Back pain is very common, but it can be quite scary when it happens. In 2017, It was estimated that 7.5% of the world population had back pain at any one point, so if you have it, you’re not alone! Here are a few tips for if you do get back pain and how to work your way through it.

First of all, have a look at the list at the bottom, to double check you don’t have any of the symptoms that require immediate attention. If you’re happy you don’t, you’re otherwise feeling well and you haven’t fallen from a height or anything similar (if you’d normally go to A+E for it, you probably should be there, rather than reading this blog!) then this is for you.

What is wrong with my back?

Many people want to know what is wrong with their back. Quite often, even with imaging (MRI/X-ray) we just don’t find out. Most people do not need any form of imaging for their back pain and manage well either on their own or with help from medical professionals. Just because we can’t see a physical cause on imaging, doesn’t mean that you are making it up or that it won’t get better. It is not possible for clinicians to feel a ‘slipped disc’ or ‘trapped nerve’ – we use our whole assessment to make a judgement on what is wrong so that we can help you manage your back in the most appropriate way.

Should I rest it?

Movement is key to preventing stiffening up (and therefore more pain) and to prevent your muscles from weakening. However, short periods of rest may be needed in between moving. The general aim is to keep changing position (every 20 min) and to do some gentle movement, such as walking, as soon as you are able to.

Should I take painkillers?

Many people avoid taking painkillers for a variety of reasons. If your pain is affecting your ability to do your normal daily activities or your exercises given to you by your physiotherapist, it is worth considering. Your GP or Pharmacist can guide you on what is appropriate for you to take.

How else can I get rid of the pain?

Movement is key. It stops you getting more pain from stiffening up and helps to get the painful area working again. Heat (hot water bottle wrapped up) or ice (wrapped in a tea towel for a maximum of 10 minutes) may help. Please wrap them up to prevent heat or ice burns though – ice burns are more common than you might think as the area gets numb so you don’t feel it! Manual therapy or acupuncture (from a suitably qualified professional) can help too, but often we use these to enable you to do your exercises more rather than as a stand alone method of eliminating pain.

When should I see you?

You can see us at any point in your back pain journey. If it’s been there for a few minutes but is worrying you, we’re happy to take your call and book you in asap. Similarly, if you’d prefer to wait and see if it settles and have checked the list of questions below, that’s fine too. If you’re unsure, please give us a ring or pop us an email and we’ll do our best to guide you. We can see you for a one off session (if you just want to check what you’re doing or you are waiting for your NHS appointment) or for a longer course of treatment.

Will it come back?

Unfortunately, a lot of back pain reoccurs. However, for many of our back pain patients this does not impact their life very much, as they know how to recognise it and manage it if it starts. We are here to help them if and when they need us to – we do not need to see the vast majority of patients routinely.

How do I stop it coming back?

The evidence (and our experience!) tells us that exercise is key. This is often a combination of specific exercises designed for you by your physiotherapist along with your chosen sport/activity.

Any other questions?

Get in touch – you can contact us by email, phone or via Facebook or our website. You can book an appointment through any of these methods or via the link on our website.

A note of caution: If any of the following symptoms develop (not something you’ve had long term and already been investigated for!) then you need to go to A+E and they will assess you as an urgent case. This needs to be done urgently, it’s not something to wait for:

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• Loss of feeling/pins and needles between your inner thighs or genitals.
• Numbness in or around your back passage or buttocks.
• Altered feeling when using toilet paper to wipe yourself.
• Increasing difficulty when you try to urinate.
• Increasing difficulty when you try to stop or control your flow of urine.
• Loss of sensation when you pass urine.
• Leaking urine or recent need to use pads.
• Not knowing when your bladder is either full or empty.
• Inability to stop a bowel movement or leaking.
• Loss of sensation when you pass a bowel motion.
• Change in ability to achieve an erection or ejaculate.
• Loss of sensation in genitals during sexual intercourse.

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Bibliography

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Wu A, March L, Zheng X, Huang J, Wang X, Zhao J, Blyth FM, Smith E, Buchbinder R, Hoy D. Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. Ann Trans Med 2020; 8(6): 299-313.

Finucane LM, Downie A, Mercer C, Greenhalgh SM, Boissonnault WG, Pool-Goudzwaard AL, Beneciuk JM, Leech RL, Selfe J. International framework for red flags for potential serious spinal pathologies. J Orth Sports Phys Ther 2020; 50(7): 350-372.  

de Campos TF, Maher CG, Fuller JT,et al. Prevention strategies to reduce future impact of low back pain: a systematic review and meta-analysis. British Journal