October 6, 2020

Many people suffer back pain at some point in their lives, but very rarely is there a serious cause, and most people will recover quickly.

Have you ever felt like you couldn’t move because of low back pain? You’re not alone. Four out of five people experience low back pain at some point in their lives1.

Macquarie University Faculty of Medicine, Health and Human Sciences Dr Hazel Jenkins says even a simple muscle strain can be extremely painful, but that does not mean you will have ongoing back pain.

Minor back injuries can be incredibly painful

“Many people experience a lot of pain with low back injuries, but this does not mean there is any damage in their back. Lots of research shows that strong pain does not equal a bad injury” Dr Hazel Jenkins said.

Most people will experience a significant improvement in their low back pain in the first four to six weeks following an injury2.

Half of these will go on to get further episodes of low back pain throughout their life. “Recurrence is common and does not mean that there is greater reason for concern” Dr Hazel Jenkins said. There is evidence that regular exercise can reduce the risk of recurrences.

For most people recurrent episodes of back pain only last a few days and will settle down without major intervention. Remaining relatively active during an episode of back pain is the best thing you can do.

Don’t rush into imaging

Imaging (eg. X-Rays, CT or MRI scans) doesn’t usually help find the cause of pain. “The treatment and speed of recovery for most cases of back pain is the same whether imaging is used or not” Dr Hazel Jenkins said.

Imaging often reveals changes in your back that may cause stress, anxiety and worry, even though they are usually unimportant.
“Most of the changes seen on imaging are normal age related changes and are more common the older you get. People without low back pain commonly have these same changes” Dr Hazel Jenkins said.

Serious causes of low back pain (such as cancer or infection) are very rare. Less than 1 in 100 people have a serious cause for their low back pain. Your GP, physio or chiro will check for signs of a possible serious cause for low back pain and send you for appropriate management, including imaging if needed.

“Imaging for simple low back pain – where no signs of a serious cause can be found – tends to be associated with worse outcomes and higher levels of unnecessary surgery3. ” Dr Hazel Jenkins said.

Stay as active as possible

Your treatment provider will give you advice and information about managing your low back pain.
Activity can help keep your back mobile, flexible and strong. Movement, even if it causes temporary mild pain, is good for your back.

“You may need to take it easier for a few days, but the best thing you can do is get back to your normal activities as soon as possible. Normal activities include your regular work, household and recreational activities” Dr Hazel Jenkins said.

Lifestyle factors may also be associated with low back pain. “Try to stay positive and take steps towards a healthier lifestyle. You might find it helpful to address poor sleep patterns and consider changes to diet, alcohol intake and smoking.”


Who to contact if you experience back pain

  • Your Manager or Human Resources department
  • Your GP

If you have an accepted claim for a work-related injury, speak with your EML case manager about your treatment options.


Check out the video series Pain after an injury for insights into the science of pain, treatment and recovery, available at eml.com.au/resources/spotlight-pain-after-an-injury

Macquarie University researcher and lecturer, Dr Hazel Jenkins, is a chiropractor and completed her PhD on the appropriate use of imaging for low back pain. She is currently leading a research team, including physiotherapists, radiologists and general practitioners from Macquarie University to reduce unnecessary imaging in the management of low back pain.

Download a digital copy of “Understanding my low back pain and whether I need imaging” booklet from Macquarie University


[1] Manchikanti (2000) Epidemiology of Low Back Pain. Pain Physician 3(2) 167 – 192. Accessed online 8 July 2020, https://pdfs.semanticscholar.org/1b6b/783b74d0202c5dbcd8c9f7ef9ffa9ae89a63.pdf

[2] Pengel LH, Herbert RD, Maher CG, and Refshauge KM (2003) Acute low back pain: systematic review of its prognosis. BMJ (Clinical research ed.), 327(7410), 323. https://doi.org/10.1136/bmj.327.7410.323

Gurcay E, Bal A, Eksioglu E, Esen Hasturk A, Gurhan Gurcay A, and Cakci A (2009) Acute low back pain: clinical course and prognostic factors. Disability and Rehabilitation, 31:10, 840-845, DOI: 10.1080/09638280802355163

Abbott J, Mercer S (2002) The Natural History of Acute Low Back Pain. New Zealand Journal of Physiotherapy 30,3 8-16.

[3] Webster, Barbara S. BSPT, PA-C; Cifuentes, Manuel MD, MPH, ScD Relationship of Early Magnetic Resonance Imaging for Work-Related Acute Low Back Pain With Disability and Medical Utilization Outcomes, Journal of Occupational and Environmental Medicine: September 2010 - Volume 52 - Issue 9 - p 900-907 doi: 10.1097/JOM.0b013e3181ef7e53

Webster, Barbara S., BSPT, PA-C*; Bauer, Ann Z., MPH†; Choi, YoonSun, MA*; Cifuentes, Manuel, MD, MPH, ScD*,†; Pransky, Glenn S., MD, MOccH* Iatrogenic Consequences of Early Magnetic Resonance Imaging in Acute, Work-Related, Disabling Low Back Pain, Spine: October 15, 2013 - Volume 38 - Issue 22 - p 1939-1946 doi: 10.1097/BRS.0b013e3182a42eb6

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