Back pain

Back pain is very common and most people suffer from it at some time, however, most back problems heal naturally. The spinal cord which carries nerves from the brain the rest of the body travels in a canal through the ‘vertebrae’. These are the bones that make up the ‘spinal column’. This is what you feel if you run your fingers up the centre of your back.

What causes back pain and who is at risk?

Pain from the back may have a single cause, such as a blow, a fall or over-exertion, but is far more likely to be caused by a gradual accumulation of stress and strain on the back over a long period. Occasionally, back pain may be caused by pressure on the nerves in the spine, usually from a damaged vertebral disc.

General causes of back pain include:

Prolonged standing or bending at work

Badly designed seating, especially during sedentary work

Stress



Specific causes of back pain include:

Lifting, pulling, pushing or carrying objects incorrectly or that are too heavy

An accident, such as a fall

Menstruation or pre- menstrual syndrome (PMS)

Arthritis



Causes of lumbar pain include:

Pressure on a nerve in the lower back

Bladder infection, an enlarged prostate or prostate cancer

A damaged (‘ruptured’) vertebral disc

Degeneration of the vertebrae (spondylosis)

Inflammation of the vertebrae (spondylitis)



Some other conditions can cause pain:

Inflammation of the pancreas (pancreatitis)

Aortic aneurysm (enlargement and weakening of the major artery called the aorta)

Heartburn



How do doctors recognise back problems?

Pain that travels down the legs below the knee

Weakness or numbness in one or both legs

Loss of control of the bowel or bladder



You should also seek your doctor’s advice if:

You have persistent pain after a severe blow, a fall or an injury

Your back pain lasts longer than a week.



If damage to the nerves of the spinal cord is suspected, you may need additional tests or treatment. These may include X-rays, CT (computerised tomography) scans, MRI (magnetic resonance imaging) or a myelogram (a special X-ray) which shows the nerves and spinal cord (see separate factsheets for descriptions of these investigations).

What is the treatment for back pain?

Self-care action plan

The best way to prevent common back problems is to stay fit and active. An exercise programme should include stretching and strengthening specifically for the back, and aerobic exercises. A physiotherapist, osteopath, chiropractic or fitness trainer can suggest which exercises are best for each individual but remember: any exercise should be gentle and you should never be forced to strain your back.Rest the feet flat on the floor or use a foot support to prevent the weight of the lower legs being supported by the front of the thighs.

To lift safely:

Make a firm base with the feet, keeping them about shoulder width apart

Lift with the legs, bending the knees rather than the back

Do not kneel or overbend the knees

Keep the chin held in and raised as this helps keep the back straight

Ensure the load is as close to the body as possible



Complementary therapy

The Alexander technique can help you adopt a posture that puts less strain on the back.