Adults
Mechanical (non-inflammatory) back pain
Back pain that worsens with activity and eases with rest, without inflammatory features or red flags.
What to look for
- Pain worse with activity or posture, better with rest
- Short morning stiffness and no night waking from pain
- No uveitis, psoriasis, IBD or other extra-articular features. Onset is often after 45.
What to do
- Manage with activity, exercise and physical therapy, and NSAIDs if appropriate.
- Image only for red flags (cancer history, fever, weight loss, neurologic deficit, trauma, osteoporosis).
Refer if
- Inflammatory back pain features appear (see axial spondyloarthritis)
About this urgency level
Common in referral queues. Many can be managed in primary care with the guidance below, though some rheumatology practices are happy to see them. A pre-referral e-consult can help decide.
Timeframes are typical targets. Local pathways, capacity and clinical judgment come first.