--- title: "Your back’s just gone. What to do in the first 48 hours" id: "8874" type: "post" slug: "back-just-gone-what-to-do-first-48-hours" published_at: "2026-11-04T01:06:21+00:00" modified_at: "2026-11-04T01:06:21+00:00" url: "https://www.allforone.com.au/back-just-gone-what-to-do-first-48-hours/" markdown_url: "https://www.allforone.com.au/back-just-gone-what-to-do-first-48-hours.md" excerpt: "Your lower back has seized up. What to do in the first 48 hours, whether you need a scan, when to get urgent help, and how to stop it coming back." taxonomy_category: - "All in" --- Physio · 8 minute read You bent down for the washing basket and something in your lower back grabbed. Now you’re stuck halfway, breathing through your teeth and working out how you’ll ever reach the couch. It feels catastrophic, and it almost never is. ### The short version - Fewer than 5% of people with low back pain have something serious going on, and most new flare-ups settle quickly. - Keep moving gently, even while it hurts. Rest for a day or two at most, because long stretches in bed can slow your recovery. - A few signs need urgent help: trouble passing urine or controlling your bladder or bowels, numbness between your legs, or new weakness in your legs. Your back rarely goes during something impressive. You’d at least have a story if it happened on a ski slope. It goes while you’re picking up a sock, lifting a toddler out of the car seat or reaching for the dog’s bowl, and then you lie on the floor wondering how a sock did this to you. You’ve got company on that floor. About 8 in 10 Australian adults have had low back pain at some point. The first thing most people want to know is whether they’ve done something terrible. Usually they haven’t. ## Why it hurts so much The muscles around your back can spasm, which is why you can feel locked in place, and the pain can feel far bigger than the problem. It’s real pain, and it’s also a poor guide to how much damage there is, because a sharp flare during a movement doesn’t mean you’ve hurt anything new. Of 1,172 people in Sydney who saw a health professional for new back pain, just 0.9% had something serious. Your back is more likely to go when you’re tired, distracted, in an awkward position or holding something heavy, and mornings are the worst. That comes from a study of 999 people in Sydney. So if you were rushing the school bags out the door on four hours’ sleep, your back may have had a point. ## What to do in the first 48 hours 1. 1**Get comfortable first**Some people find it easier lying on their side with a pillow between the knees, or on their back with pillows under the knees. 2. 2**Then get up, little and often**Walk to the kitchen and back, then do it again a bit later. You don’t need to wait for all the pain to go before you move, and staying active is the best way to recover. 3. 3**Try some heat**A heat pack or wheat bag can take the edge off for a while. Wrap it in a towel so you don’t burn your skin. 4. 4**Keep your day as normal as you can**Go to work if you’re able to and do the school run. It’s fine to swap out the things that hurt most for a few days, like heavy lifting. 5. 5**Ask your pharmacist about pain relief**The point of medicine here is to turn the pain down enough to keep moving. Paracetamol on its own did no better than a dummy tablet for new back pain in a big Australian trial of 1,652 people. Anti-inflammatories help only a little. Opioids aren’t usually recommended. A pharmacist or GP can tell you what’s safe for you. 6. 6**See a physio early if you can**You don’t have to wait it out. A physio can check for warning signs, explain what’s going on and show you which movements to start with, which makes the first few days a lot less frightening. [Book a physio appointment](https://www.allforone.com.au/book-appointment/) ## Do you need a scan? Most people don’t. Without warning signs, a scan done early doesn’t help people get better any sooner. When researchers pooled the scans of 3,110 people with no back pain at all, 30% of 20-year-olds had a disc bulge, and by 80 it was 84%. Think of them as grey hairs on the inside. A physio or GP can examine you and work out whether you need a scan. ## Why you can stop being scared of bending Lots of us grew up being told to lift with a straight back, and after one bad episode it’s easy to start moving like you’re made of glass. There isn’t much behind that rule. People with and without back pain bend much the same way when they lift, at least in 9 of 11 studies. They weren’t great studies, so we can’t be certain, but a rounded back at the washing basket looks a lot less dangerous than we were taught. The exception is osteoporosis or a past spinal fracture, where loaded forward bending isn’t recommended, so ask your physio what suits you. ## How to make it less likely to come back Once the pain goes, life rushes back in and you forget about your back until it goes again. In one study, 69% of people had it happen again within a year, and for 40% it was bad enough to limit what they could do. **Keep moving after it stops hurting.** Exercise has the best record of anything at keeping back pain away. **Walk.** Of 701 Australians who’d just recovered, most of them women with an average age of 54, those on a physio-guided walking and education program typically went 208 days before back pain next got in the way of their day, against 112 days without it. **Build some strength.** Doing some strength work two or three times a week, with a bit of stretching or cardio mixed in, seems to mean fewer flare-ups. **Get a plan from a physio.** Once the pain has settled, a physio can look at how you move, work out what might be setting it off and build you a program that fits your week. ## The takeaway Give yourself a few minutes on the floor, then get moving a little at a time, even if it’s only as far as the kettle. Your back is almost certainly less damaged than it feels, and gentle movement is what helps most. ### When to get help **Call 000** if you lose feeling or movement in your legs, can’t pass urine, can’t control your bladder or bowels, have numbness between your legs or around your genitals, have trouble breathing, or your back pain follows a serious accident. **Get urgent medical care** if you have new weakness in your legs, trouble passing urine, a fever above 38 degrees, or severe pain that keeps getting worse instead of better. **See a doctor as soon as you can** if you’ve had cancer, have osteoporosis, take long-term steroids, get infections easily, or are losing weight without trying. **Book a physio** if it isn’t settling, if it keeps coming back, if you’ve become nervous about moving, or if you get a numb patch, pins and needles or pain spreading down your leg. Back still grumbling? One of our physios can look at how you’re moving, talk you through what’s going on and work out what to do next. [Book a physio appointment](https://www.allforone.com.au/book-appointment/) ## Common questions ### Should I use heat or ice? Heat has the better evidence. There isn’t enough research on cold to say either way. ### Should I stay home from work? If you can get there, staying active usually helps more than staying in bed. ### Is it a slipped disc? Discs don’t slip out of place. Bulges are common, including in people with no pain at all. A physio or GP can check whether a nerve is involved. ### Can I still go to my class? Gentle movement is a good idea. Tell your teacher what’s going on, and check with your physio if you’re unsure. ### Why does it keep happening? Back pain often comes back, and a repeat doesn’t mean something is wrong with your spine. ### Keep reading - [Pain Is Not Damage](https://www.allforone.com.au/pain-is-not-damage/) - [Sit however you like, as long as you get up often](https://www.allforone.com.au/the-posture-myth-why-sitting-up-straight-isnt-the-whole-story/) - [Your first strength class: what to expect](https://www.allforone.com.au/your-first-strength-class/) **General information only.** This article is general information, not advice for your situation. If you’re worried about your back, or have any of the warning signs above, see your GP, physio or another health professional. ### Sources - Australian Commission on Safety and Quality in Health Care. [Low Back Pain Clinical Care Standard](https://www.safetyandquality.gov.au/standards/clinical-care-standards/low-back-pain-clinical-care-standard) , 2022. - Healthdirect Australia. [Back pain](https://www.healthdirect.gov.au/back-pain) and [Low back pain](https://www.healthdirect.gov.au/lower-back-pain) . - Better Health Channel, Victorian Government. [Back pain](https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/back-pain) . - Hartvigsen J and others. [What low back pain is and why we need to pay attention](https://pubmed.ncbi.nlm.nih.gov/29573870/) . The Lancet, 2018. - Walker BF and others. [Low back pain in Australian adults: prevalence and associated disability](https://pubmed.ncbi.nlm.nih.gov/15148462/) . Journal of Manipulative and Physiological Therapeutics, 2004 (lifetime prevalence 79.2%). - Henschke N and others. [Prevalence of and screening for serious spinal pathology in patients presenting to primary care settings with acute low back pain](https://pubmed.ncbi.nlm.nih.gov/19790051/) . Arthritis and Rheumatism, 2009. - Steffens D and others. [What triggers an episode of acute low back pain? A case-crossover study](https://pubmed.ncbi.nlm.nih.gov/25665074/) . Arthritis Care and Research, 2015. See also [Machado and others, 2016](https://pubmed.ncbi.nlm.nih.gov/27503263/) . - Dahm KT and others. [Advice to rest in bed versus advice to stay active](https://pubmed.ncbi.nlm.nih.gov/20556780/) . Cochrane Database of Systematic Reviews, 2010. - French SD and others. [Superficial heat or cold for low back pain](https://pubmed.ncbi.nlm.nih.gov/16437495/) . Cochrane Database of Systematic Reviews, 2006. - Williams CM and others. [Efficacy of paracetamol for acute low-back pain: a double-blind, randomised controlled trial](https://pubmed.ncbi.nlm.nih.gov/25064594/) . The Lancet, 2014. - van der Gaag WH and others. [Non-steroidal anti-inflammatory drugs for acute low back pain](https://pubmed.ncbi.nlm.nih.gov/32297973/) . Cochrane Database of Systematic Reviews, 2020. - Brinjikji W and others. [Systematic literature review of imaging features of spinal degeneration in asymptomatic populations](https://pubmed.ncbi.nlm.nih.gov/25430861/) . American Journal of Neuroradiology, 2015. - Chou R and others. [Imaging strategies for low-back pain](https://pubmed.ncbi.nlm.nih.gov/19200918/) . The Lancet, 2009. - Saraceni N and others. [To flex or not to flex? Is there a relationship between lumbar spine flexion during lifting and low back pain?](https://pubmed.ncbi.nlm.nih.gov/31775556/) JOSPT, 2020. - da Silva T and others. [Recurrence of low back pain is common: a prospective inception cohort study](https://pubmed.ncbi.nlm.nih.gov/31208917/) . Journal of Physiotherapy, 2019. - Steffens D and others. [Prevention of low back pain](https://pubmed.ncbi.nlm.nih.gov/26752509/) . JAMA Internal Medicine, 2016. See also [Shiri and others, 2018](https://pubmed.ncbi.nlm.nih.gov/29053873/) . - Pocovi NC and others. [Effectiveness and cost-effectiveness of an individualised, progressive walking and education intervention for the prevention of low back pain recurrence (WalkBack)](https://pubmed.ncbi.nlm.nih.gov/38908392/) . The Lancet, 2024.