The Releaf Guide to Lower Back Pain Causes and Treatments, 2026

What is lower back pain, and why is it so common?

Lower back pain is quite self-explanatory. While the causes of musculoskeletal pain are super varied, they all result in pain issues focused on the lower lumbar region of the spine, which can then send referred pain into the hips, buttocks, groin, and legs. This is due to the fact that the muscles, joints, discs, and nerve structure are all interconnected in the lower back, so when an issue happens in one, it can cause a chain reaction of pain and movement issues. 

But why is lower back pain so common?

The lower back is central to almost all movement. The true mid-point of human anatomy, it connects the upper body to the pelvis and legs, helping to support your weight every time you bend, twist, walk, run, jump, or even just sit. In fewer words, the lower back is under almost constant strain and demand, even if it doesn't always feel that way. And that is exactly why lower back pain is so common, and one of the most common reasons people seek pain treatment.

Lower back pain (and all pain, for that matter) is split into two main groupings: acute and chronic. 

• Acute lower back pain pops up suddenly, usually without much warning and often after lifting something a little heavier than your body is used to, twisting in a way that extends past your normal range of movement, or moving awkwardly when the muscles involved are not ‘warmed up’. Acute pain lasts a few days to a week, and will almost always settle with rest and gentle stretching once the pain ahs started to subside.
• Chronic pain is different. It can develop after an acute pain episode that never fully settles, or it may just appear with no obvious starting point. For pain to be classed as ‘chronic’, it has to have been present for 12 weeks or longer. That doesn't necessarily mean that the pain must be there every minute of every day for 12 weeks, but it does return consistently and has an impact on day-to-day functioning. 

Further on in this guide, we share findings from our 2025 Releaf patient survey, the largest medical cannabis patient survey ever conducted in the UK, with 1,669 respondents, and explain what people reported after starting Releaf medical cannabis treatment for lower back pain.

What commonly causes lower back pain?

Cause category	Typical symptoms	Common contributors
Injury and sudden strain	Sudden onset of pain, stiffness, reduced movement, pain with certain actions	Lifting something heavier than usual, awkward twisting, slips or sudden changes in movement
Repetitive movement and overuse	Gradual build-up of aching or tightness, pain that worsens with activity, stiffness	Repeated lifting, twisting, bending, side-dominant movement, and lack of recovery time
Poor posture and movement habits	Persistent stiffness, discomfort after sitting or standing, reduced flexibility	Prolonged sitting, desk work, slouched posture, uneven loading, and limited movement variety
Age-related wear and reduced flexibility	Ongoing stiffness, reduced range of motion, and pain that develops gradually	Natural changes in joints and discs, reduced muscle flexibility, and lower activity levels
Sports-related causes	Pain during or after activity, tightness on one side, flare-ups after training	Side-dominant sports, high-impact activity, sudden increases in training load
Work-related causes	Localised or spreading pain, stiffness after work, recurring flare-ups	Manual handling, prolonged sitting or driving, repetitive tasks, uneven lifting
Underlying health conditions	Persistent or recurring pain, pain not clearly linked to movement alone	Inflammatory conditions, joint disorders, nerve involvement, other medical conditions

Can where you experience lower back pain point to a potential cause?

Yes, but we have to be careful. The location of your pain can offer clues, but it is not usually enough for a full diagnosis in itself. As mentioned above, the internal structures are all interconnected, which means that pain doesn't always show up where the underlying issue actually is. 

If you are experiencing chronic back pain, please use the below as a guide and seek proper clinical advice before drawing any concrete conclusions about the potential underlying cause. 

Pain on the left side of the lower back

Pain on the left-hand side of the lower back can be linked to how the body loads and moves, rather than a single clear injury. 

If you are left-sided dominant (left-handed, left-footed), the chances of developing chronic pain on the left side of your lower back are slightly increased, as that side of the body automatically takes on more work during everyday tasks without you potentially even noticing. 

Left-sided pain is often caused by a mechanical issue, but problems with the muscles are not always the main cause. Small spinal joints, or the sacroiliac joint, can also refer pain into the lower left back, buttock, or hip, which is why symptoms can sometimes feel deeper or harder to pinpoint.

• Muscle strain linked to imbalance or overuse on one side
• Uneven weight loading due to posture, sitting habits, or carrying weight
• Repeatedly twisting in one way (not always to the left)
• Favouring the left leg in general
• Joint irritation
• Gradual age-related changes that increase strain on the soft tissues, discs, tendons, and ligaments.

Pain on the right side of the lower back

With around 90% of the UK population being right-handed, and 60% being right-footed (with almost 30% of us being ‘mixed-footed’ - most likely, thanks to our passion for football), lower back issues with localised pain on the right side are more common than the left. Mixed-footed individuals, while ambidextrous with their feet, are still more likely to prefer their right foot than their left. 

As with left-side lower back pain, this is often linked to how we move, lift, and load our bodies, rather than being caused by a specific injury, although (of course) an injury can cause chronic right-side lower back pain. Repetitive strain issues and overuse play a key role here. 

• More common due to the right-sided dominance in the UK population
• Overuse of the same muscles and joints during work or daily tasks
• Sports that favour using the right leg more than the left
• Muscle or joint overuse from long-term repetitive movements
• Gradual age-related changes that increase strain on the soft tissues, discs, tendons, and ligaments.

Central lower back pain

Central lower back pain is felt across the middle of the spine rather than on one obvious side. If you have ever had a bad flu that causes body pain issues, you have most likely felt a similar kind of deep, central discomfort. Central lower back pain sometimes points to how the spine and it’s supporting structures have been overloaded for long periods of time, rather than a single strained muscle. 

• Increased spinal compression and disc stress from prolonged sitting or standing. 
• Disc stress caused by sustained bending (especially if picking up a heavy weight incorrectly) or poor posture.
• Reduced overall movement, which leads to a lack of central lower back mobility
• Prolonged sitting and/or inactivity can also play a major role

Lower back pain that spreads to the hips or legs

When lower back pain spreads down into the hips and/or legs, it is often caused by nerve irritation. The nerves in this area run from the spine down into the pelvis and legs, and when they become irritated or are placed under pressure, pain can quickly spread. 

This is often described as ‘sciatic type pain’, as the sciatic nerve is the largest, running from the lower back to the legs. Sciatica is a particularly painful condition, but not all lower back pain that is referred down the legs is actually sciatica, and similar symptoms can occur for a range of reasons. Pain may travel into one or both legs and can be accompanied by sensations such as tingling, numbness, or a sharp or burning feeling, depending on which nerve pathways are affected.

• Pain that travels from the lower back through the hips, groin, and down the legs
• Sensations can include blunt or sharp pain, tingling, burning, and/or numbness
• Symptoms often change when the body position is moved from standing to sitting or lying 
• The pain itself can be ‘mobile’, and does not always present in the same spot repeatedly
• Pain intensity can also fluctuate 

Pain location	Likely causes	Typical triggers
Left side of the lower back	Muscle strain, repetitive loading, posture imbalance, sacroiliac or facet joint irritation, age-related wear	Carrying weight on one side, leaning or twisting while sitting, or favouring one leg when standing
Right side of the lower back	Overuse strain, asymmetrical movement, work-related loading, joint irritation	Manual work, side-dominant sport, repeated lifting or twisting led by the dominant side
Central lower back	Disc irritation, mechanical lower back pain, posture-related strain, sustained spinal loading	Prolonged sitting, limited movement variety, forward bending, inactivity
Lower back pain spreading to hips or legs	Nerve irritation, disc-related changes, surrounding tissue pressure on nerve pathways	Sitting for long periods, bending, certain movements or positions, prolonged inactivity

With all that said, any type of lower back pain can come from a wide range of causes. If you are struggling with ongoing, chronic back pain, we strongly suggest you seek specialist guidance before you decide on any treatment path. 

What treatments are available for long-term lower back pain?

Understanding how to manage long-term lower back pain is a concern raised with Releaf’s world-class clinical team almost daily.

Lower back pain without any obvious injury is common, and chronic pain rarely comes with a simple fix. Even more so when that pain is localised in an area that is almost impossible to rest for long periods without being mostly immobile, and even then, still under a certain amount of strain thanks to human physiology. 

Because of this, treating long term lower back injuries usually involves multimodal pain management approaches. There is no ‘one-size-fits-all’. What helps for one person won't be effective, or even potentially practical for another. The underlying causes, how long the issue has been presenting, and how the lower back pain affects quality of life all play a heavy hand in the treatment route. 

Most treatment plans involve layering several approaches rather than picking one option and relying on it to fix the issue. A certain level of experimentation is often the best way forward, and adjusting the treatment plan over time is the norm as you find what works and what doesn't (for your specific lower back pain treatment needs). 

Medical cannabis treatment for lower back pain

While medical cannabis treatment for ongoing low back pain is a fully legal option for UK patients, there is one important caveat to first point out: medical cannabis is not a ‘first-line’ treatment option in the UK. Before a specialist can consider prescribing it for any condition, including chronic back pain, patients must first try at least two conventional treatment options without finding the symptom relief they need. 

That said, chronic pain issues are the most common reason that Releaf patients seek support with, including ongoing lower back pain that has not responded well to the conventional approaches available, such as physiotherapy, yoga, exercise programmes, and standard pain relief. For many people, the pain continues despite these options, affecting sleep, movement, and day-to-day functioning.

Unlike most individual traditional treatment options, medical cannabis treatment has been shown to help patients address more than just the pain itself. 

The secondary symptoms that quite often go hand-in-hand with chronic pain can include disrupted sleep, low mood and/or anxiety, ongoing muscle tension, issues with appetite, heightened stress, and difficulty relaxing both physically and mentally. For many Releaf patients, their medical cannabis prescription has helped with changes beyond just the pain itself. 

In Releaf’s 2025 patient survey, 96.6% of respondents with lower back or lumbar-related pain reported “improvement in their overall quality of life”.

All Releaf patients have full access to consultations with world-class pain specialists, often at a lower cost and with shorter waiting times than many traditional private pain services. Appointments are fully online, meaning that you can speak with your preferred specialist from the comfort of your own home, without the delays or having to physically attend a clinic. 

Releaf patients have access to prescriptions for a range of treatment options, including medical cannabis oil, THC vapes, medical cannabis pastilles, and medical cannabis flower (with sativa-dominant, indica-dominant, and balanced medical cannabis strains available). 

Interested in the potential health benefits that a UK medical cannabis prescription may offer? Head to our fast and free medical cannabis eligibility checker. In just 20 seconds, you will have a clear idea of whether a Releaf medical cannabis prescription could be suitable for your health needs.

Rest, self-care, and activity modification 

This probably goes without saying, but the first thing that almost everyone with lower back pain does is rest, particularly when the pain pops up after an obvious strain or tweak.

And while rest is the right move in the short term, extending that lack of movement for long periods rarely results in positive outcomes. Staying inactive for more than a few days usually leads to more stiffness and sensitivity, and can lead to you feeling less confident in normal movements in the long-run.

For most people, gentle, controlled movement will be more helpful than long periods of total inactivity. The level of activity that your lower back can handle is something that you will need to gauge yourself (at least, until you seek guidance from a healthcare professional or physiotherapist). Light, slow walking is a good place to start, and remember to change your sitting/lying position regularly. 

The aim is not to push through the pain, but to keep that lower back somewhat mobile while it recovers. A good rule of thumb is that if the pain is below a 4/5 out of 10, then you are likely not causing any more harm. But if the pain sticks around for more than a few days, or gets worse, it is time to head to a physiotherapist for more structured guidance and support.

Physiotherapy, exercise programs, and adjunct techniques

Rather than focusing purely on the specific area that hurts, a physiotherapist will look at how your lower back is moving in relation to the rest of your body, specifically the chain of muscles and joints in that area that support everyday movement - the hips, core, and legs, specifically, but also the mid and upper back. 

Physiotherapists take all of this into account and then build an exercise/movement plan that takes in account how your body is currently responding to certain movements, not how it is supposed to be able to move when there is zero pain. Strengthening, mobility, and guided movement usually form the core of treatment, introduced gradually and adjusted as your pain and strength improve.

These days, most physiotherapists also offer additional treatment options such as physical manipulation (massage), dry needling, acupuncture, cupping, etc. While these techniques alone rarely fix the root issue, they can help reduce muscle tension, ease discomfort, and improve movement in the short term. 

Just don’t expect the pain to disappear without also doing the hard work required yourself. The longer-term aim of physiotherapy is to build strength, mobility, and confidence in your own body. 

Heat, cold, and supportive aids

Specific advice on using heat and cold packs for pain shifts every few years, which can make this whole area feel a little more confusing than it needs to be. Both heat and cold packs are commonly suggested to help manage acute and chronic pain issues, but what works best depends on the specific symptoms, pain region, and how long the pain has been present.

• Heat packs are more commonly suggested when stiffness/muscle tightness is the main issue
• Cold packs are the more often suggested route when the area is inflamed, irritated, or reactive, particularly after a recent strain or flare following activity.

Supportive aids can be very helpful. Lumbar cushions, chair supports, back braces, and even specifically designed ergonomic chairs can all make a big difference to overall comfort levels while the pain is still flaring, and reduce the chances of the pain returning in the long term. 

Over-the-counter options, prescribed pain relief, and other therapies

OTC and prescribed pain relief options, such as simple analgesics, anti-inflammatory medicines, and other pain-reducing medications, can also make a big difference in managing lower back pain, particularly during heavy flare-ups. 

But these need to be taken in line with clinical guidelines and with a level of caution, as they can come with some heavy side effects and are not always suitable for long-term use.

Chiropractic interventions may also provide relief for some individuals with lower back pain; however, the effects are not always consistent or long-lasting, and outcomes vary from patient to patient. The heavy manipulation techniques involved carry risk, especially if there are underlying structural issues causing the lower back pain.

Treatment options and when they may help

Treatment option	What it may help with	When it is commonly used
Medical cannabis treatment	Managing ongoing lower back pain alongside related symptoms such as disrupted sleep, low mood, muscle tension, stress, and difficulty relaxing	When at least 2 conventional treatments have been tried without adequate symptom relief, under specialist guidance
Rest and activity modification	Settling short-term irritation and reducing immediate strain after a flare or minor injury	Early stages of pain following a clear strain or increase in activity
Gentle movement and light walking	Maintaining mobility and confidence in movement while pain settles	During recovery from a flare and when pain allows controlled movement
Physiotherapy and exercise programmes	Improving strength, mobility, movement confidence, and long-term resilience in the lower back	When pain persists beyond the short term or keeps returning
Adjunct physiotherapy techniques such as massage, dry needling, acupuncture, or cupping	Reducing muscle tension and discomfort to support engagement with exercise	Used alongside physiotherapy and movement-based rehabilitation
Heat therapy	Easing muscle tightness and stiffness to make movement feel more comfortable	When stiffness or tight muscles are the dominant symptoms
Cold therapy	Settling pain that feels inflamed, irritated, or reactive	After recent strains or flare ups, particularly following activity
Supportive aids such as lumbar cushions or back braces	Improving comfort and reducing strain during sitting or specific activities	Short-term use during flare ups or periods of increased load
Over-the-counter pain relief	Reducing pain intensity to allow daily activity or rehabilitation	Short-term management during flare ups
Prescribed pain relief	Managing pain when symptoms significantly affect sleep or daily function	When pain is persistent and requires clinical oversight
Chiropractic and other manual therapies	Short-term relief of stiffness or discomfort for some individuals	Used as complementary approaches rather than standalone long-term treatments

What does clinical research say about medical cannabis for lower back pain?

There are particularly relevant and interesting studies published in 2025 that can help shed some light on exactly how medical cannabis treatment can fit into long-term lower back pain management. 

Both had large-scale participation, ran for multiple years, and focused on patient outcomes, including quality of life, day-to-day functioning, and the potential reduction of opioid usage. 

Evidence from long-term observational studies in chronic low back pain

One of the most detailed long-term datasets comes from a 10-year prospective study on cannabis for chronic low back pain titled “Long-Term Cannabis Therapy for Chronic Low Back Pain: A 10-Year Prospective Study”. 

The researchers followed 168 adults with chronic lower back pain and structural spinal abnormalities over 10 years in a specialist clinical setting, and the findings paint a pretty clear picture:

• Average pain scores reduced by around 90% over 10 years
• Disability scores related to daily activities reduced by over 90%
• Physical and mental quality-of-life scores improved by around 20 points on standard scales
• Opioid use fell from 91% of patients at the start of the study to just over 8% at long-term follow-up
• Among that 8%, average daily opioid dose was reduced by over 95%
• Only 4% of patients stopped treatment due to adverse effects, which were classed as ‘mild’

Evidence from placebo-controlled trials of cannabis-based treatments

The second study is what is generally considered the gold standard in medical research: a placebo-controlled trial on cannabis for chronic low back pain titled “Full-spectrum extract from Cannabis sativa DKJ127 for chronic low back pain: a phase 3 randomized placebo-controlled trial”.

This trial included 820 participants in total, and again, the outcomes are quite clear:

• Average pain scores reduced by around 20% more in the cannabis group compared with the placebo group
• In people with a nerve-related component to their pain, neuropathic pain symptoms improved by around 25% more than a placebo
• Pain reduction continued during longer-term treatment phases, with overall pain scores falling by close to 30% from baseline during open-label follow-up
• People who stopped treatment and switched to a placebo saw a noticeable increase in pain, compared with those who continued treatment
• Improvements in pain were accompanied by meaningful improvements in physical function, meaning people found movement and daily activities easier while on treatment
• Improvements in sleep were also reported during treatment phases, particularly as pain levels reduced

It is important to note that the secondary symptom benefits were not universal, but were still statistically significant enough for the authors of the study to discuss. 

What did patients with lower back pain report in the UK’s largest medical cannabis survey?

As we have mentioned above in this guide, in mid-2025, Releaf carried out the UK’s largest medical cannabis patient survey. 

The survey was designed to help us (and the wider medical cannabis sector) understand real-world patient experiences across the full range of conditions Releaf supports, rather than focusing on a single diagnosis or outcome.

In total, 1,669 patients participated, with 90 respondents being prescribed Releaf medical cannabis for lower back or lumbar-related pain as their main health issue. The findings below relate specifically to this lower back pain subgroup, and reflect how these patients described their own experiences.

Reported effectiveness for lower back pain

• 31% described their treatment as ‘extremely effective’
• 53% described it as ‘very effective’
• 10% reported ‘moderate effectiveness’

When combined, that's a total of 94% of study participants who were prescribed Releaf medical cannabis options for lower back pain reported at least a moderate level of treatment effectiveness.

How quickly did patients notice pain relief?

• 34% noticed some level of relief from the ‘first dose’
• 16% noticed changes ‘within the first day’
• 37% noticed changes ‘within the first week’

That's 87% of lower back pain respondents who felt effective pain relief from their Releaf prescription within the first week of starting treatment.

Reported quality-of-life changes

• 62.2% said their quality of life had ‘improved significantly’
• 34.4% said their quality of life had ‘improved slightly’
• Only 3.3% reported ‘no change’
• 0% reported a worsening in quality of life

This equates to 96.6% of lower back pain respondents reporting a measurable level of improvement in their overall quality of life after starting medical cannabis treatment with Releaf.

Releaf patient survey results for lower back pain

Measure	Patient-reported response	Percentage of respondents
Overall treatment effectiveness	Reported treatment as at least moderately effective (extremely, very, or moderately effective combined)	94%
Speed of pain relief	Noticed some level of pain relief within the first week of treatment	87%
Quality-of-life impact	Reported some level of improvement in their overall quality of life	96.6%

To see more, please download the Releaf Medical Cannabis Patient Survey 2025: Key Findings (PDF)

Download Key Findings Report

Download the Full Report

When should you see a doctor about lower back pain?

That is quite a hard question to answer universally, as there are so many variables in play. The type of pain, where it is felt, and how debilitating it is all play a role in determining when it is time to seek clinical guidance. 

But, generally speaking, it is best to speak with a doctor if your lower back pain is worsening over time, settles but then returns quickly, or is starting to have a noticeable impact on your ability to work, sleep, or just live your normal life over a period of 7 to 10 days. 

That said, if your lower back pain is having a severe impact on your quality of life, and you are not able to mitigate the pain through self-care methods within 24 to 48 hours, please do not hesitate to seek medical attention. 

What tests or scans are used for lower back pain, and why are they not always needed?

The lower back is a complicated area that consists of muscles, bones, discs, nerves, and joints, which scans do not always show in a way that clearly explains why your pain is presenting, and can sometimes complicate things further. Many people without any pain at all show disc bulges, normal wear and tear, or joint changes linked to ageing on scans, while others with significant pain have imaging that appears largely normal.

Imaging is usually only suggested when the pain has persisted for many months, when conventional treatment avenues are not have not helped significantly, or in the instance of a significant injury such as a car crash or fall from heights. 

X-rays, MRI scans, and CT scans can show bones, discs, and soft tissues, but they cannot measure pain itself. A scan may help rule out specific conditions, but it does not always explain why pain continues.

Are there exercises that can help lower back pain?

For most people suffering from ongoing lower back pain, a gentle exercise routine can play a crucial role in recovery. That said, it should not be intense, gruelling, or complex, especially when first beginning. Slow, controlled movements are the name of the game here, and consistency is key.

Do not expect to see results overnight. It can take weeks or months (and in some cases, longer) for your old strength, mobility, and confidence in movement to build back up to what it once was. 

There are guides online that show specific movements and exercises for lower back pain, but we will refrain from offering that here. The lower back and the cause of pain in this region are simply too complex, and the last thing we want is to give advice that may worsen the pain. A physiotherapist is the best person to assess your situation and guide you through exercises that are appropriate for your body and your pain.

What can you do today to ease lower back pain, and what are the next steps if it affects your quality of life?

If you are in the midst of a lower back pain flare-up, there are a few main recommendations and small adjustments you can make right now to help the symptoms settle while you decide on your next steps:

• Adjust your seated position and ensure your feet are flat on the floor when sitting, make use of a supportive aid, and try not to sit in the same position for too long. 
• When sleeping or lying down, try lying on your side with a pillow between your knees, or on your back with a pillow under your knees.
• Use a heat or cold pack, depending on your specific symptoms. Heat is for stiffness and/or tight muscles, cold is for inflammation and irritaion control
• Keep moving through the day, but gently. Try soft stretching exercises, but never push past the point of pain. 
• Avoid heavy lifting, fast twisting, or any uncomfortable movements. 
• Keep a pain journal over the next few days. It can be easy to forget when the pain spikes, but this will really help healthcare workers consider your case and possible treatment options. 

If the pain doesn't subside over the next few days, head to your local GP and/or physiotherapist. Both will be able to guide you through your next logical and appropriate treatment options.

If your lower back pain is already classed as chronic, and conventional approaches have not reduced symptoms to a level you can live with, a UK medical cannabis prescription may be the first step to less pain and a better quality of life. 

To see whether medical cannabis treatment could be appropriate for your lower back pain, or other conditions medical cannabis is prescribed for, head over to Releaf’s medical cannabis eligibility checker. It is free, takes less than 20 seconds, and provides a clear preliminary answer on your potential UK medical cannabis prescription eligibility.

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