Back Pain: When You Should Worry and What You Should Do

Jess Mcdonald

Jul 10, 2025

4 min read

Updated: Nov 2

Back pain is the leading cause of disability worldwide, and around 4 million Australians live with it. While it can significantly affect your day-to-day life, the reassuring news is that most back pain is not serious.

In around 90% of cases, low back pain is 'non-specific', meaning there isn't a single identifiable structure to blame, and it's not a sign of serious disease. At MOVE Sports Physiotherapy & Pilates in Geelong, we'll help you understand when you should be concerned and what steps to take to recover.

When Should You Worry About Back Pain?

Serious causes of back pain are rare (around 1% of cases), but it's important to recognise the warning signs. Seek urgent medical care if you have back pain with:

Numbness around your groin, genitals or buttocks (saddle area).
New bladder or bowel problems, such as difficulty passing urine, loss of control or reduced sensation.
Progressive weakness in one or both legs.
Fever, chills or feeling generally unwell.
Significant trauma, such as a fall or accident, or a minor fall if you have osteoporosis.
A history of cancer with new back pain.
Unexplained weight loss.

Pain at night on its own is common and usually not a sign of anything serious, but constant, unrelenting night pain alongside other symptoms should be checked. If you're unsure, it's always best to get assessed.

10 Myths About Back Pain

Many beliefs about back pain cause unnecessary worry. These facts are drawn from current research and international guidelines.

Myth 1: Back pain is usually a serious medical condition

Fact: Back pain is rarely dangerous. Most people recover well, and staying active helps.

Myth 2: Back pain will only get worse as you age

Fact: There's no evidence that back pain inevitably worsens with age. Most episodes improve, especially with the right management.

Myth 3: Persistent back pain always means tissue damage

Fact: Ongoing pain is influenced by many factors, including fear of movement, sleep, stress, mood and how protective our movement becomes. Pain is real, but it isn't a reliable measure of damage.

Myth 4: You need a scan to find out what's wrong

Fact: Scans rarely change treatment for back pain and are only needed when a serious cause is suspected. 'Abnormal' findings are extremely common in people with no back pain at all. For example, disc degeneration is found in over a third of 20-year-olds and most people over 60 without symptoms.

Common MRI findings in people with no back pain

Myth 5: Pain with exercise means you're harming your back

Fact: When you start moving again, your back may be sensitive. This is normal and doesn't mean harm. Gradual, controlled movement and exercise improve pain and function over time.

Myth 6: Poor posture causes back pain

Fact: Research has not found that sitting, standing or lifting posture causes back pain. Comfortable, varied postures and regular movement matter more than finding the 'perfect' position.

Myth 7: A weak core causes back pain

Fact: A weak core is not the cause of back pain. Many people with back pain actually brace their trunk too much. Strength training is helpful, and so is learning to relax and move freely.

Myth 8: Repeated loading causes 'wear and tear'

Fact: Your spine is strong and adapts to load. Progressive loading, like lifting and exercise, builds resilience.

Myth 9: Flare-ups mean damage

Fact: Flare-ups are more often linked to changes in activity, stress, sleep or mood than to new damage. Staying active and calm helps them settle.

Myth 10: Strong medication or surgery is usually needed

Fact: Guidelines, including the World Health Organization's 2023 guideline, recommend education, exercise and staying active as first-line care. Strong opioid medications are not recommended for most back pain, and surgery is needed only in a small number of cases.

When Should You See a Back Pain Physio?

Many episodes settle with self-care, but a physiotherapist can make a significant difference, especially if pain is persisting or recurring. At MOVE, we use Cognitive Functional Therapy (CFT), an approach shown in the large RESTORE trial (The Lancet, 2023) to produce large, lasting improvements for people with persistent back pain.

Thorough assessment: Understanding your pain, movement, beliefs and the factors that contribute to it.
Making sense of pain: Clear explanations that reduce fear and build confidence.
Personalised exercise program: Progressive, meaningful exercises to restore movement and strength.
Reducing flare-ups: Strategies to manage setbacks and increase the time between episodes.
Long-term management: A structured plan to get you back to the activities you value.

Do you need to go to hospital for back pain?

In most cases, no. However, if you have any of the red flags listed above, seek medical attention immediately. For most people, a physiotherapist can provide the care and support needed to get back to full health.