How common is back pain?
It is estimated that around 80 per cent of adults in industrialised countries will suffer from back pain at some point in their lives. In a survey conducted in 2000, 49 per cent of the UK adult population reported low back pain lasting at least 24 hours at some point in the year. Most people will recover quickly, but some will have serious or long-term problems with their back.
What causes back pain?
Your spine is made up of a column of bones (vertebrae) stacked one on top of another, with a cushioning disc between each. Your bones and discs are held in place by ligaments and muscles. All of these can become stretched, damaged, or move out of place, causing pain.
Back pain can be caused by standing or sitting in the wrong position, straining the muscles suddenly, lifting in the wrong way or being overweight. Back pain is also common during pregnancy.
A 'slipped disc' occurs when one of the discs in your spine gets squashed and bulges. Your disc does not slip out altogether, but it can put pressure on nerves causing sciatica, a numbness or pain travelling down the back of your leg. A 'slipped disc' can also cause weakness in your ankle or foot, or problems with your bowels or bladder, such as constipation or being unable to pass urine.
Less commonly, back pain may be caused by disease in the spine itself or in the joints of your spine.
What tests will I need?
Your doctor will examine your back, and if the pain is persistent may arrange an X-ray, although these are not recommended routinely. Although X-rays are not usually helpful in sorting out the cause of the pain, they can sometimes help to make the diagnosis. Occasionally your doctor may want to do blood tests or refer you to hospital for a scan.
What treatment is best?
Bed rest is not recommended as a treatment for simple low back pain. Patients are advised to stay as active as possible and to continue normal daily activities. You should, therefore, move around again and do some walking to gradually loosen your back muscles. As the pain subsides, it is important to strengthen up the muscles with exercises to help prevent further problems. Your doctor or physiotherapist will be able to tell you about these.
If the pain starts, you can apply ice for five to 10 minutes at a time, or alternate ice with heat to help settle the pain.
Your doctor or pharmacist will advise you on which painkillers or anti-inflammatory medications to take. These will help make you comfortable enough to move around gently and do the exercises. In most cases you will be advised to try a simple painkiller such as paracetamol to begin with. If this doesn't help you will usually be advised to try an anti-inflammatory medication such as ibuprofen (available from pharmacies without a prescription). If necessary, your doctor may prescribe a stronger painkiller such as co-dydramol (paracetamol + dihydrocodeine) or a stronger anti-inflammatory such as diclofenac. Your doctor may also prescribe a short course of a muscle relaxant such as diazepam if painkillers or anti-inflammatories alone fail to control the pain. In a small percentage of cases back surgery may be recommended.
Pain is a warning to you that you have a problem. Do not ignore it. Even when the pain begins to settle, take things easy and avoid straining your back.
How can I prevent back pain?
Your back is involved in every movement you make, so you need to take care how you sit, stand, drive, sleep, exercise and work, especially if you have had back problems before. A physiotherapist can advise you about this.
Taking regular exercise will help to strengthen your back muscles. Take care when lifting; always bend your knees and keep your back straight, rather than bending over at the waist. Use a trolley to carry heavy weights.
Take action now
- Try not to sit for too long at any one time as this increases the pressure on the discs in your back. Stand up and walk around regularly.
- Sit on firm chairs. Avoid very soft chairs that you sink into.
- Sleep on a bed with a firm mattress. If your bed is very soft, put a board under your mattress or move the mattress onto the floor.
- Do not sleep on your stomach as this can lead to back pain. Lie on your side or back instead.
- Walking and swimming are good exercises if you have had back pain before. However, avoid swimming when your back is painful.
- If your back pain does not settle, see your doctor, physiotherapist, osteopath or chiropractor.
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Fact sheet provided by MIMS
Date last reviewed: June 2014