Approximately 80% of adults experience back pain at some point in their lives leading to time off work and preventing them from doing their daily activities.  It is the most common musculoskeletal complaint affecting Western society today, costing the economy and society in the UK millions of pounds.

Your spine is strong, robust and resilient and an episode of back pain will normally recover in around 6 weeks with the right management.  A very small percentage, about 1%, will be caused by more serious conditions such as fractures, infection or cancer.

What causes back pain?

Many reasons for why you have back pain are unknown. Often back pain can occur as the final straw, following an accumulative effect of years of a particular movement, task or position.  It is not so much the activity that you were doing at the time the back pain began, such as lifting something out of the car, bending down to pick something up or reaching across for the light switch that is the cause as you will have done these activities many times before.  However, at this time there could be other factors involved such as stress, fatigue, recovering from an illness or injury, lack of sleep that will contribute to this episode of back pain.

Your back pain may be due to any one or more of the tissues in and around the spine – ligaments, tendons, muscles, joints, discs. Sometimes there can be irritation of a nerve leading to referred leg pain, commonly known as sciatica. This leg pain often settles down over time.

The main treatment of back pain remains similar regardless of the structures involved.

Management of back pain with physio

• Movement. It’s important to keep moving as this is vital for healing.  Sitting still or lying down for long periods of time will increase stiffness and in turn, pain.  Find what works for you, you may not be able to move as much as before but discover what you can do.  Short, gentle walks are really beneficial to help limit stiffness. 

• Gentle mobility exercises. Gentle back movements, perhaps initially lying down, to allow muscle spasm to relax and soft tissues to move and heal.

• Pain relief. Take regular pain relief, paracetamol is extremely effective if you are able to take it.  Speak to a chemist about what you are able to take and how often.  Pain relief will enable you to move which will enable the healing process to take place. You can also use heat or ice (whichever you prefer), gels and TENS machines.

• Sleep. It can be difficult to get good sleep when your back is very painful.  Finding a comfortable position, maybe with pillows between your legs, taking pain relief and using a hot water bottle may help.  Sleep is very important in the healing process.

• Getting back to normal.  As your back pain begins to improve you will be able to challenge it with daily activities, work and exercise.  Building strength and endurance in your body will help, long term, in avoiding future back pain episodes where possible.

• Physiotherapy. Physiotherapists can help guide you through this process with exercise, manual techniques to help the soft tissues and advice on rehabilitation. We can also advise on why this may have occurred and how to prevent it occurring again, perhaps by correcting abnormal movement patterns that may be putting increased strain on your back. Physiotherapists can diagnose if there is a more serious problem and when further investigations may be necessary.

Continued Pain

A small proportion of the population who experience this “non-specific back pain” will go on to develop long term chronic pain. The reasons why this happens are unclear but pain is hugely complex and may be related to stress, anxiety, depression, our immune system, fatigue and fear of movement. Living with chronic pain can be challenging but physiotherapy may be able to help you develop management strategies.