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Are all cases of low back pain chronic?
- Yannick Sarton
- Jan 22
- 3 min read
Updated: 4 hours ago
Low back pain is one of the most common reasons people seek medical or physiotherapy care. Despite this, many patients fear that once back pain appears, it will inevitably become a long-term problem. This belief is understandable, but it is not supported by clinical evidence.
Low back pain is common and part of normal life
Experiencing low back pain at some point in life is normal. The vast majority of people will experience at least one episode, often related to daily activities, work demands, sport, stress, or temporary overload. Low back pain affects people of all ages and activity levels and is considered a major public health issue worldwide.
Most episodes are benign and do not reflect serious damage. The spine is a strong and adaptable structure, designed to tolerate load and movement. Pain often reflects temporary sensitivity rather than injury.
When low back pain is acute
Acute low back pain refers to pain that appears suddenly and usually lasts from a few days to a few weeks. In this phase, pain often comes from tissues such as muscles, ligaments, joints, or discs that have become temporarily sensitive.
This does not mean that something is broken or fragile. It simply means the system is reacting to load or stress. Early physiotherapy can help reduce pain, restore movement, and prevent unnecessary fear or avoidance. Guided movement, reassurance, and appropriate exercise often allow symptoms to settle naturally.
Most acute episodes improve significantly within weeks, even when pain feels intense at the beginning.
When and why pain becomes chronic
Low back pain is considered chronic when it persists beyond three months. At this stage, pain is less about ongoing tissue injury and more about changes in how the nervous system processes signals.
The brain can remain in a protective mode, continuing to produce pain even though tissues are healed or no longer at risk. Factors such as fear of movement, catastrophising, stress, poor sleep, and inactivity can reinforce this cycle.
Chronic low back pain is not imaginary, but it is complex. Treatment shifts away from fixing a structure and toward retraining movement, restoring confidence, and calming an overprotective nervous system. Physiotherapy plays a key role by combining education, graded exercise, and functional rehabilitation.Early care reduces the risk of chronic pain
Low back pain is one of the most common reasons people seek medical or physiotherapy care. Despite this, many patients fear that once back pain appears, it will inevitably become a long-term problem. This belief is understandable, but it is not supported by clinical evidence.
Early care reduces the risk of chronic pain
The earlier low back pain is managed appropriately, the lower the risk of it becoming persistent. Education, reassurance, and active care help patients stay mobile and avoid unnecessary rest or fear-based behaviours.
International guidelines emphasise conservative management, with physiotherapy as a cornerstone of care. Passive rest alone is rarely effective and can sometimes worsen outcomes.
Conclusion
Most low back pain is not chronic
The majority of low back pain episodes are acute, reversible, and not dangerous. Chronic pain represents a smaller proportion of cases and is influenced by how pain is understood and managed over time.
Early physiotherapy intervention helps prevent chronicity by restoring movement, confidence, and control.
I provide structured and evidence-based online physiotherapy for patients worldwide, offering clinical assessment, diagnosis, and personalised rehabilitation.
I also receive patients in person at my physiotherapy clinic in Phnom Penh.
You can begin your online physiotherapy session through the dedicated platform:
More information on clinical standards and supporting evidence is available here:
Yannick Sarton, MSc Physiotherapist
International Online Physiotherapy & In-Clinic Care, Phnom Penh
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