back pain that comes and goes

Overview

Back pain that comes and goes means you have episodes of pain in your back that may last for a few days or weeks, then ease or disappear, and later return. It can range from a dull ache to a sharp, stabbing feeling, and it is usually related to the muscles, ligaments, joints, or discs in the spine.

Yes. Back pain is one of the most common health issues. Around 7 in 10 people will experience back pain at some point in their lives.

Back pain can affect anyone at any age, but it becomes more common after age 30. It tends to affect more people who have physically demanding jobs, who sit for long periods, or who have low levels of physical activity.

Symptoms

Common symptoms

• A dull ache or sharp pain in the lower, middle, or upper back
• Pain that comes and goes, sometimes better with rest or gentle movement
• Stiffness in the back after sitting or lying down for a while
• Pain that gets worse with certain movements, like bending, lifting, or twisting
• Occasional pain that spreads into the buttock or leg (sometimes called sciatica)

Symptoms in children

• Back pain in children is less common than in adults
• It may be caused by muscle strain from heavy school bags, sports, or poor posture
• If a child has back pain, it is wise to have them checked by a doctor, especially if it lasts more than a few days or gets worse

Symptoms in older adults

• Pain may come from age-related changes in the joints, such as osteoarthritis
• It may be related to weaker muscles or thinning bones
• Pain often eases with rest and returns with activity
• Regular gentle movement and a healthy lifestyle can help keep the back strong

Causes

Main causes

• Muscle or ligament strain from heavy lifting, twisting, or overuse
• Poor posture or prolonged sitting or standing
• Disc problems, such as a bulging or degenerating disc in the spine
• Osteoarthritis of the spine, which affects the joints between the vertebrae
• Spinal stenosis, a narrowing of the space around the spinal cord
• Stress and tension, which can make the back muscles feel tight or painful

Risk factors

• Being over 30 years old
• Being overweight or having excess abdominal weight
• Having a physically demanding job
• Sitting at a desk for long hours without breaks
• Lack of regular exercise or poor core muscle strength
• Smoking, which may affect blood flow to the spine
• Stress, anxiety, or depression

When to see a doctor

See a doctor urgently if:

• If you lose control of your bowel or bladder
• If you feel numbness in your groin or between your legs
• If you have weakness in both legs or difficulty walking
• If back pain comes with a fever or chills

Book a routine appointment if:

• If the pain lasts longer than two to three weeks
• If the pain gets worse despite rest and simple pain relief options
• If the pain is severe enough to interrupt your normal life
• If you have tingling, numbness, or weakness in your legs or feet
• If you have a history of cancer and develop new back pain

Diagnosis

Your doctor will ask about your symptoms, how the pain started, and what makes it better or worse. They will also examine your back, check your posture, and test your strength and reflexes. For most episodes of recurring back pain, no special tests are needed at first.

Tests that may be done

• X-rays to look at the bones in your spine
• MRI or CT scans, if there are nerve problems or warning signs
• Blood tests, if an infection or inflammation is suspected
• Nerve conduction tests or electromyography (EMG) to check nerve function, if nerve damage is suspected

What to expect at your appointment

Your doctor will explain what might be causing the pain, reassure you about the likely good outcome, and give you advice on staying active. They may refer you to a physiotherapist or another specialist if your symptoms are persistent or complex.

Treatment

The main goals are to relieve pain, keep you moving, and reduce the chance of future episodes. Most back pain that comes and goes can be managed without surgery.

Self-care at home

• Keep moving with gentle activities like walking, swimming, or cycling
• Apply a heat pad or a cold pack to the painful area for short periods in the early days
• Try to keep a normal routine as much as possible
• Practice good posture when sitting and standing
• Ask your pharmacist about pain relief options suitable for you

Medical treatments

Your doctor or physiotherapist may suggest hands-on treatments such as manual therapy, massage, or acupuncture. They may also recommend a structured exercise programme. For short periods, they might offer prescription medicines to relax muscles or reduce nerve pain, but always under supervision. In certain cases, a spinal injection can reduce inflammation and relieve pain.

When is surgery considered?

Surgery is rarely needed for back pain that comes and goes. It may be considered only if you have severe nerve compression, a spinal fracture, or if the pain lasts for months despite trying other treatments. Your specialist will discuss all options with you.

Living with this condition

Try to pace yourself during the day. Avoid staying in one position for too long, take short breaks if you sit at a desk, and change your position often. When lifting, use your legs and keep your back straight. Listen to your body and rest briefly if you need to, but try not to stay inactive for long.

Lifestyle tips

• Build regular physical activity into your week
• Reach and maintain a healthy weight to reduce strain on your back
• Stop smoking to improve blood flow and spine health
• Manage stress with relaxation techniques, hobbies, or talking with friends
• Use a supportive mattress and pillow

Diet and exercise

A balanced diet rich in calcium and vitamin D supports bone health. Regular low-impact exercise such as walking, swimming, and gentle strengthening exercises can improve muscle support around the spine. Stretching and core-strengthening exercises like yoga or Pilates may also help.

Mental health and emotional wellbeing

Living with recurring pain can be frustrating and tiring. It can affect your mood, sleep, and energy. It is normal to feel that way. Acknowledging these feelings and seeking support can make a difference. Stress and worry can also make pain feel worse, so finding ways to relax is important.

Prevention

You cannot always prevent back pain, but you can reduce how often it comes back. Keep a good posture, use safe lifting techniques, stay active, avoid long periods of inactivity, and work on strengthening your core and back muscles. A healthy weight and not smoking also lower risk.

Complications

If left untreated

• Recovery may take longer or the pain may become chronic (lasting more than three months)
• Reduced activity can lead to muscle weakness and stiffness
• Daily activities, work, and sleep can be affected
• In rare cases, an underlying problem that is not treated could worsen

Long-term outlook

Most people with back pain that comes and goes improve significantly within a few weeks. Even if episodes return, learning how to manage triggers and staying active usually leads to a good long-term result. There are many effective treatments available to help you get back to the things you enjoy.

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