Lower Back Pain That Won't Go Away? Here's What It Means and What to Do
Updated July 20261 minute read
Lower back pain lasting more than about 6–12 weeks is called persistent (chronic) back pain. It usually doesn't mean ongoing damage — instead, the pain system has become sensitized, and muscles have weakened from guarding and inactivity. The most effective approach is active: graded exercise, building strength and confidence, and a structured PT plan. New red-flag symptoms (leg weakness, groin numbness, fever, weight loss) should always be checked.
What this usually means
Most likely causes. Persistent pain is often driven by a sensitized nervous system, deconditioning, fear of movement, and stress — rather than a single structural "thing" still being injured. Conditions like disc aging or facet irritation may be involved, but hurt does not always equal harm. Less common causes. Ongoing or worsening pain with red flags (weight loss, fever, night pain, neurological changes) warrants medical evaluation to rule out other causes.
What you can try at home
Resume activity gradually rather than waiting to be pain-free. Walk daily, set small movement goals, prioritize sleep, and avoid the "rest until it stops" trap. A graded plan you can stick to beats passive treatments.
When to see a physical therapist
Persistent pain is exactly what PT is designed for — a therapist builds a paced, confidence-restoring program and addresses the factors keeping pain switched on.
Red flags — don't wait
Seek care for new or worsening leg weakness, groin numbness, loss of bladder/bowel control, fever, or unexplained weight loss.
How a PT treats this
Care combines graded exercise, strength building, education about pain, and strategies to reduce flare-ups and rebuild activity.
Frequently asked questions
Sources (3)
- Qaseem A, et al. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017. — PubMed
- George SZ, et al. Interventions for the management of acute and chronic low back pain: revision 2021. Clinical practice guideline. J Orthop Sports Phys Ther. 2021. — PubMed
- MedlinePlus: Low back pain - chronic. — NIH/MedlinePlus
This article is for education only and isn't medical advice. Always talk to a licensed clinician about your specific situation.