BACK PAIN About back pain
Back pain is a very common complaint – an estimated 60-80%
of people are affected at some point in their lifetime. Anyone can get back pain at any age, but it's most common in people
between the ages of 35 and 55, or over. It is one of the main
Your back has contains a number of different structures,
including bones, joints, muscles, ligaments and tendons. Its
main support structure is the spine, which is made up of 24
separate bones called vertebrae, plus the bones of the sacrum and coccyx. Between the vertebrae are discs that act as shock
absorbers and allow your spine to bend. Your spinal cord
threads down through the central canal of each vertebra,
carrying nerves from your brain to the rest of your body.
It's often very difficult to know exactly what causes back pain, but it's usually thought to be related
to a strain in one of the interconnecting structures in your back, rather than a nerve problem. Back
pain caused by a more serious, underlying condition is rare and you're unlikely to be affected unless you are very old or very young. Symptoms of back pain
If you have low back pain, you may have tension, soreness or stiffness in your lower back area. This
pain is often referred to as 'non-specific' back pain and usually improves on its own within a few days.
Back pain may be called either 'acute' or 'chronic' depending on how long your symptoms last. You
acute back pain - lasting less than six weeks
sub-acute back pain - lasting six weeks to three months
chronic back pain - lasting longer than three months
You should see your GP as soon as possible if, as well as back pain, you have:
numbness or weakness in one or both legs or around your buttocks
loss of bladder or bowel control (incontinence)
pain that is getting much worse and is spreading up your spine
These symptoms are known as red flags. It's important to seek medical help for these symptoms to
ensure you don't have a more serious, underlying cause for your back pain. Causes of back pain
For most people with back pain, there isn't any specific, underlying problem or condition that can be
identified as the cause of the pain. However, there are a number of factors that can increase your risk of developing back pain, or aggravate it once you have it. These include:
standing, sitting or bending down for long periods
lifting, carrying, pushing or pulling loads that are too heavy, or going about these tasks in the
There may be other, more serious underlying causes of your low back pain, but these are rare. They
fracture - a crack or break in one of the bones in your back
osteoporosis - a condition where bones lose density causing them to become weak, brittle
a slipped disc - this is when a disc bulges so far out that it puts pressure on your spinal nerves
spinal stenosis - a condition in which the spaces in your spine narrow
spondylolisthesis - when one of your back bones slips forward and out of position
degenerative disc disease - when the discs in your spinal cord gradually become worn down
osteoarthritis - a wear-and-tear disease that can particularly affect the joints of your spine
rheumatoid arthritis - an inflammatory condition in which your immune system causes
inflammation of the lining of your joints and surrounding structures
Low back pain may also be caused by an infection or cancer, but these two causes are very rare. Diagnosis of back pain
Your GP or Physiotherapist will usually be able to diagnose low back pain from your symptoms and
there is usually no need for further tests. If, however, your symptoms don't improve after a few weeks, or you have some red flag symptoms, he or she may advise further investigations. These
could be an x-ray, CT scan or MRI scan. They will help to find out whether you have a more specific,
underlying cause for your back pain. Treatment of back pain
If your back pain is non-specific, your GP & Physiotherapist will usually recommend conservative
rehabilitation as the first form of treatment. This consists of self-help and physiotherapy techniques. Your GP may also prescribe or advise pain relieving medications. If your symptoms are more severe,
or do not settle down you may be referred to a specialist, to assess whether you are suitable to have
spinal injections or surgery. These measures are not usually required with most forms of back pain, and aren't suitable for everyone. Self-help
There are a number of things you can do to help relieve low back pain.
Stay active and continue your daily activities as normally as you can. Bed rest may actually make low back pain worse, so try to limit the time you spend resting to a minimum.
Apply hot or cold packs to the affected area. You can buy specially designed hot and cold
packs from the White House clinic. If you prefer, you can apply a cold compress, such as ice or a bag of frozen peas, wrapped in a towel. Don't apply ice directly to your skin as it can
Use a TENS machine to help control your pain. Speak to your physiotherapist to see if this
Do some gentle mobilising and strengthening exercises: see our Exercises for Low Back Pain
Physiotherapy
A Physiotherapist is a health professional who specialises in maintaining and improving movement
and mobility. After a thorough assessment they may recommend a course of manual therapy
involving spinal mobilisation or manipulation, and techniques such as acupuncture, massage,
electrotherapy & supportive taping. Other treatment can include exercises, stretches & postural advice.
All of the physiotherapists at the White House have extensive training & experience of treating
patients with low back pain. They employ up to date & medically researched treatment techniques. They can help advise you on the best treatment options if you are suffering from low back pain, and
guide you through the recovery process. Medicines
Taking an over-the-counter painkiller (such as aspirin or paracetamol) or anti-inflammatory medicine (such as ibuprofen) is often enough to relieve acute low back pain. You can also use creams, lotions
and gels that contain painkillers or anti-inflammatory ingredients. Ask your GP or Physiotherapist if
If your pain is severe or chronic, your GP may prescribe stronger medicines such as diazepam,
morphine or tramadol. However, these aren't suitable for everyone because they can be addictive
and cause side-effects. Always ask your doctor or pharmacist for advice and read the patient
information leaflet that comes with your medicine.
Back pain, even if it's chronic, can usually be treated or managed successfully, but about one in 10
people have ongoing problem. Back surgery is really only considered as a last resort if the pain is related to a specific cause. Prevention of back pain
Good back care can greatly reduce your risk of getting low back pain. To look after your back, make sure you:
take regular exercise - walking and swimming are particularly beneficial
try to keep your stress levels to a minimum
bend from your knees and hips, not your back
maintain good posture - keep your shoulders back and don't slouch
Some general tips
Speak to your GP or Physiotherapist for advice Use something to help control the pain Stay active and at work if you can do Use a lumbar roll to improve your posture Avoid activities that can aggravate your symptoms Remember that back pain is rarely due to something serious
Further information Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. The White House Physiotherapy clinic has used all reasonable care in compiling the information but make no warranty as to its accuracy.
Consult a doctor or other health care professional for diagnosis and treatment of medical conditions.
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