Recurring back pain
Why does my back catch when I get out of the car?
You can sit through the whole drive, then feel your back catch the moment you stand. I want to see the moment it happens. Getting out of the car gives us a movement we can compare before and after we change something.
Why the catch gives us a place to start
Getting out of a car asks you to turn, shift your weight, and stand in a small space. If you’ve started pushing off the door with both hands or pausing halfway up, tell me when you started doing that. Pain can change how people move and share the work across their body. The pattern can help us decide what to compare during an exam.1
Show me how you get out on a stiff day. The part you’ve learned to work around is worth looking at.
What I might assess and retest
I might watch you stand from a low seat and ask when the catch starts. Then I may compare what changes with a different foot position or assess how your hips and lower back move. If gentle joint work seems appropriate, we can repeat the same stand afterward and compare the catch, the effort, and whether you still need your hands. Low back pain guidelines support joint mobilization for some patients and also recommend exercise selected for the person’s needs.2
If standing feels easier in the clinic, we have a lead. Your next drive tells us whether that change carries into your day.
What would make me change my approach?
Suppose you stand more comfortably when the seat is higher, but your back still catches from the original seat after hands-on work. I’d use the higher seat to understand what makes the task easier and go back to the original height to see what still needs attention. I might compare how you shift weight or how the hip moves before deciding what to try next. The original seat stays our point of comparison.
We keep coming back to the movement you came in for. If it feels the same, that tells us to keep looking.
What progress looks like outside the clinic
We can track how long you sit comfortably, how easily you stand afterward, and whether a normal day brings the same flare. As movement becomes easier, the plan can include practice and gradually rebuilding what you tolerate. In the WalkBack trial, a tailored walking and education program helped delay recurrence in adults who had recovered from an episode of low back pain.3
The goal is for you to get out of the car without thinking through every part of it.
Do I need an MRI first?
For most people with low back pain, guidelines advise against routine imaging at the start. Imaging can help when the exam suggests a serious problem or when the result would change care.4
When to get urgent help. Get emergency care for new numbness around the genitals or anus, new difficulty passing or controlling urine or stool, or severe or worsening weakness or numbness in both legs.5
References
- Hodges and Tucker. Moving differently in pain, a proposed model of pain adaptation. Pain, 2011. ↩
- George et al. Interventions for the Management of Acute and Chronic Low Back Pain. JOSPT, 2021. ↩
- Pocovi et al. The WalkBack trial of progressive walking and education after low back pain. The Lancet, 2024. ↩
- NICE. Low back pain and sciatica in over 16s, guideline NG59. ↩
- NHS. Sciatica and when to seek emergency care. ↩