Back pain

Non-specific back pain is by far the most common type of back pain. Your doctor may be unable to identify exactly why you are experiencing pain, but it’s unlikely to be caused by anything serious. Muscle, tendon or ligament strain are the usual causes.

You may be able to pinpoint an event or movement that triggered your back pain. This could have been from lifting, straining or twisting awkwardly. You may have recognised your back pain coming on slowly, perhaps through repetitive movement in the workplace or sitting in one place for too long.

Back pain can also be the result of the normal “wear and tear” we all experience as we age.

Muscle tension, poor posture and even worry or stress can trigger back pain, or indeed delay recovery of existing pain.

Back pain can also be caused by damage to specific areas of the spine, also known as specific back pain. Some examples of such conditions are:

• A slipped disc
• A fracture
• Inflammation of the joints (arthritis) from conditions such as ankylosing spondylitis or rheumatoid arthritis

If you do see your GP about your back pain, they will always look out for signs of more serious conditions, but it is important to remember back pain is common and very rarely has a serious cause.

The NHS website advises you to contact your GP or NHS 111 immediately if you have back pain and:

• numbness or tingling around your genitals or buttocks
• difficulty peeing
• loss of bladder or bowel control
• chest pain
• a high temperature (fever) of 38C (100.4F) or above
• unexplained weight loss
• a swelling or a deformity in your back
• it doesn’t improve after resting or is worse at night
• it started after a serious accident, such as after a car accident

These problems could be a sign of something more serious and need to be checked urgently.

This information has been taken directly from the NHS website

Non-specific back pain can often be managed at home or with support from your local pharmacist or physiotherapy team. Pain usually subsides on its own within a few weeks or months however there are lots of things you can do in the meanwhile to reduce pain and feel better.

Stay active

It is now known that keeping active during a bout of back pain can help your back heal.

It can be quite uncomfortable to push through the pain and to keep moving – but your pain will start to improve as you do gentle exercise and continue with your activities.

Exercises and stretches

Gentle stretching and exercise will help you to manage your back pain. You can click on the links below for more information.

• Exercises for back pain – Arthritis UK
• Back Stretches (Youtube video)
• Lower back pain exercises (NHS website)

Resting in moderation

It can be tempting to rest when you have back pain, particularly if your pain is severe, however it is important to break rest periods with bouts of gentle activity.

Losing weight

If you are overweight, shedding the extra pounds can help to improve your back pain. Research shows that weight loss can benefit back pain even for those who do not have a lot of weight to lose.

Pain relief

It is not advisable to use medication on a long-term basis, however using pain killers for a short period of time can ease pain enough to get you up and more active. Non-steroidal anti-inflammatory drugs (“NSAIDs”) are the most widely used for musculoskeletal pain (e.g., ibuprofen) but, if unsure, it is important to check with your pharmacist that they are safe for you and don’t mix badly with your other medications. They may also be able to give advice about other options.

Relax

Research shows that stress and anxiety can worsen pain. If you are struggling with stress or anxiety, you may wish to visit our stress condition page, which includes advice and resources to help you manage your stress. Our understanding pain page, written by the local pain specialists, will also give you more information about this.

Stopping smoking

Stopping smoking is one of the best things you can do to improve your overall health. Research shows that smokers are more likely to suffer with back pain issues than non-smokers. Click here to discover other health benefits associated with giving up, or read more about quitting via smokefree Devon.

Hot and cold therapy

Most people find soaking in a warm bath soothing and relaxing – but did you know this could help manage your back pain, too? Other ways to use heat to relieve pain is by using disposable heat pads or deep heat (these can be found in your local pharmacy or supermarket).

Cold compresses can also help reduce pain and swelling. It is important to note that, if used for too long, ice packs can cause stiffness. To avoid this, it is advised to use packs for no longer than 15 to 20 minutes at a time, and make sure you are not placing a pack directly on to bare skin by wrapping it in a towel before placing on the skin.

If you have none of the ‘Red Flag’ symptoms and your pain is not improving after a few weeks, despite trying the above ways of managing your condition, you should think about seeking help. You can contact your GP, who may suggest an examination of your back and ask you questions about your symptoms and suggest possible treatments for you. They may suggest a physiotherapist for further help. Other support and treatment that may be available to you has been listed below:

NHS exercise classes

Exercise programmes, led by a qualified instructor, may be available in your area. Speak to your local physiotherapy department for more information.

Psychological support

Visit our supporting my mental health page for further advice and how to access your local psychology team.

Manual therapy

This includes spinal manipulation, mobilisation or soft tissue techniques such as massage for managing low back pain with or without sciatica. Physiotherapy is the only service available on the NHS that can offer these treatments. These treatments should only be used as part of a treatment package including exercise, with or without psychological therapy.

Surgery

Surgery for back pain is not usually recommended and will only be carried out if you’ve been suffering with pain for a long time and your pain is severe with a clearly identified physical cause. Please note that injections for non-specific back pain are no longer available on the NHS. This is because alternative, less risky treatments, such as exercise and psychological support, have been shown to result in more positive outcomes for patients. You can read the associated policy here.

Please find further information about managing your back pain by clicking the links below.

• Back pain guide – NHS UK
• Your guide to back pain & what to do about it – Keele University leaflet
• Back Pain Pamphlet – Versus Arthritis (previously Arthritis research UK)
• The Back Care website – Various back pain information leaflets
• Further information about back pain – Patient.info

Videos about my back pain

Physio advice on managing back pain | Chartered Society of Physiotherapy

Chartered Society of Physiotherapy | Published 4 May 2017

Low back pain | Dr. Mike Evans

DocMikeEvans – Reframe Health Lab| Published 24 January 2014

Back stretches | NHS

NHS UK | Published 14 February 2014