Back Pain

Every experienced back pain? The answer is probably yes as figures suggest that as many as 80% of people have at least one episode at some time in their life.  A study in 2018 suggested that 2.5 million people in the UK have back pain every day.

The poll found that, contrary to popular belief, back pain is just as common amongst younger age groups as the elderly.  Whereas 61% of people aged over 55 had back pain at least once a month, the figure for 18-24 year old’s was even higher at 71% and surprisingly, those in higher managerial jobs suffer more from back pain than manual workers.

Back pain can be very frightening and very debilitating but 70% of cases are caused from lumbar spine strains or sprains. The most important aspect of management is getting good pain medication and continuing to be active as much as possible. Gone are the days where the advice was to remain in bed. The NHS web site has some good information – http://www.nhs.uk/Conditions/Back-pain/Pages/Introduction.aspx .

There is a whole wealth of research  that supports the benefits of exercise for reducing and managing/preventing back pain.  Carrying excess weight also puts excess load through the spine so losing weight and exercising regularly can be a good start to managing back pain.  A good quality systematic review in 2016 looked at the research and made interesting reading.  There’s no one single magical type of exercise but a mix of strength, flexibility and core work is useful in combating and preventing back pain.  Being sedentary seems to be an indicator to back pain so if you are desk based then its is even more important to keep fit and move regularly. (check out my desk workout here)

As a physiotherapist I see many patients with mechanical lower back pain.  Causes range from gardening, desk work, carrying children and a whole host of others.  Often the biggest part of treating back pain is the reassurance.  If you have ever hurt your back it is scary. It effects every part of you.  You may not be able to sleep well, movement is restricted, simple tasks like putting your shoes on become difficult.  Due to the number of structures that attach around the back the pain can radiate into the hips, legs, up into your middle or even into your shoulders.  Muscles can spasm causing you to stoop to one side or lean forward.  Its important to understand that most cases (85%) have no specific cause and are simply down to a soft tissue injury.  Even with an x-ray or scan it may not show the cause or in non symptomatic people there are often irregularities on investigations that cause no pain what so ever. Patients are often looking for a scan to find out the cause so education is vital to help them understand the potential cause and the prognosis.  Back pain generally settles in 3-12 weeks and even if there are neurological symptoms such as sciatic pain this generally settles in this time.

If you experience back pain the most important first step is to get some good medication.  The pharmacist is a good place to start as they can advise around other meds you may take.  Try to keep active but rest when you can.  Use heat or ice to reduce your pain.  There’s no real set rules around which one to use and I usually go with what the patient prefers.  There is a set of symptoms that we ask all back pain patients due to the potential of developing a very rare condition known as Cauda Equina. Red flags for back pain are:

• Thoracic pain.
• Age of onset less than 20 or more than 55 years.
• Loss of control of the bowel or bladder.
• Weakness or numbness in a leg or arm.
• Foot drop, disturbed gait.
• High fever.
• Saddle anaesthesia (numbness of the anus, perineum or genitals).
• History of cancer

If you experience any of these you should speak to your GP straight away.  Otherwise don’t panic.  You will recover and it doesn’t mean you have a ‘bad back’ .  Most of us have sprained a wrist or ankle at some point.  These are big, obvious joints so try to think about your back with lots of little joints.  Each one can be injured.  There are also lots of little muscles, ligaments and soft tissue around the spine that can be pinched, stretched, overloaded.  Keeping all those structures healthy by exercising regularly is your best remedy for keeping back pain at bay.

The link below is a downloadable leaflet on simple back mobility exercises that may reduce symptoms if you have experienced back pain

http://www.csp.org.uk/publications/back-pain-exercises

If you have any questions or want to book in to have your back pain assessed please contact me

info@khphysiotherapy.com