knees from side to side. This is a helpful pose if you have spinal stenosis.
3. Pilates
Pilates consists of lots of different exercises designed to strengthen your core and back muscles. It’s ideal for those who have been advised to strengthen and tone the abdominal and core muscles to provide extra spine stability.
What is the best thing for lower back pain?
The best things you can do to treat lower back pain include:
- Getting a diagnosis — Many cases of low back pain are non-specific, but you may be able to pinpoint a direct cause with diagnostic imaging and other tests. This can help you find an appropriate, effective treatment more quickly.
- Staying active — Unless your doctor has advised you otherwise, it’s best to keep moving despite lower back pain. Bed rest can make your joints stiffen up and lead to muscle weakness.
- Talking to a back pain specialist — While your NHS GP can give you good advice around first-line treatments, chronic or relentless back pain should be tackled by a back pain specialist. At Harley Street Specialist Hospital, you can access advice and support from the UK’s largest pool of pain management specialists.
- Don’t ignore back pain red flags — If you have numbness around your genitals or buttocks, shooting pains in both legs, or loss of bladder/bowel control alongside low back pain, seek immediate medical attention.
Alternatives to NHS care for low back pain
Many patients turn to private healthcare when they have low back pain, due to the limited resources of the NHS. Private back pain care means you can get seen more quickly — at Harley Street Specialist Hospital, we can often assess, diagnose, and treat your back or spine condition the same day.
Book an appointment at our London back pain clinic to get a diagnosis for your low back pain.