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Back Pain

If you think all your friends suffer from back pain, you're probably right - about 3 out of 4 people get it at some point. Fortunately, the vast majority of cases aren't due to a serious condition, and should settle over time with no long term complications. Here are some pointers to help you work out if you need medical help, and how you can cope with the problem.

Back pain - what causes it?

Apart from your vertebrae (the bones in your back), your back has dozens of ligaments and muscles supporting it. Between the vertebrae are intervertebral discs, with a tough fibrous coat and a jelly like centre. These provide a combination of support and shock absorption and flexibility for the spine. The strong, non-flexible ligaments also provide support, keeping the many vertebrae in alignment. Muscles attach at dozens of points, allowing us to move in a variety of ways. In addition, the spinal cord, carrying all the nerve pathways from the brain to the rest of the body, passes through the middle of the intervertebral discs. Individual nerves leave the spinal cord through gaps between the vertebrae to connect the brain with every part of the body. These nerves are vulnerable as they leave the spinal cord to getting squashed, especially if one of the discs they pass next to 'prolapses', allowing the gel-like inside to protrude.

The common symptoms include lower back pain that radiates down to the buttocks, inflammation of the soft tissues that surround the muscles, stiffness in the lower back; restricted movements, inability to maintain correct posture, muscle spasms, and pain which continues for a longer period.

Back pain - what can I do?

Doctors used to recommend complete bedrest if you had back pain. We now know this can actually make matters worse, by allowing you to stiffen up. We also used to recommend a very firm mattress, and sleeping on your back. That advice has changed, too. Now we know that the best ways to speed recovery are:

  • keep as active as possible.
  • avoid heavy lifting and anything that causes severe pain.
  • sleep in the position which is most comfortable for you.
  • use the kind of mattress you find most comfortable.
  • set yourself targets to increase the amount of exercise you do each day. For instance, start with walking around in your bedroom and bathroom; then around the house; then taking a walk outside.
  • take painkillers regularly rather than 'when required', at least to start with. This will help you to keep active, and won't stop them working in the future or allow you to do things that damage your back more.
  • Talk to your GP about physiotherapy, or consider seeing an osteopath or chiropractor.
  • Go back to your GP if the pain gets worse, or if it persists beyond a few weeks.
  • In the longer term, keeping fit is hugely important. Swimming, walking and cycling are all great.
  • Avoid lifting when you're in an awkward, twisted position, even if you don't have back pain.
  • Always bend from the knees rather than bending forward to lift things from the floor.

If you suffer from persistent back pain, please consult one of our doctors who will perform a physical examination and take a brief medical history. Other additional tests such as X-ray or MRI scan may be required to confirm the cause of the condition and guide necessary treatment.

  • Queen's University Belfast
  • University of New South Wales
  • University of Syndey
  • Kings College London