What is Acute / Mechanical lower back pain?Acute/mechanical lower back pain can come on suddenly, or over time and can range from a mild pain or ache to quite severe pain, which can be extremely distressing and can sometimes stop you carrying out your everyday activities. Mechanical means that the pain comes on as you move, for example; standing up, leaning forward or twisting.Causes:It is often difficult to identify why your back is painful as the pain can come from joints, muscles or nerves being inflamed, stretched or compressed. More often than not, acute back pain comes on without any specific injury to your back.These are some factors why you may get acute/mechanical back pain: Normal age-related changes such as osteoarthritis in the spine.Previous injury to the area.Repetitive activity/physical job.High Body Mass Index (being overweight)Being less active than you used to be and losing muscle due to this.Symptoms:Back pain - this could be central / left side or right sided or diffuse across the back.Muscle spasm.Stiffness in the back.Leg pain - if you do have leg pain please read the section on "Sciatica / also known as radicular leg pain".Treatment:Most commonly a physiotherapist will be able to make a diagnosis acute/mechanical lower back pain through an assessment of your back and talking to you about your symptoms. The most important part of treating mechanical back pain and to get you better as quickly as possible is to keep moving. Back's generally prefer movement rather than rest. It is important to listen to your body however pain does not equal damage. We would encourage pacing yourself and doing little bits at a time (such as house work) rather that trying to get a big task done all in one go. The most common methods of treatment will include: Physical activity such as stretching and strengthening exercises. Group exercises programmes such as a spinal rehabilitation class. Weight loss.Advice/education regarding managing lower back pain.Pain relief - please speak to your GP regarding medication.Promotion of return to work. It is not advisable to wear corsets or belts for lower back pain or foot orthotics and acupuncture is not recommended for this pain. Transforaminal spinal injections are also not recommended for mechanical lower back pain. Do I need an MRI (Magnetic Resonance Imaging) scan?Neck and back pain is very common and most of the time it will settle down and recover without any intervention. We know that it can be very painful and limit our daily lives and it is natural to want to find out the cause of this pain.So, do you need a scan? Usually not.An MRI scan of your neck or back can give a very detailed picture of the bones, discs and other soft tissue in that area. But that’s all it is, a picture. It does not tell you which part is causing the pain or why you feel the amount of pain you do.​As we get older, we have an aging process that happens to the body – our hair starts to grey, our skin starts to wrinkle. We have an aging process on the outside of our body, but we also have an aging process that happens on the inside of the body. MRI scans are very good at giving us a picture of this process.It would be normal to find a disc bulge or degeneration on an MRI scan. But these do not always cause us pain.So how do we know what is causing the pain?The best way to diagnose your pain is to talk to a healthcare professional about your signs and symptoms. They will ask you questions like; "where exactly do you have the pain? What makes your pain worse? What makes it better? Do you have any pins and needles or numbness?" A detailed assessment is much better at helping us understand why you have pain, and what you can do to help it.​So when should I have an MRI?MRI scans are often used to rule out a serious problem, such as a broken bone or cancer. MRI scans can also be useful to help plan for further treatment e.g if surgery or an injection might be considered. A healthcare professional will take all of this into account when they assess you and might arrange an MRI scan if it would change your treatment. Back or neck pain on its own would not normally need a scan. This is what is recommended in the "NICE (National Institute for Health and Care Excellence) low back pain and sciatica in over 16's: assessment and management guidelines: Last updated July 2026".When should I seek urgent help?New / Sudden onset weaknessSometimes, if the nerves in your back have have been pinched enough, this can cause weakness in certain movements. You should attend Accident and Emergency at the hospital if:You have developed new onset or worsening weakness into your arms or legs e.g unable to pull your foot up towards you or audibly hear your foot slapping on the floor as you walk. Cauda equina syndrome is a rare and severe type of narrowing in the spine where all of the nerves in the lower back suddenly become severely compressed. Cauda equina syndrome is most commonly caused by a disc herniation compressing the cauda equina nerve rootlets.​Symptoms include:Sciatica on both sides of the legs (pain/numbness/weakness down both legs) that is severe or getting worse.Numbness around or under your genitals, or around your anus. When you go to wipe, you may not feel the paper touching you or this may be less sensitive.Finding it hard to start peeing, can't pee or can't control when you pee, this may include difficulty stopping – and this isn't normal for you.Loss of sensation when you pass urine.Leaking urine or recent need to use pads.Loss of awareness when you pass a bowel motion.Inability to stop a bowel movement or leaking.New onset erectile dysfunction, including inability to ejaculate. Loss of sensation in genitals during sexual intercourse. (Full credit goes to MACP CES CARDS 2018)If you have any other the urgent symptoms above which are new for you, you need to attend Accident and Emergency immediately.Cauda equina syndrome requires emergency hospital admission and emergency surgery, because the longer it goes untreated, the greater the chance it will lead to permanent paralysis and incontinence.If you are unsure if you need more urgent help, ring your GP or 111 as soon as possible or if you have been referred to Physiotherapy, contact the Physiotherapy Department.Exercises: Please click the link below for level 1 and level 2 lower back pain exercises:Back Pain Exercise Pamphlet (Arthritis UK) . Please download this leaflet below: Further Resources:Chartered Society of Physiotherapy - Back pain information - Please click the link here: https://www.csp.org.uk/conditions/back-painStartback Tool - Keele University - First-line resource for people with back pain. Please click the link here: https://keele.health/startbackcalculator/ Arthritis UK - Back pain website. Please click the link here: https://www.arthritis-uk.org/information-and-support/understanding-arthritis/conditions/back-pain/ North Yorkshire - Talking therapies - self referral. Please click the link here: https://northyorkshiretalkingtherapies.co.uk/online-referral-form/ Nuffield Joint Pain Programme - A six month programme which is designed to help you self-manage your joint pain, with access to Nuffield Facilities and lifestyle advice and exercise sessions. You can refer yourself. Please click the link here: https://www.nuffieldhealth.com/about-us/our-impact/healthy-life/joint-pain-programme Active North Yorkshire - Healthy You - 12 week free weight loss programme and gym access. You can refer yourself. Please click the link here: https://www.northyorks.gov.uk/healthy-living/healthy-you Active North Yorkshire - MSK Hub: The MSK Hub is a free 12 week programme to help support working people that have a reduced ability to work due to musculoskeletal joint pain. You can refer yourself. Please click the link here: https://www.northyorks.gov.uk/active-north-yorkshire/lifestyle-and-wellbeing-sessions/help-musculoskeletal-conditions Active North Yorkshire - Exercise Classes. Please click the link here: https://www.northyorks.gov.uk/active-north-yorkshire/exercise-classes Live Well with pain website. Please click the link here: https://livewellwithpain.co.uk/Last reviewed Mar 2026. To be reviewed Mar 2027.

What is sciatic / also known as radicular leg pain?Sciatica is a pain that travels down from your lower back or buttock, to your foot.It usually happens when the jelly within the discs that separate the bones of your spine (vertebrae) pushes out of the disc and irritates the sciatic nerve. Sometimes you may hear it referred to as a disc herniation.  Swollen muscles, joints or ligaments can also irritate the nerve causing sciatica.The sciatic nerve runs down through the back, into the buttock, down the back of the leg and round to the outside of the lower leg and foot. Causes:There does not always have to be a specific cause or injury for sciatic/radicular nerve pain to start. Sometimes it may start after lifting something heavy and feeling a "pop" sensation at the time in your back, other times you may wake up without injury and notice pain in your leg.We know that as we age, our discs in our spine will change. It is normal for them to move and normal for them to herniate. If you performed an MRI scan of the lumbar spine on everyone over the age of 30, with or without back/leg pain, it is common to see disc herniations. However, not all disc herniations will irritate nerves or cause pain.Symptoms:When the nerve gets compressed or irritated within the spine, the brain interprets the pain as coming from the buttock or leg, instead of the back, where the problem actually is. The pain is often a severe shooting pain, sometimes accompanied with pins and needles or numbness in the legs. Sometimes you may have back pain to start with and then the leg pain develops later. Sometimes the pain can be worse in your leg when you lean forward, however sometimes it can be constant regardless of your position. If the pain is worse when you stand and walk, this pain may be more likely to be cause by spinal stenosis - in which case please read the section on "Spinal stenosis".In the lumbar spine the most common nerve roots to be affected are L2-S1. Sciatic/radicular leg pain distribution will vary depending on which nerve roots are irritated. Your physiotherapist will commonly ask you where your pain travels.Typically the pain distribution is as follows: If the L2 nerve root is irritated: You may experience pain around the top of your thigh near your groin. If the L3 nerve root is irritated: You may experience pain down the front of your thigh to the inside aspect of your knee. If the L4 nerve root is irritated: You may experience pain around the front of your thigh to the inside aspect of your knee and down the inside aspect of your shin. If the L5 nerve root is irritated: You may experience pain around the buttock to the outside aspect of your thigh down to the outside aspect of your calf and into the big toe. If the S1 nerve root is irritated: You may experience pain around the buttock, back of the thigh and into the back of the calf and into the heel.Treatment:Most commonly a physiotherapist will be able to make a diagnosis of sciatica/radicular leg pain through an assessment of your back and nerves and talking to you about your symptoms. Generally radicular leg pain will ease over 6-12 weeks naturally as the body re-absorbs the disc material and the nerve stops becoming irritated. The most important part of treating sciatica/radicular leg pain and to get you better as quickly as possible is to keep moving. Back's generally prefer movement rather than rest. It is important to listen to your body however pain does not equal damage. We would encourage pacing yourself and doing little bits at a time (such as house work) rather that trying to get a big task done all in one go. The most common methods of treatment will include: Physical activity such as stretching and strengthening exercises. Group exercises programmes such as a spinal rehabilitation class. Weight loss.Advice/education regarding managing radicular leg pain.Medication may also be advised to help alleviate pain and symptoms, and should allow you to exercise and improve your function. If you have any questions about pain medication, you can discuss this with your GP or pharmacist. Sometimes you may benefit from neuropathic pain medication which is specifically used to target nerve pain such as; amitriptyline, pregablin or gabapentin. This decision to take this medication would be between yourself and the GP.Promotion of return to work. It is not advisable to wear corsets or belts for radicular leg pain. Foot orthotics and acupuncture is not recommended for this pain.Do I need an MRI (Magnetic Resonance Imaging) scan?Usually not. Back and leg pain are very common and most of the time it will settle down and recover without any intervention within 6-12 weeks. Your physiotherapist will be able to determine which nerve root is likely irritated by listening to what makes your symptoms better/worse, assessing you and understanding where your pain radiates.However, sometimes it may be appropriate to refer you on for a lumbar MRI scan if physiotherapy and conservative management has failed to ease your leg symptoms over a certain duration of time.Lumbar MRI scans for leg pain are only helpful if it will change your management options; such as surgery. If you are not considering surgery or interventional treatments, an MRI scan will not change your physiotherapy management. Your physiotherapist will treat you and your symptoms rather than the scan alone. Surgery is a last resort once all conservative options have been trialled and will only be intended to help leg pain. Surgery is not recommended to improve back pain symptoms alone. When should I seek urgent help?New / Sudden onset weaknessSometimes, if the nerves in your back have have been pinched enough, this can cause weakness in certain movements. You should attend Accident and Emergency at the hospital if:You have developed new onset or worsening weakness into your arms or legs e.g unable to pull your foot up towards you or audibly hear your foot slapping on the floor as you walk. Cauda equina syndrome is a rare and severe type of narrowing in the spine where all of the nerves in the lower back suddenly become severely compressed. Cauda equina syndrome is most commonly caused by a disc herniation compressing the cauda equina nerve rootlets.​Symptoms include:Sciatica on both sides of the legs (pain/numbness/weakness down both legs) that is severe or getting worse.Numbness around or under your genitals, or around your anus. When you go to wipe, you may not feel the paper touching you or this may be less sensitive.Finding it hard to start peeing, can't pee or can't control when you pee, this may include difficulty stopping – and this isn't normal for you.Loss of sensation when you pass urine.Leaking urine or recent need to use pads.Loss of awareness when you pass a bowel motion.Inability to stop a bowel movement or leaking.New onset erectile dysfunction, including inability to ejaculate. Loss of sensation in genitals during sexual intercourse.(Full credit goes to MACP CES CARDS 2018)If you have any other the urgent symptoms above which are new for you, you need to attend Accident and Emergency immediately.Cauda equina syndrome requires emergency hospital admission and emergency surgery, because the longer it goes untreated, the greater the chance it will lead to permanent paralysis and incontinence.If you are unsure if you need more urgent help, ring your GP or 111 as soon as possible or if you have been referred to Physiotherapy, contact the Physiotherapy Department.Exercises: Please click the link below for lower back exercises:Back Pain Exercise Pamphlet (Arthritis UK) . Please download this leaflet below: Further Resources:Please click the link below for 10 facts about sciatica:Chartered Society of Physiotherapy - Back pain information - Please click the link here: https://www.csp.org.uk/conditions/back-painStartback Tool - Keele University - First-line resource for people with back pain. Please click the link here: https://keele.health/startbackcalculator/ Arthritis UK - Back pain website. Please click the link here: https://www.arthritis-uk.org/information-and-support/understanding-arthritis/conditions/back-pain/ North Yorkshire - Talking therapies - self referral. Please click the link here: https://northyorkshiretalkingtherapies.co.uk/online-referral-form/ Nuffield Joint Pain Programme - A six month programme which is designed to help you self-manage your joint pain, with access to Nuffield Facilities and lifestyle advice and exercise sessions. You can refer yourself. Please click the link here: https://www.nuffieldhealth.com/about-us/our-impact/healthy-life/joint-pain-programme Active North Yorkshire - Healthy You - 12 week free weight loss programme and gym access. You can refer yourself. Please click the link here: https://www.northyorks.gov.uk/healthy-living/healthy-you Active North Yorkshire - MSK Hub: The MSK Hub is a free 12 week programme to help support working people that have a reduced ability to work due to musculoskeletal joint pain. You can refer yourself. Please click the link here: https://www.northyorks.gov.uk/active-north-yorkshire/lifestyle-and-wellbeing-sessions/help-musculoskeletal-conditions Active North Yorkshire - Exercise Classes. Please click the link here: https://www.northyorks.gov.uk/active-north-yorkshire/exercise-classes Live Well with pain website. Please click the link here: https://livewellwithpain.co.uk/Last reviewed Mar 2026. To be reviewed Mar 2027.

What is Spinal Stenosis? In our spine, we have gaps (holes) between the bones where the nerves pass through. There is a hole in the middle of the bone, known at the central canal and two holes either side of this, known as the lateral recess. The nerves travel through each of these holes. In some people, the size of these gaps become smaller (narrowed) over time. If the nerves have less space to travel due to a smaller gap, they can become irritated, which can cause pain down one, or both your legs. This is known as Spinal Stenosis. Remember, there may be a few causes of pains into your legs. It doesn’t always mean you have spinal stenosis. Causes:Unfortunately there is nothing to stop or prevent spinal stenosis as it is a normal aging process. As we get older, we have an aging process that happens to the body – our hair starts to grey, our skin starts to wrinkle. We have an aging process on the outside of our body, but we also have an aging process that happens on the inside of the body. Spinal stenosis (narrowing of the gaps where nerves travel in the spine) may be due to the disc, the ligaments, enlargement of facet joints or arthritis of the bone. Symptoms:When the nerves get compressed or irritated within the spine due to narrowing, the brain interprets the pain as coming from the buttock or leg, instead of the back, where the problem actually is. The pain is often a severe shooting pain, sometimes accompanied with pins and needles or numbness in the legs. Generally with spinal stenosis the pain is worse when walking or standing for long periods. It is usually quickly made better when you sit down or lean forward. This is because when we stand we naturally make the gaps in our spine narrower but when we sit or lean forward we make the gaps in our spine open up.In the lumbar spine the most common nerve roots to be affected by spinal stenosis are L2-S1. Spinal stenosis leg pain distribution will vary depending on which nerve roots are irritated. Your physiotherapist will commonly ask you where your pain travels.Typically the pain distribution is as follows: If the L2 nerve root is narrowed: You may experience pain around the top of your thigh near your groin. If the L3 nerve root is narrowed: You may experience pain down the front of your thigh to the inside aspect of your knee. If the L4 nerve root is narrowed: You may experience pain around the front of your thigh to the inside aspect of your knee and down the inside aspect of your shin. If the L5 nerve root is narrowed: You may experience pain around the buttock to the outside aspect of your thigh down to the outside aspect of your calf and into the big toe. If the S1 nerve root is narrowed: You may experience pain around the buttock, back of the thigh and into the back of the calf and into the heel.Treatment:In most cases, a healthcare professional will be able to diagnose spinal stenosis through an assessment of your back and nerves and talking to you about your symptoms. It can be helpful if you are able to tell them how long you have had it for, what makes it worse? What makes it better? Where exactly do you have your pain?Generally spinal stenosis leg pain will ease over 6-12 weeks with physiotherapy exercises however it is not uncommon for leg symptoms to persist. Unfortunately as the spaces for the nerves travel become narrower, symptoms do flare up from time to time. Sometimes you may go a few months without symptoms and then your pain may flare up again without a specific cause/reason. Non-surgical management:Non-surgical treatment of spinal stenosis is aimed to reduce the level of pain, help increase your quality of life and maintain your tolerance to exercise and day to day activity. Exercise is safe to continue with as long as pain is at a manageable level. Often if you complete regular exercise that encourages your back to bend forwards, this can be helpful, and sometimes sitting and resting before, and during a walk can allow you to walk further, with more manageable symptoms. The use of a walking stick or a hiking pole can really help. Current guidelines recommend an initial 12 weeks of exercise therapy. Medication may also be advised to help alleviate pain and symptoms, and should allow you to exercise and improve your function. If you have any questions about pain medication, you can discuss this with your GP or pharmacist. Sometimes you may benefit from neuropathic pain medication which is specifically used to target nerve pain such as; amitriptyline, pregablin or gabapentin. This decision to take this medication would be between yourself and the GP.How can I help myself? Group exercise programmes such as a spinal rehabilitation class. Weight loss.Looking after your mental health.It is not advisable to wear corsets or belts for spinal stenosis leg pain. Foot orthotics and acupuncture is not recommended for this pain.Do I need an MRI (Magnetic Resonance Imaging) scan?Usually not. Spinal stenosis is very common and most of the time it will settle down without any intervention within 6-12 weeks. Your physiotherapist will be able to determine which nerve roots is are likely irritated by listening to what makes your symptoms better/worse, assessing you and understanding where your pain radiates.However, sometimes it may be appropriate to refer you on for a lumbar MRI scan if physiotherapy and conservative management has failed to ease your leg symptoms over a certain duration of time.Lumbar MRI scans for leg pain are only helpful if it will change your management options; such as surgery. If you are not considering surgery an MRI scan will not change your physiotherapy management. Injections are not recommended for central canal stenosis. Do I need surgery? Widening of the gaps in your spine is known as a Lumbar Decompression. This surgery can be offered to help with the leg pain you get from stenosis but is usually only considered only if non-surgical management hasn’t worked, and symptoms are significantly affecting quality of life. Surgery will only be recommended if you are healthy enough to withstand the effects of anesthesia and surgery. It is not a “cure” but another option to lessen symptoms.Surgery can help with the symptoms in the legs or arms, but will usually not be recommended if back pain is your main issue.When should I seek urgent help?New / Sudden onset weaknessSometimes, if the nerves in your back have have been pinched enough, this can cause weakness in certain movements. You should attend Accident and Emergency at the hospital if:You have developed new onset or worsening weakness into your arms or legs e.g unable to pull your foot up towards you or audibly hear your foot slapping on the floor as you walk. Cauda equina syndrome is a rare and severe type of narrowing in the spine where all of the nerves in the lower back suddenly become severely compressed. Cauda equina syndrome is most commonly caused by a disc herniation compressing the cauda equina nerve rootlets.​Symptoms include:Sciatica on both sides of the legs (pain/numbness/weakness down both legs) that is severe or getting worse.Numbness around or under your genitals, or around your anus. When you go to wipe, you may not feel the paper touching you or this may be less sensitive.Finding it hard to start peeing, can't pee or can't control when you pee, this may include difficulty stopping – and this isn't normal for you.Loss of sensation when you pass urine.Leaking urine or recent need to use pads.Loss of awareness when you pass a bowel motion.Inability to stop a bowel movement or leaking.New onset erectile dysfunction, including inability to ejaculate. Loss of sensation in genitals during sexual intercourse.(Full credit goes to MACP CES CARDS 2018)If you have any other the urgent symptoms above which are new for you, you need to attend Accident and Emergency immediately.Cauda equina syndrome requires emergency hospital admission and emergency surgery, because the longer it goes untreated, the greater the chance it will lead to permanent paralysis and incontinence.If you are unsure if you need more urgent help, ring your GP or 111 as soon as possible or if you have been referred to Physiotherapy, contact the Physiotherapy Department.Please download this for spinal stenosis information as a PDF: Exercises: Level 1 spinal stenosis exercises: Level 2 spinal stenosis exercises: Further Resources:Live Well with pain website. Please click the link here: https://livewellwithpain.co.uk/Chartered Society of Physiotherapy - Back pain information - Please click the link here: https://www.csp.org.uk/conditions/back-painStartback Tool - Keele University - First-line resource for people with back pain. Please click the link here: https://keele.health/startbackcalculator/ Arthritis UK - Back pain website. Please click the link here: https://www.arthritis-uk.org/information-and-support/understanding-arthritis/conditions/back-pain/ North Yorkshire - Talking therapies - self referral. Please click the link here: https://northyorkshiretalkingtherapies.co.uk/online-referral-form/ Nuffield Joint Pain Programme - A six month programme which is designed to help you self-manage your joint pain, with access to Nuffield Facilities and lifestyle advice and exercise sessions. You can refer yourself. Please click the link here: https://www.nuffieldhealth.com/about-us/our-impact/healthy-life/joint-pain-programme Active North Yorkshire - Healthy You - 12 week free weight loss programme and gym access. You can refer yourself. Please click the link here: https://www.northyorks.gov.uk/healthy-living/healthy-you Active North Yorkshire - MSK Hub: The MSK Hub is a free 12 week programme to help support working people that have a reduced ability to work due to musculoskeletal joint pain. You can refer yourself. Please click the link here: https://www.northyorks.gov.uk/active-north-yorkshire/lifestyle-and-wellbeing-sessions/help-musculoskeletal-conditions Active North Yorkshire - Exercise Classes. Please click the link here: https://www.northyorks.gov.uk/active-north-yorkshire/exercise-classes Last reviewed Mar 2026. To be reviewed Mar 2027.

Chronic back pain refers to pain that has not gone away after three months. Like acute back pain, it is usually caused by a strain or a sprain in the back - but the pain and distress can last for much longer and it can have a big impact on your day-to-day life.Chronic back pain can range from a mild pain or ache, to a more severe pain. This can depend on a variety of things, such as how happy you are at home or at work, if you are prone to depression or if you have had back pain before. Chronic back pain usually requires treatment such as medication or physiotherapy. In most cases though, your back will heal itself. It is important that you keep active and continue as normal, but if your pain is severe and persistent then you should seek medical advice for diagnosis and the appropriate treatment.Treatment:Do I need an MRI scan? Neck and back pain is very common and most of the time it will settle down and recover without any intervention. We know that it can be very painful and limit our daily lives and it is natural to want to find out the cause of this pain.​So, do you need a scan? Usually not. An MRI of your neck or back can give a very detailed picture of the bones, discs and other soft tissue in that area. But that’s all it is, a picture. It does not tell you which part is causing the pain or why you feel the amount of pain you do.​As we get older, we have an aging process that happens to the body – our hair starts to grey, our skin starts to wrinkle. We have an aging process on the outside of our body, but we also have an aging process that happens on the inside of the body. MRI is very good at giving us a picture of this process.It would be normal to find a disc bulge or degeneration on an MRI scan. But these do not always cause us pain.​So how do we know what is causing the pain?The best way to diagnose your pain is to talk to a healthcare professional about your signs and symptoms. They will ask you questions like; "where exactly do you have the pain? What makes your pain worse? What makes it better? Do you have any pins and needles or numbness?" A detailed assessment is much better at helping us understand why you have pain, and what you can do to help it.​So when should I have an MRI?MRIs are often used to rule out a serious problem, such as a broken bone or cancer. MRI can also be useful to help plan for further treatment e.g if surgery or an injection might be considered. A healthcare professional will take all of this into account when they asses you and might arrange an MRI if it would change your treatment. Back or neck pain on its own would not normally need a scan.However, should you develop any of the below signs alongside your neck or back pain, you should quickly seek further help:Sciatica in both arms or legs​Weakness or numbness in your legs or arm that is severe or getting worse. Finding it difficult to use your hands for tasks like buttoning a shirt, picking up coins.​Numbness around or under your genitals or around your anus. Problems getting an erection.​Finding it hard to start peeing, or can’t control when you pee or you have accidents - and this is not normal for you.​A loss of balance or control of your legs when walking.​Unable to control what you do with your foot as you walk​Dizziness, vomiting or blackouts, linked to moving your neckWhen should I seek urgent help?Cauda equina syndrome is a rare and severe type of spinal stenosis where all of the nerves in the lower back suddenly become severely compressed.​Symptoms include:sciatica on both sides of the legsweakness or numbness in both legs that is severe or getting worsenumbness around or under your genitals, or around your anusfinding it hard to start peeing, can't pee or can't control when you pee – and this isn't normal for youyou don't notice when you need to poo or can't control when you poo – and this isn't normal for younew onset erectile dysfunction​​Cauda equina syndrome requires emergency hospital admission and emergency surgery, because the longer it goes untreated, the greater the chance it will lead to permanent paralysis and incontinence.New / Sudden onset weaknessSometimes, if the nerves in your back have have been pinched enough, this can cause weakness in certain movements. You should seek more urgent help if:You have developed new onset or worsening weakness into your arms or legs e.g unable to pull your foot up towards you or reducing grip strength​If you are unsure if you need more urgent help, ring your GP or 111 as soon as possible or if you have been referred to Physiotherapy, contact the Physiotherapy Department. Exercises: Please click the link below for level 1 and level 2 lower back pain exercises:Back Pain Exercise Pamphlet (Arthritis UK) . Please download this leaflet below: Further Resources:North Yorkshire - Talking therapies - self referral. Please click the link here: https://northyorkshiretalkingtherapies.co.uk/online-referral-form/ Live Well with pain website. Please click the link here: https://livewellwithpain.co.uk/Chartered Society of Physiotherapy - Back pain information - Please click the link here: https://www.csp.org.uk/conditions/back-painStartback Tool - Keele University - First-line resource for people with back pain. Please click the link here: https://keele.health/startbackcalculator/ Arthritis UK - Back pain website. Please click the link here: https://www.arthritis-uk.org/information-and-support/understanding-arthritis/conditions/back-pain/ Nuffield Joint Pain Programme - A six month programme which is designed to help you self-manage your joint pain, with access to Nuffield Facilities and lifestyle advice and exercise sessions. You can refer yourself. Please click the link here: https://www.nuffieldhealth.com/about-us/our-impact/healthy-life/joint-pain-programme Active North Yorkshire - Healthy You - 12 week free weight loss programme and gym access. You can refer yourself. Please click the link here: https://www.northyorks.gov.uk/healthy-living/healthy-you Active North Yorkshire - MSK Hub: The MSK Hub is a free 12 week programme to help support working people that have a reduced ability to work due to musculoskeletal joint pain. You can refer yourself. Please click the link here: https://www.northyorks.gov.uk/active-north-yorkshire/lifestyle-and-wellbeing-sessions/help-musculoskeletal-conditions Active North Yorkshire - Exercise Classes. Please click the link here: https://www.northyorks.gov.uk/active-north-yorkshire/exercise-classes Last reviewed Mar 2026. To be reviewed Mar 2027.

When should I seek urgent help? Cauda equina syndrome is a rare and severe type of spinal stenosis where all of the nerves in the lower back suddenly become severely compressed. ​ Symptoms include: sciatica on both sides of the legs weakness or numbness in both legs that is severe or getting worse numbness around or under your genitals, or around your anus finding it hard to start peeing, can't pee or can't control when you pee – and this isn't normal for you you don't notice when you need to poo or can't control when you poo – and this isn't normal for you new onset erectile dysfunction ​​ Cauda equina syndrome requires emergency hospital admission and emergency surgery, because the longer it goes untreated, the greater the chance it will lead to permanent paralysis and incontinence. New / Sudden onset weakness Sometimes, if the nerves in your back have have been pinched enough, this can cause weakness in certain movements. You should seek more urgent help if: You have developed new onset or worsening weakness into your arms or legs e.g unable to pull your foot up towards you or reducing grip strength ​ If you are unsure if you need more urgent help, ring your GP or 111 as soon as possible or if you have been referred to Physiotherapy, contact the Physiotherapy Department.  Exercises: Further Resources: Chartered Society of Physiotherapy - Back pain information - Please click the link here: https://www.csp.org.uk/conditions/back-pain Live Well with pain website. Please click the link here: https://livewellwithpain.co.uk/ Startback Tool - Keele University - First-line resource for people with back pain. Please click the link here: https://keele.health/startbackcalculator/ Arthritis UK - Back pain website. Please click the link here: https://www.arthritis-uk.org/information-and-support/understanding-arthritis/conditions/back-pain/ North Yorkshire - Talking therapies - self referral. Please click the link here: https://northyorkshiretalkingtherapies.co.uk/online-referral-form/ Nuffield Joint Pain Programme - A six month programme which is designed to help you self-manage your joint pain, with access to Nuffield Facilities and lifestyle advice and exercise sessions. You can refer yourself. Please click the link here: https://www.nuffieldhealth.com/about-us/our-impact/healthy-life/joint-pain-programme  Active North Yorkshire - Healthy You - 12 week free weight loss programme and gym access. You can refer yourself. Please click the link here: https://www.northyorks.gov.uk/healthy-living/healthy-you  Active North Yorkshire - MSK Hub: The MSK Hub is a free 12 week programme to help support working people that have a reduced ability to work due to musculoskeletal joint pain. You can refer yourself. Please click the link here: https://www.northyorks.gov.uk/active-north-yorkshire/lifestyle-and-wellbeing-sessions/help-musculoskeletal-conditions  Active North Yorkshire - Exercise Classes. Please click the link here: https://www.northyorks.gov.uk/active-north-yorkshire/exercise-classes  Last reviewed Mar 2026. To be reviewed Mar 2027.