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. 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. Symptoms: • Back pain • Muscle spasm • Stiffness • Leg pain (sciatica) 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 neck 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 (https://www.nhs.uk/conditions/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: 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-pain(https://www.csp.org.uk/conditions/back-pain) • Startback Tool - Keele University - First-line resource for people with back pain. Please click the link here: https://keele.health/startbackcalculator/ (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/ (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/ (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 (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 (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 (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 (https://www.northyorks.gov.uk/active-north-yorkshire/exercise-classes) • Live Well with pain website. Please click the link here: https://livewellwithpain.co.uk/(https://livewellwithpain.co.uk/) 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 neck 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 (https://www.nhs.uk/conditions/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: 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/ (https://northyorkshiretalkingtherapies.co.uk/online-referral-form/) • Live Well with pain website. Please click the link here: https://livewellwithpain.co.uk/(https://livewellwithpain.co.uk/) • Chartered Society of Physiotherapy - Back pain information - Please click the link here: https://www.csp.org.uk/conditions/back-pain(https://www.csp.org.uk/conditions/back-pain) • Startback Tool - Keele University - First-line resource for people with back pain. Please click the link here: https://keele.health/startbackcalculator/ (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/ (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 (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 (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 (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 (https://www.northyorks.gov.uk/active-north-yorkshire/exercise-classes) Last reviewed Mar 2026. To be reviewed Mar 2027.

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. 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. When the nerve gets compressed or irritated, 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. You should seek urgent medical attention if you experience any of the following: - loss of control of your bladder or bowel - numbness around your saddle (genital) area - problems with the coordination of your steps when walking Sciatica can usually be helped with exercise. If the pain is too severe to exercise, speak to your GP about medication you could take for a short time to allow you to exercise. When you're ready, try to exercise class on the back pain webpage. 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 (https://www.nhs.uk/conditions/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: 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-pain(https://www.csp.org.uk/conditions/back-pain) • Startback Tool - Keele University - First-line resource for people with back pain. Please click the link here: https://keele.health/startbackcalculator/ (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/ (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/ (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 (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 (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 (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 (https://www.northyorks.gov.uk/active-north-yorkshire/exercise-classes) • Live Well with pain website. Please click the link here: https://livewellwithpain.co.uk/(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 me. This is known as Spinal Stenosis. The narrowing of these gaps may be due to the disc, the ligaments or arthritis of the bone. 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 arms or legs. In our back, this is usually when you’re walking or standing for a period. It is usually quickly made be er when you sit down. Remember, there may be a few causes of pains into your legs. It doesn’t always mean you have spinal stenosis. How is it diagnosed? In most cases, a healthcare professional will be able to diagnose your backpain by talking to you about your experience with it. 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? In some cases, they may request an MRI scan of your back. This would be to help plan if surgery or an injection might be an option 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 anaesthesia 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. What is the non-surgical management for Spinal Stenosis? 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. Treatment recommendations are based on clinical assessment and best evidence as well as patient preference. 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. You may benefit from pain killers that target specific nerve pain. How can I help myself? Anything that improves your general health, and reduces pressure on the spine can help you with this condition. Weight loss, stopping smoking, and looking after your mental health all play an important part in making symptoms more manageable. 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 (https://www.nhs.uk/conditions/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.  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/(https://livewellwithpain.co.uk/) • Chartered Society of Physiotherapy - Back pain information - Please click the link here: https://www.csp.org.uk/conditions/back-pain(https://www.csp.org.uk/conditions/back-pain) • Startback Tool - Keele University - First-line resource for people with back pain. Please click the link here: https://keele.health/startbackcalculator/ (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/ (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/ (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 (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 (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 (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 (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 (https://www.nhs.uk/conditions/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(https://www.csp.org.uk/conditions/back-pain) • Live Well with pain website. Please click the link here: https://livewellwithpain.co.uk/(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/ (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/ (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/ (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 (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 (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 (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 (https://www.northyorks.gov.uk/active-north-yorkshire/exercise-classes) Last reviewed Mar 2026. To be reviewed Mar 2027.