Lower Back Pain That Feels Like It’s Locking: Causes, Relief & Costs

What does “lower back pain feels like it’s locking” mean?

When lower back pain feels like it’s locking, the spine or pelvis briefly feels stuck or jammed when you move—often after sitting or when standing up. This usually reflects facet joint irritation, sacroiliac joint dysfunction, and/or muscle spasm that limits the glide of the small joints, rather than a pinched nerve from a slipped disc.

Why your “back locks up when I stand” — common triggers

• Rising from a chair, twisting to reach, or taking first steps after waking

• Prolonged sitting or long drives

• Deconditioning, recent over-exertion, or an awkward lift

You may also notice short, sharp catches, stiffness, or a protective lean. These patterns are typical of mechanical pain sources.

Common Causes

1) Facet Joint Irritation (Facet Arthropathy)

Facet joints are small paired joints at the back of each spinal level. Inflammation here can cause localised low back pain, stiffness and spasm, which can feel like a “lock” during movement.

2) Sacroiliac (SI) joint dysfunction

The SI joints connect your spine to your pelvis. When irritated, they can cause lower back and buttock pain that may catch with standing or stair-climbing—again often described as “locking”.

3) Protective muscle spasm

Your paraspinal and gluteal muscles often tighten to protect sore joints, adding to the locked sensation.

How does this differ from disc-led sciatica?

Sciatica is nerve root pain, typically causing leg pain that’s worse than back pain, with pins and needles or numbness. It’s commonly due to a disc prolapse touching a nerve. Locking is less typical.

Red Flags & When to Seek Urgent Care

Seek same-day medical attention (A&E/999) if you have any of the following, as they can indicate cauda equina syndrome or other serious conditions:

• New urinary retention, incontinence, or loss of bladder/bowel control

• Saddle numbness (between the legs)

• Severe, progressive leg weakness or numbness

• Unexplained fever, weight loss, history of cancer, significant trauma

• Use your local emergency services if these occur.

How Specialists Diagnose the Cause

1. History & examination – Patterns of pain, locking triggers, and targeted provocation tests for facet/SI sources.
   
   

2. When imaging is (and isn’t) needed – Routine X-rays/MRI are not recommended in non-specialist settings unless red flags are present or results would change management.

3. Diagnostic blocks
   
   

• Medial branch block (MBB): a tiny amount of local anaesthetic is placed on the medial branch nerves that supply the facet joints. Short-term pain relief confirms facet origin.

• SI joint diagnostic injection: local anaesthetic into the SI joint to confirm it as a pain generator.
  
  

These targeted tests help decide if interventional care (e.g., radiofrequency denervation) is appropriate. NICE recommends RFD only after a positive MBB.

First-Line Self-Care & Physiotherapy

• Keep moving: normal activity within comfort helps recovery and prevents further stiffness.
  
  

• Physiotherapy-led exercise: gradual mobility, core conditioning and pacing (aim for regular sessions across the week).

• Simple analgesia: short courses of over-the-counter pain relief if safe for you.

• Pacing: break tasks into smaller, manageable chunks; avoid long periods in one posture.

• Expectations: many episodes settle over weeks with active self-management.

Image-Guided Treatments: What to Expect

Who might benefit? People with persistent mechanical low back pain who’ve tried appropriate conservative care and have diagnostic evidence pointing to facet or SI joints. For acute/severe sciatica, an epidural steroid injection may be considered.

What are they?

• Facet joint injections or SI joint injections (local anaesthetic ± steroid) can calm inflamed joints and help you progress with rehab.

• Medial branch blocks confirm facet-led pain and are a gateway to RFD in the right candidates.

• Radiofrequency denervation (RFD) uses heat at the tip of a fine probe to interrupt facet nerve pain signals, typically after positive diagnostic blocks. Evidence of benefit is mixed overall, but selected patients may gain meaningful relief.

• Lumbar epidural steroid injection is usually reserved for sciatica (nerve-root leg pain), not for mechanical locking alone.

How procedures are performed

At specialist clinics, injections are done as day-case procedures using ultrasound and/or fluoroscopy (X-ray) guidance to place medication precisely and safely. Ultrasound avoids radiation and is accurate for some spinal/nerve-root approaches in experienced hands; fluoroscopy remains standard for many spine targets.

Typical steps

1. Pre-assessment: review medicines (especially blood thinners), allergies and consent.

2. Positioning & skin prep (sterile technique).

3. Local anaesthetic to numb the skin; needle guided to the target under imaging.

4. Test dose/contrast (if fluoroscopy) to confirm placement.

5. Injection (local anaesthetic ± steroid) or RFD lesioning if indicated.

6. Aftercare: short observation, advice on activity, and return to physiotherapy. (Contact your health provider urgently if you develop fever, new leg weakness or signs of infection.)

Benefits of a Private Pain Clinic

• Shorter waiting times and flexible scheduling

• Consultant-delivered assessments and procedures

• Routine image guidance for precision and safety

• Integrated physiotherapy to protect and extend gains

• Continuity of care with proactive follow-up

Searching “lower back pain specialist near me”: How to Choose a Provider

• CQC registration and safety record (independent hospitals/clinics in England).

• Routine ultrasound/fluoroscopy guidance for spinal/SI procedures.

• Consultant experience in pain medicine/anaesthesia; ask about volume and outcomes.

• Transparent pricing (what’s included/excluded, likely repeat schedule).

• Evidence-aligned pathway (e.g., diagnostic medial branch block before RFD; epidural offered primarily for sciatica, not mechanical locking).

Risks, Side Effects, and Recovery

Common, short-lived effects after injections/RFD include bruising, temporary numbness, and a flare of pain for a few days. Contact the clinic if you feel feverish/unwell, experience chest pain, or have severe breathlessness. Serious complications are uncommon. 

Results & How Long Relief May Last

• Facet/SI injections: relief varies (days to months); often best used to enable rehab. 

• Radiofrequency denervation: not a cure; in selected individuals, it may reduce pain for months to a year or more. Relief can last 6–24 months and occasionally longer; if the pain returns, the procedure may be repeated.

• Epidural for sciatica: may help acute/severe nerve-root pain; benefit is usually short- to medium-term.

About RAD Clinics

Expert-led, patient-centred care delivering ultrasound-guided non-surgical spine and SI treatments (facet/SI injections, medial branch blocks, radiofrequency denervation), with integrated rehabilitation and short waiting times. Teleconsultations available; personalised care plans and clear aftercare.

FAQ

1) Is a locking sensation dangerous?
Usually, no—it commonly reflects mechanical facet/SI irritation and muscle spasm. Red flags (new bladder/bowel issues, saddle numbness) need urgent care.

2) Do I need a scan first?
Not usually. NICE advises against routine imaging unless serious pathology is suspected or the results would change management.

3) What is a medial branch block?
A diagnostic injection that numbs the facet joint’s nerve supply. If your pain eases temporarily, your pain is likely facet-led, and you may be considered for RFD.

4) How soon will injections work?
Local anaesthetic acts quickly; the steroid (if used) can take a few days. Soreness for 24–72 hours is common. Resume gentle activity as advised.

5) How long does RFD last?
If effective, RFD may ease pain for months to 1–2 years, sometimes longer; nerves can regrow over time.

6) Who should avoid certain injections?
People with active infection, uncontrolled bleeding risks, or certain medical conditions may need to delay/avoid procedures—your consultant will advise.

7) What are the benefits of ultrasound guidance?
No radiation, real-time soft-tissue visualisation; accuracy is high for several spinal approaches in experienced hands. Fluoroscopy remains standard for others—clinics often use both.

8) Private vs NHS—what’s different?
Private care can offer faster access and longer consultations. Pathways should still follow NICE guidance (e.g., RFD only after positive MBB).

9) Can I drive after my injection?
Usually not on the same day—arrange a lift. Your team will confirm when you’re safe to drive.

10) When is an epidural appropriate?
Mainly for acute/severe sciatica, not for mechanical “locking” pain by itself.

Next Steps

If lower back locking is holding you back, book a thorough assessment with our specialists. We’ll confirm the source of pain, tailor non-surgical back pain treatment, and discuss options—from physiotherapy to ultrasound-guided back injection pathways. Learn more or enquire about ultrasound-guided SI joint injections at RAD Clinics.