Lower Back Pain and Why Rest Isn't The Answer
What is Low Back Pain?
Low Back Pain (LBP) affects everyone differently. For some people, it is an occasional ache or discomfort, while for others, it can be more persistent or intense. It can start after an injury or trauma, after lifting something heavy at work, for example, or sometimes it can seem to appear for no obvious reason at all. It may last a few days, or it may persist for months or even years. Equally, pain and disability can often persist after a flare-up (World Health Organization, 2023).
Low back pain isn’t one single condition. Instead, it’s a symptom that can have many different causes and contributing factors.
The first important step is always to make sure there isn’t a more serious cause of your pain (Wirth, 2024). Fortunately, this is very uncommon. However, if you’re worried about your symptoms, it’s always a good idea get booked in with a healthcare professional who can assess you properly.
Around 90-95% of people with low back pain are diagnosed with what we call non-specific low back pain (NSLBP). This simply means there isn’t one specific structure, such as a muscle, disc or joint, that can be confirmed as the definite cause of pain (World Health Organization, 2023). This can sound demoralising, but is actually very normal. What we know is that many people can have changes that appear on scans, including signs of aging in the lower spine, or disc bulges, even though they have no back pain whatsoever. Conversely, other people experience significant low back pain, even though their scans appear normal. This shows us that pain is much more complex than what we can see on a scan (Institute for Quality and Efficiency in Health Care [IQWiG], 2025).
Pain isn’t only influenced by what’s happening mechanically in your back. Factors such as lack of sleep, stress, anxiety and general fitness can all influence how sensitive your nervous system becomes in response to pain. This means there are many different factors that can contribute to worsening your back pain (Wirth, 2024).
How can we manage low back pain, and why isn’t rest the answer.
We can completely appreciate that pain is very real, and it’s understandable to want to rest. Most people worry that movement will make things worse, so avoiding activity often intuitively feels like the safest thing to do. Patients commonly have negative connotations towards exercising with back pain and can become avoidant of certain activities, particularly when pain has been present for years.
But we are here to MYTH BUST! For most people with non-specific low back pain, exercise and physiotherapy are recommended as first-line treatments for low back pain (NHS, 2023).
We know that gentle movement can help you to maintain function, as well as help settle the nervous system and reduce some pain (Institute for Quality and Efficiency in Health Care [IQWiG], 2025). Gentle movement is safe and shouldn’t cause additional harm. In fact, gradually returning to normal movement is one of the best ways to support your recovery. While moderate rest can be helpful for a day or so during a severe flare-up, it is actually recommended to avoid bed rest (Knezevic, 2021; Wirth, 2024). Staying in bed can slow your recovery as your supporting muscles can weaken, your joints can stiffen and your nervous system can become more sensitive to movement. In contrast, normal activity maintains strength, confidence and your ability to function in everyday life.
So, if exercise, what exercise?
The best exercise is the one you’ll do! That could include walking, swimming, yoga, dancing or gardening. As long as the activity is appropriate for you, anything that gets you moving can be beneficial for your lower back pain (Institute for Quality and Efficiency in Health Care [IQWiG], 2025).
We encourage our patients to find activities that they enjoy and will be motivated to take part in. Whether that means returning to work, going for walks, getting back to a favourite hobby or simply staying active throughout the day, finding something that you enjoy and can do consistently is what’s going to make all the difference.
References
Institute for Quality and Efficiency in Health Care (IQWiG). (2025, December 16). Overview: Low back pain. In InformedHealth.org. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK284941/
Knezevic, N. N., Candido, K. D., Vlaeyen, J. W. S., Van Zundert, J., & Cohen, S. P. (2021). Low back pain. Lancet (London, England), 398(10294), 78–92. https://doi.org/10.1016/S0140-6736(21)00733-9
NHS. (2023, October 18). Back pain. https://www.nhs.uk/conditions/back-pain/
Wirth, B., & Schweinhardt, P. (2024). Personalized assessment and management of non-specific low back pain. European journal of pain (London, England), 28(2), 181–198. https://doi.org/10.1002/ejp.2190
World Health Organization. (2023, June 19). Low back pain. https://www.who.int/news-room/fact-sheets/detail/low-back-pain