About Back Pain
Back pain is a very common complaint – an estimated 60-80% of people are affected at some point in their lifetime. People can experience back pain at any age, but it is most common between the ages of 35 and 55. It is one of the main reasons for sickness absence from work.
Your back contains numerous structures, including bones, joints, muscles, ligaments and tendons. The spine is made up of 24 individual bones called vertebrae, plus the bones of the sacrum and coccyx. There are discs between each of the vertebrae that act as shock absorbers and allow flexibility in your spine. Your spinal cord travels down the central canal of each vertebra, carrying nerves from your brain to the rest of your body.
Back pain can be caused by a number of structures, but it can be difficult to determine exactly which one is at fault. More often than not the problem is related to a strain rather than nerve damage. More serious causes of back pain are quite rare.
Back pain is classified as either 'acute' or 'chronic'. This relates to the length of time that you have had your symptoms.
You should consult your doctor as soon as you can if you have any of the following symptoms as well as back pain:
constant unremitting pain, especially in the night pain down your legs and/or below your knees numbness or weakness in either leg, or in the buttock region high temperature incontinence: loss of bladder or bowel control It is important to seek medical help for any of these symptoms, to rule out a more serious, underlying reason for your back pain.
Causes of back pain
There are a number of factors that can lead to the development or aggravation of back pain. These include sustained postures such as standing and sitting, and repetitive movements such as bending and twisting. If you lift, carry or pull loads that are too heavy for you, this may lead to potential symptoms. You will be more prone to back pain if you are stressed, anxious or overweight.
Diagnosis of back pain
Your physiotherapist will ask you a few questions about your symptoms and perform a physical assessment in order to diagnose the cause of your low back pain. There is not usually a need for further tests.
Additional investigations, such as an x-ray, CT scan or MRI scan may be recommended if your symptoms aren't resolving.
Treatment of back pain
Evidence recommends conservative rehabilitation as the first line of treatment. This may involve self-help advice, exercises and physiotherapy mobilisations and soft tissue release.
You may also be prescribed pain relief by your doctor What can you do to help your pain?
Try to maintain your activity levels as much as you can. Bed rest is no longer recommended for low back pain, so avoid this, as it can lead to worsening symptoms. Use warm or cold treatment applications such as a hot water bottle or ice pack. These can ease pain and relax the muscles. You can buy specially designed hot and cold packs from the White House clinic. Don't apply ice or heat directly to your skin as it can cause burns. A TENS machine may help you to manage the pain. Your physiotherapist can advise as to whether this would be a suitable option for you 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.
Painkillers such as aspirin or paracetamol may be of use. Anti-inflammatory medicine, such as ibuprofen is another option. We recommend that you discuss this with your GP or pharmacist.
Most back pain will settle with conservative treatment, however approximately 10% of people have ongoing symptoms. Surgery will only be considered when all other options have been explored.
How to look after your back
Taking care of your back can minimise the risk of developing back pain. We advice that you take regular physical activity each week, try to minimise the amount of stress in your life and take measures to look after your posture and the way you use your body. Your physiotherapist can advise you on all of these matters.
You can try a few of these simple exercises to help ease low back pain. We advise that you consult with your Physiotherapist before commencing them.
Lie on your back with your knees bent up and feet flat. Keep your knees together and roll them steadily from side to side. Go as far as you can within your comfort zone.
Often you will not be able to allow a large movement initially as it may be uncomfortable, so keep a smooth and gentle motion going. It may become easier after a few repetitions.
Lie on your back with your legs straight out. Bend one leg up, pulling your knee up towards your chest with your hands. Try and keep the other leg relaxed. Hold the position for a few seconds at the top of the movement. Lower your leg back down and repeat on the other side.
Extension in lying
Lie on your front. Get up so you are resting on your forearms, as if you are lying on the beach and looking out to sea, then lie down again.
If you find this difficult you might need to start by just lying on your front for a short period of time for your back to get used to being in extension of some degree.
Your back and hips should be relaxed as you let them go and remain where they want. The only work you are doing is supporting your upper body weight with your arms and shoulders.
Standing side flexion
Stand with your hands against the sides of your thighs. Slide one hand down the same thigh, bending to that side and avoiding any twisting. Come back up and repeat on the other side.
Allow the range to increase slowly as you do it.
Stand with your palms against your buttocks, as if you are holding on to them. Move your hips forward, then lean back as far as you easily can. This can feel a bit tricky to start with but go easily and you will find it easier with time. This can be a very useful movement to do if you have a disc related problem and can’t lie down to do the extension in lying exercise.
Lie on your back with your knees bent up and feet flat. Start by tilting your pelvis a little so your back arches a bit. Now press the small of your back down to the surface and tuck your bottom under. Do not lift your buttocks up. This is a forward and back rocking motion and often tricky to get right. You should feel the small of your back has pushed down against the surface. If put your hand under your back when you arch slightly you will feel the pressure as you tilt correctly in the opposite direction.
Lie on your back with your feet flat and hip-width apart, arms relaxed, and knees bent. Squeeze your buttocks as you lift your hips, creating a straight line from the knees to the shoulders. Hold for a slow count of two, then lower slowly. Build up to 10 to 12 repetitions.
This move helps to stretch the hip flexors and strengthen the muscles that stabilise the spine, including those of the lower back, the gluteals, and the large, stabilising abdominal muscles.
Make it harder: When you get to the top of the movement lift one foot off the floor and hold it straight up toward the ceiling, keeping the hips even. This is much more challenging, so start by holding this pose for just a few seconds. Repeat 5 to 8 times, then switch legs.
General exercise such as swimming or walking can be beneficial when dealing with low back pain. Once it is settling down it is worth considering a course of Pilates to help strengthen the core muscles, or Yoga to help improve flexibility.
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