Back Pain

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Video Credit: Cheshire & Merseyside Back Pain Campaign

Back pain is common with 80%  of people having an episode of back pain in their lifetime. In most cases, this will improve within a few days / weeks. Very few cases are due to serious disease.

Back pain can be very painful and disabling leading to a big impact on your everyday activities at work and home. Most back pain will recover without any medical intervention.

Understanding your back pain and the right things to do helps reduce the fear and concern about the condition. This along with keeping moving helps you to recover more quickly.

Episodes of back pain are usually short-lived and most people will see an improvement by doing the following:

  • Continue with your day-to-day life as much as possible - Gentle movement / activity helps speed recovery. Remember pain does not mean you are damaging your back and you should improve more quickly if you continue to move, even if this causes some discomfort. 

  • Take regular pain relief - Seek advice from a pharmacist if you are unsure what to take.

The body needs time to recover. You should start to feel gradual improvement after 7-10 days but if after 2 weeks there is little change, or if your pain is severe contact your GP surgery. 

When should I seek urgent help?

Cauda equina syndrome is a rare and severe type of spinal stenosis where all of the nerves in the lower back suddenly become severely compressed.

Symptoms include:

  • sciatica on both sides

  • weakness or numbness in both legs that is severe or getting worse

  • numbness around or under your genitals, or around your anus

  • finding it hard to start peeing, can't pee or can't control when you pee – and this isn't normal for you

  • you don't notice when you need to poo or can't control when you poo – and this isn't normal for you

Cauda equina syndrome requires emergency hospital admission and emergency surgery, because the longer it goes untreated, the greater the chance it will lead to permanent paralysis and incontinence.

New / Sudden onset weakness

Sometimes, if the nerves in your back have have been pinched enough, this can cause weakness in certain movements. You should seek more urgent help if:

  • You have developed new onset or worsening weakness into your arms or legs e.g unable to pull your foot up towards you or reducing grip strength

If you are unsure if you need more urgent help, ring your GP as soon as possible or if you have been referred to Physiotherapy, contact the Physiotherapy Department. 

More about back pain

Sciatica


Sciatica is a pain that travels down from your lower back or buttock, to your foot. It usually happens when the jelly within the discs that separate the bones of your spine (vertebrae) pushes out of the disc and irritates the sciatic nerve. Swollen muscles, joints or ligaments can also irritate the nerve causing sciatica. The sciatic nerve runs down through the back, into the buttock, down the back of the leg and round to the outside of the lower leg and foot. When the nerve gets compressed or irritated, the brain interprets the pain as coming from the buttock or leg instead of the back, where the problem actually is. The pain is often a severe shooting pain, sometimes accompanied with pins and needles or numbness. You should seek urgent medical attention if you experince any of the following: - loss of control of your bladder or bowel - numbess around your saddle (genital) area - problems with the coordination of your steps when walking




Acute back pain


Acute back pain can come on suddenly, or over time and can range from a mild pain or ache to quite severe pain, which can be extremely distressing and can sometimes stop you carrying out your everyday activities. It is often difficult to identify why your back is painful as the pain can come from joints, muscles or nerves being inflammed, stretched or compressed. It can often be caused by lifting or moving awkwardly. However, more often than not, acute back pain comes on without any specific injury to your back. You may experience:

  • Back pain
  • Muscle spasm
  • Stiffness
  • Leg pain (sciatica)
Watch the video above to find out how to help with this. For most cases of back pain, X-ray and scans are of little benefit.




Chronic Back Pain


Chronic back pain refers to pain that has not gone away after three months. Like acute back pain, it is usually caused by a strain or a sprain in the back - but the pain and distress can last for much longer and it can have a big impact on your day-to-day life.

Chronic back pain can range from a mild pain or ache, to a more severe pain. This can depend on a variety of things, such as how happy you are at home or at work, if you are prone to depression or if you have had back pain before. Chronic back pain usually requires treatment such as medication or physiotherapy. In most cases though, your back will heal itself. It is important that you keep active and continue as normal, but if your pain is severe and persistent then you should seek medical advice for diagnosis and the appropriate treatment.





Keeping Active

Regular exercise is a great way to manage back pain. People with higher fitness levels tend to experience less back pain. Try to go walking, swimming or cycling for 30 minuets or more a day.

 

Exercise classes such as yoga or pilates are also great for building strength in your back, and visiting the gym could also help.

Keeping active is good for you, even if you're suffering back pain. Exercising can feel painful, but keeping active is one of the best ways to help manage your back.

 

Often people who have had back pain for long periods lose confidence their back. This means we often move the back less and are more cautious, which can mean we're less active and lose strength and our  pain can get worse.

 

Exercise is a great way to build up confidence again, but it can be daunting. Start slow and steady. It takes time, but in most cases our back can recover. 

Gardening

Tips with Gardening

For many people, gardening is an active hobby that allows them to enjoy being outdoors. Having back pain doesn't mean you need to stop gardening. But it can help to adapt what we do.

Plan out what you have to do that day. It can be a good idea to warm up and get your back moving. Think about what you have been doing recently to keep active. The body does not like big increases in exercise, so if you’ve not done much over the colder months, then its important to gradually build your fitness as you return to the garden.

Supplementing gardening  or physical work with an overall exercise program is a great way to keep the back and body healthy.  If you’re not used to heavy lifting then it may be better to get some help or lighten the load. This may mean it takes a little longer to perform the task but lots of light trips are better for your back than one heavy task. Wheelbarrows can be really useful to make things easier. If you are tired, have a break to recover. Gardening is a great way to keep active, but be realistic with how fit you are. Consider the layout of your garden. It may be more suitable to have raised beds or pots which mean easier access and less demanding body positions. Again, it's better to start easy and gradually build up. Your health and your back are much more important than the condition of our garden. 

The Myths about back pain. 

from The Chartered Society of Physiotherapy