Back pain is a very common condition, almost everyone in their lifetime will experience some form of back pain. Indeed, the World Health Organisation (WHO) reported that 619 million people worldwide experience lower back pain. Back pain commonly presents in older adults from around 50-55 – and even into their 80s. However, back pain – and more specifically lower back pain – can be experienced by anyone at any age.
What causes general back pain?
There isn’t always a clear-cut answer to why people experience back pain. In fact, 90% of lower back pain is defined as non-specific which means that there isn’t a structural or disease related reason to cause pain.
Specific back pain typically relates to disease, structural problems with the spine or even radiating pain from another part of the body.
When it comes to looking at back pain and the cause it is important to think about the cause of back pain – although this might not always be obvious.
- Do you spend a lot of time at a desk or even hunched over at work?
- Is work and/or life stressful (as this could impact back pain)?
- Do you get to sleep ok?
- Do you wake up stiff?
- Was there a mechanism of injury (lifting heavy objects, sudden twisting)?
- Was there direct trauma (falling and then landing on your back, being tackled in sport, car accident)?
Some common conditions are:
- Herniated disks
- Arthritis
- Sciatica
- Ankylosing spondylitis
- Osteoporosis
- Other presentations of back pain can look like:
- Muscle strains (over stretching or over loading)
- Neve pain (shooting, stabbing, tingling, burning
- Joint discomfort
- Muscle spasm (involuntary muscle contractions, that can be painful)
- Stiffness
- General discomfort
Many people experiencing back pain may have leg pain, leg numbness or weakness in the legs. These symptoms can often be distressing and although it is not normal, it may not be anything to worry about. However, you should go and have it looked at by a medical professional.
In some instances back pain can be very serious. There is a rare but serious condition Cauda equina syndrome (CES) that can lead to permeant damage or disability and requires emergency specialist attention. It is important to be aware of the following and seek urgent medical care and advice.
- Sudden onset bilateral radicular pain or unilateral radicular pain progressing to bilateral pain. Note: this is not by itself a feature of CES but can be a warning that CES may occur
- Severe or progressive bilateral neurological deficit of the legs, such as major motor weakness with knee extension, ankle eversion, or foot dorsiflexion
- Gait disturbance or difficulty walking
- Difficulty initiating micturition or impaired sensation of urinary flow
- Loss of sensation of rectal fullness
- Perianal, perineal, or genital sensory loss (saddle anesthesia or paraesthesia)
- Laxity of the anal sphincter
- Erectile dysfunction
Back pain risk factors
Common risk factors can be low physical activity levels, smoking, obesity, as well as high physically stressful evolvements, prolonged poor posture.
Will back pain go away?
Back pain can last for a variety of time depending on the person or the initial cause of back pain.
There are three categories:
- Acute: Lasting less than six weeks.
- General discomfort, Stiffness or low-grade strain
- Sub Acute: Lasting 6 – 12 weeks.
- Nerve pains, Muscle spasms, mid-grade strains
- Chronic: 12 Weeks (3 months) or more.
- Medical conditions such as those listed above in common conditions, regular poor posture, overweight
When to see a Physio
In the cases where there may seem to be little to no apparent reason for pain and it doesn’t get better on its own between 2-4 weeks or limits your daily activities, then there could be more going on under the surface. This is when it would be important to go to a health care professional, for example, physio therapist or GP to have your back pain looked at.
More often than not, exercise is prescribed to people with lower or upper back pain. This doesn’t mean you need to start hitting the gym or running marathons but it does mean that appropriate stretching and strengthening exercise can be given by health care professionals such as Physiotherapist, Sport rehabilitators or Exercise Therapist.
There are other treatments out there that the National Institute for Health and care Excellence (NICE) recommend, such as Massage therapy, Acupuncture, Medication and Psychological support in specific conditions of prolonged on complex conditions.
NICE also states that that for Chronic pain, pain that has been present for 3 month or more some treatments should be avoided due to the lack of evidence benefiting chronic pain.
- TENS Machine
- Ultrasound
- Interferential Therapy
What can you do at home?
Firstly, look at adapting the environment you are in and where you get aggravation and pain. For example, if you get pain working at a desk, looking at type of chair being used, check if your monitor is at eye level or are you constantly looking down.
If it is lifting heavy objects or more active work, look at ideal manual handling techniques. Reduce the amount of load you are lifting/moving at a time, even if it requires taking more trips.
Below are some exercises you can do to aid in easing your back pain. Do 10 reps x two sets. Some discomfort would be expected around 3/10. The most important thing is it shouldn’t feel more painful the next day:
Stretch – Cat camel – upper and lower back
Stretch – Open the book – upper back
Strengthen – Glute bridge – lower back
Strengthen – Cable twist – lower upper – back Rotation – to be completed with light weight or exercise band
Strengthen – MTY – Upper back
When completing exercise like these, or after seeing a medical professional, we would expect to see some positive results in 4-8 weeks and to be continually improving. Unfortunately, with pain and injuries, progress isn’t always up, sometimes it might plateau or go back; this is ok and can happen.
In these situations, it is important to be honest and open with your medical professional so that they can guide you in the right direction for your personal situation.
If you’re experiencing back pain, please make an appointment with one of our clinicians.
