Back pain is very common. Approximately 8 out of 10 people will experience an episode of back pain at some point in their life, often starting for no obvious reason, which can be very frustrating. It is important to remember although back pain can be painful and worrisome it is rarely serious. The spine is strong and back problems are rarely due to any serious disease or damage. Most back pains normally resolve without any treatment within 6-12 weeks. You will not normally need an X-ray or an MRI scan.
A number of factors have been associated with back pain including:
- A sprain/strain e.g. lifting something awkwardly or something that is too heavy for what you are physically used to doing.
- A sudden increase or decrease in your normal activity or exercise levels.
- Conditions such as osteoarthritis and fibromyalgia.
- Increased stress, worry or low mood.
- Poor sleep, fatigue or feeling run down.
- Lifestyle factors such as being overweight and smoking.
- A flare up of longstanding back pain.
- Pregnancy with increased and altered load as well as hormonal changes. Often back pain can continue following birth too.
These include:
- Pain in your lower back which can travel into your buttocks, thighs or hips.
- Stiffness after a period of rest or reduced movement e.g. first thing in the morning.
- Difficulty moving e.g. getting up from a chair or out of bed, or bending and lifting.
- You may experience constant or intermittent (come and go) symptoms, that are aggravated by certain activities and reduced by others.
What should I do?
- Keep moving & stay active, even if slowly at first. This helps you to stay active and maintain muscle strength.
- Keep living and working normally. This is important and is the best way to get better.
- It is normal to experience some pain during your recovery, but it does not mean you are causing harm or damage to your back.
- Consider doing light tasks at first. Speak to your manager about work concerns that you may have.
- Don’t sit down for too long, change positions regularly wherever you are.
- Avoid bed rest during the day.
- Stay active and remember to re-introduce activities like heavy lifting gradually.
- Exercise really helps your back and can relieve pain, start with light fitness training.
- It is recommended to try to continue at work or return as soon as you are able. Your employer, GP or health practitioner will be able to advise on how to return to your normal work duties.
- Regarding returning to sports, start with light fitness training, and play when you feel ready.
Try these self-help tips to aid your recovery:
- Review our condition specific self -help guides
- Apply a heat or ice pack on a wet cloth, to the painful area – for up to 15 minutes. Never apply heat or ice directly to the skin to avoid burning.
- Pain medication can help to reduce the pain and help you move more comfortably, which can help your recovery. Speak to your pharmacist about medication or other methods of pain relief . It is important to take medication regularly.
- Keep moving. Regular movement and exercise is safe and helpful for back pain. It is important to build up gradually – the exercise or activity you enjoy most, is likely to help your recovery. NHS keep moving
- If sitting causes pain try adopting varied and relaxed postures throughout the day which may help.
- Good sleep habits and managing stress may help you cope better with your pain. NHS sleep well
Please see our condition specific self help guides, with exercises and management advice for you to try to self manage your condition.
TBC
- Back pain is RARELY linked to serious tissue damage or a life-threatening condition.
- X-rays and scans often DO NOT show the cause of your pain.
- Backs DO NOT go ‘out of place’ and are very strong.
- Your back can become stronger and healthier with regular movement and exercise.
- Gradually loading your back by including bending and lifting movements is SAFE and can make your back stronger.
- There is NO perfect posture, slouching will NOT damage your back but could lead to muscle strains and imbalances.
- Improving your sleep and general health is also important for your back pain.
- Treatments such as surgery, injections and strong medications are NOT very effective in the long term and often can have negative side effects.
- Your back pain can often improve with the right management. So, even if you have had it a long time regardless of your age, DO NOT give up and stick with a good management routine.
Call your GP surgery if:
- Your pain is getting worse.
- You have tried the self-help tips for 3-4 weeks and your symptoms have not improved.
- You have any of the following symptoms
- An unexplained onset of back pain accompanied by a history of Tuberculosis, HIV, cancer or rheumatoid arthritis.
- Feeling unwell with your back pain and have a fever or significant sweating that is keeping you awake at night.
- Feeling unwell with your back pain and have a history of cancer, loss of appetite or unexplained weight loss.
There are occasions, where you may have a combination of back and leg pain. These symptoms can be distressing, but don’t necessarily require medical attention.
When to seek immediate medical advice:
Cauda Equina Syndrome is an extremely rare but serious back condition. It can cause permanent damage and disability. It is important to seek immediate medical advice if you have any combination of the following symptoms:
- Pain in both legs accompanied by weakness and/or a loss of feeling/pins and needles.
- Loss of feeling/pins and needles between your inner thighs or genitals.
- Numbness in or around your back passage or buttocks.
- Altered feeling when using toilet paper to wipe yourself.
- Increasing difficulty when you try to urinate.
- Increasing difficulty when you try to stop or control your flow of urine.
- Loss of sensation when you pass urine.
- Leaking urine or recent need to use pads.
- Not knowing when your bladder is either full or empty.
- Inability to stop a bowel movement or leaking.
- Loss of sensation when you pass a bowel motion.
- Change in ability to achieve an erection or ejaculate.
- Loss of sensation in genitals during sexual intercourse.
If any of these warning signs develop following the onset of your back pain you should attend your nearest Accident and Emergency Department.
- X-rays or scans or are not usually required to diagnose back pain.
- X-rays or scans are not able to tell us how much pain you are experiencing. They often show normal age-related changes and often this does not change how you manage your pain.
- X-rays and scans best used where a serious injury (e.g. a broken bone) or conditions such as cancer, infection or cauda equina syndrome are suspected.
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If you’re off work sick for seven days or less, your employer will normally ask you to complete a self-certificate for sick leave as soon as you return to work.
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If you're off work sick for more than seven days your employer will normally ask for a fit note (or Statement of Fitness for Work) from your GP.
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You can read more information here: Getting a fit note (www.nhs.uk)
Lower Back
Versus Arthritis back pain information booklet
Low back pain and sciatica in over 16s: assessment and management - NICE Guidance
BestMSK Spinal MRI: Patient Advice
Maintaining a healthy lifestyle
Making healthy lifestyle changes can help you improve your overall health and wellbeing.
Tips to help you lose weight - NHS
Fall asleep faster and sleep better - Every Mind Matters - NHS
Psychological talking therapies - LSCFT
Mental health support for veterans, service leavers and reservists - NHS
It’s important to consider addressing these lifestyle changes alongside your physiotherapy treatment. Your clinician will be able to offer further advice or signpost you to other organisations or local services for further support with improving your wellbeing.