Lower Back Pain: Common Causes and When to Get Help
By Nova Physical Therapy, an outpatient physical therapy clinic in North Hollywood, CA | Published October 2026
You bent down to pick something up, or you woke up stiff after a long week at your desk, and now your lower back hurts every time you move. It's one of the most common reasons people miss work, skip workouts, or search for answers online.
The reassuring news is that most lower back pain gets better, and the right kind of activity usually helps more than rest. This article explains common causes, what helps, what to avoid, and which signs mean you should see a doctor right away.
The short answer
Lower back pain is very common and usually improves within a few weeks, though it can sometimes last longer or come back (NHS). Most cases are linked to strain or irritation of the muscles, joints, and other tissues of the back rather than serious damage. Staying active is one of the best things you can do. For both short-term and long-lasting back pain, the American Physical Therapy Association's guideline recommends exercise, with hands-on treatment and education as helpful additions. In California, you can see a physical therapist without a referral.
Why does my lower back hurt?
Most of the time, there isn't one single structure to blame. Your lower back is made up of bones, discs, joints, muscles, and ligaments that all work together, and pain often comes from several of them being sensitive at once.
Common things that may be associated with lower back pain include:
• Muscle or ligament strain from lifting, twisting, or a sudden movement
• Doing more than your back is used to, like a weekend of yard work or a new workout
• Long periods of sitting or staying in one position
• Disc-related pain, which sometimes comes with pain down the leg (sciatica)
• Stress, poor sleep, and low activity, which can make the back more sensitive to pain
It's common to hear that a disc "slipped out" or a vertebra is "out of place." Those explanations are usually inaccurate and can make people afraid to move. Many changes seen on back scans, like disc bulges, are also common in people with no pain at all.
Less often, back pain is caused by something more serious, such as a fracture, infection, or cancer (NHS). That's why the warning signs below matter.
Should I rest or stay active?
For most people, staying active is better than bed rest. The NHS advises people with back pain to stay active and try to continue with their daily activities (NHS).
A few general tips help many people:
• Keep moving gently. Short walks and normal daily tasks are usually safe, even if they're a little uncomfortable.
• Change positions often. If you sit for work, stand up and move every 30 to 45 minutes.
• Try heat or cold. A wrapped heat pack can ease stiffness or muscle spasm, and a wrapped ice pack may help some people feel more comfortable.
• Ease back into heavier activity. Return to lifting, sports, or the gym gradually rather than all at once.
• Don't be afraid of your back. Hurting doesn't always mean you're causing harm.
Questions about pain medication, injections, or imaging are best directed to your physician.
How long does lower back pain last?
It varies. Many people with a new episode of back pain feel noticeably better within a few weeks. For others, pain lasts longer or comes and goes over months. Back pain that lasts more than about three months is usually called chronic, and it's still very treatable with an active approach.
Things that may slow recovery include long periods of rest, fear of movement, poor sleep, and high stress. Things that tend to help include staying active, building strength gradually, and understanding what's going on.
How can physical therapy help?
A physical therapist starts by finding out what's driving your pain and screening for anything that needs a physician. An evaluation may include:
• How your pain started and what makes it better or worse
• How you bend, lift, sit, stand, and walk
• Strength and flexibility of the back, hips, and legs
• A check of nerve function in the legs, when needed
• How pain is affecting your work, sleep, and activities
• Screening for signs that need a physician's evaluation
The APTA's 2021 low back pain guideline recommends exercise for both acute and chronic low back pain. It also supports manual therapy, meaning hands-on joint and soft tissue treatment, and education that helps people understand their pain and stay active (George et al., JOSPT 2021). There's no single best exercise for everyone; the right plan depends on your symptoms and goals.
A typical plan may include:
• Movement and mobility exercises to ease stiffness
• Strengthening for the trunk, hips, and legs, progressed over time
• Hands-on treatment, when it helps you move more comfortably
• Practice with the tasks that matter to you, like lifting, bending, or sitting at work
• A home program you can keep doing on your own
Physical therapy doesn't guarantee a specific result or timeline. But for most lower back pain, an active, exercise-based plan is the approach research supports most.
At Nova Physical Therapy in North Hollywood, back and neck pain is one of our core services, and every plan starts with an evaluation so treatment fits what we find.
When should I see a doctor?
Call 911 or go to the emergency room if back pain comes with (NHS):
• Numbness around your genitals, buttocks, or inner thighs
• New trouble controlling your bladder or bowels, or trouble starting to urinate
• Pain, tingling, weakness, or numbness in both legs
• Chest pain
• Back pain after a serious fall or car accident
These can be signs of a serious problem, such as pressure on the nerves at the base of the spine (cauda equina syndrome), that needs immediate care.
See a physician promptly if you have back pain along with:
• A fever or feeling generally unwell
• Unexplained weight loss
• A history of cancer
• Pain that's worse at night or doesn't ease with rest or changing position
• Leg weakness that is getting worse
• Pain that isn't improving after a few weeks of home care, or that stops you from doing daily activities
We screen for these signs during every evaluation and refer you to a physician when findings call for medical assessment.
Do I need a referral for physical therapy in California?
Not to get started. California allows direct access to physical therapy. A physical therapist can evaluate and treat you without a referral for up to 45 calendar days or 12 visits, whichever comes first. After that, a physician or podiatrist needs to sign the plan of care for treatment to continue. Your insurance plan may have its own referral rules, so check your coverage.
Frequently asked questions
Should I stay in bed if my back hurts?
Usually not. Staying active and continuing your daily activities as much as you can tends to help recovery more than bed rest.
Do I need an X-ray or MRI for lower back pain?
Most people don't need imaging for a typical episode of back pain. Imaging decisions are made by your physician, often when there are warning signs or symptoms aren't improving.
Is heat or ice better for back pain?
Either can help you feel more comfortable. Heat often helps with stiffness and muscle spasm. Use whichever feels better, wrapped in a towel to protect your skin.
Can sitting all day cause lower back pain?
Staying in any one position for a long time can make your back feel stiff and sore. Changing positions and moving regularly through the day often helps.
Why does my lower back keep hurting again?
Back pain often comes and goes. Staying active, keeping your trunk and hips strong, and building up activity gradually may help lower the chance of flare-ups.
What if the pain goes down my leg?
Pain, numbness, or tingling down the leg may be associated with an irritated nerve, often called sciatica. Read our post on sciatica: what it feels like and how PT can help, and see the warning signs above.
Do I need a referral to see a physical therapist?
No, not to start. California allows direct access within the limits described above.
About Nova Physical Therapy
Nova Physical Therapy is an outpatient physical therapy clinic in North Hollywood, California, led by a Doctor of Physical Therapy. We help people recover from back and neck pain, sports injuries, work injuries, auto accident injuries, knee pain, and shoulder problems, and we also work with balance problems and rehab after surgery. Patients come to us from North Hollywood, Burbank, Studio City, Toluca Lake, Valley Village, and across the San Fernando Valley. Learn more about Nova or see our services.
Schedule an evaluation
If lower back pain is getting in the way of work, sleep, or the activities you enjoy, an evaluation can help sort out what's driving it and which next steps fit you.
Nova Physical Therapy
4795 Vineland Ave #E, North Hollywood, CA 91602
Call (818) 639-3402 | Book an appointment online
Disclaimer
This article is for general education only. It is not medical advice, a diagnosis, or a treatment recommendation for any individual. Lower back pain has many causes, and only an in-person evaluation can determine what's right for you. No treatment guarantees symptom resolution, and results vary. Physical therapists evaluate movement and function within their scope of practice and refer to physicians when findings warrant. Physical therapy in California is regulated by the Physical Therapy Board of California.
References
1. George SZ, Fritz JM, Silfies SP, et al. Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. J Orthop Sports Phys Ther. 2021;51(11):CPG1–CPG60. Link
2. Treating Acute and Chronic Low Back Pain. J Orthop Sports Phys Ther. 2021. Link