Back Pain
(with or without leg pain)
Back pain is very common as an adult. 90% get better on their own.
• In most cases it is not due to a serious cause.
• Back pain can be linked with a range of sensations including-
• Aching
• Sharp pain
• Stiffness or tight muscles
Sometimes nerves can become irritated in the back and give you feelings in your legs such as –
• Pain
• Burning
• Pins and needles
• Numbness
Tests such as X-ray and MRI are not usually helpful for the diagnosis of back pain. A diagnosis can usually be made by a Physiotherapist based on your symptoms.
- The spine is strong, and, in most cases, back pain improves on its own within 6-8 weeks.
• Keeping active is important to help with the recovery of back pain.
Why does my back hurt?
There are many factors that can contribute to having back pain:
Overload – Our bodies are used to doing a certain level of movement and activity. If we suddenly do more than we are used to, this can cause pain as we may not be strong or flexible enough yet. However, if we slowly build up our activity levels our body can change and adapt well.
For example, if you are digging your garden for longer than your joints and tissues can manage, you can cause overload and irritation leading to pain.
This is our body protecting itself, the pain is looking after you whilst your tissues settle. It does not mean there is tissue damage.
Trauma such as falls, sports injuries and car accidents can expose your body to a rapid change in movement and/or blunt impact. This force can cause injury to the body’s tissues and lead to swelling and inflammation.
Inactivity and staying in one position for too long. Remember: keeping active is important.
Non-physical factors can also influence your pain such as:
· Emotional stress for example anxiety, depression; family or work issues can make your pain system more sensitive, meaning you experience more pain.
· Lifestyle factors such as disturbed sleep, poor diet, lack of exercise / activity and smoking can also contribute to back pain.
With simple advice provided within this leaflet, your back pain should start to settle within 6 weeks. It is important that you remain active and continue as normal as much as possible. However, if your back pain continues and is severe then you should seek medical advice for the appropriate treatment.
What about work?
Because back pain is so common, it can affect your ability to work as usual.
It is important you discuss any concerns or limitations with your employer as remaining in work, or returning as soon as you are able is important for good health.
What about sports?
As discussed above, keeping active is important to help recovery of your back pain however you should pace your return to your sporting activity. You will need to re-start at a lower level than you were used to before and slowly increase this amount. Be prepared, however, for slight discomfort at first and remember to warm up before and cool down following participating in your sport.
What can I do to help my back pain?
Movement and exercise can help to ease back pain.
When you have back pain it is important for you to keep moving and this can improve our back pain. You may experience some discomfort after moving however this should settle down soon afterwards and does not cause harm.
If you are very uncomfortable after, this may be a sign that you have done too much. However, do not stop moving, you may need to move a little more gently and build up gradually or may need some stronger painkillers to help you to keep moving.
Painkillers can help you keep moving. However, it is important to discuss this with your GP, especially if you are already taking medication for something else before taking painkillers for your back problem.
Ice can help you if you have had an injury or flare-up of an old problem in the last 2 days:
• Wrap ice in a damp towel and hold it for 5 to 10 minutes
against the part of your back that hurts.
• You can do this every 2 to 3 hours. Make sure you use a damp towel between the ice and the skin to avoid an ice burn.
Alternatively, you could try sports sprays and gel packs which do a similar job.
After 2 days you may find that heat is more relaxing:
• You could use a heat pad or a hot water bottle with a cover on it. Make sure this is not too hot and not directly touching your skin. You should do this for 10 to 15 minutes, three to four times a day.
You can also continue with ice to help reduce the pain and further swelling.
Understanding and discussing the nature of your back pain with your GP or a healthcare professional can help you deal with unhelpful thoughts and emotions.
Eating a well-balanced diet, maintaining a healthy weight and stopping smoking have all been shown to help back pain.
Aims of Physiotherapy:
Physiotherapy may be one part of your management, helping you identify the main factors to change whilst working together to plan your rehabilitation. Your physiotherapist may spend time talking with you about your back pain, providing advice, reassurance and helping discuss any concerns you may have. As mentioned previously, exercise is one of the most effective treatments for back pain. A physiotherapist can provide and help oversee a personalised exercise programme focused on what you want and need your body to achieve.
If you have severe pain which is getting worse over several weeks, or if you are unwell with back pain, you should consult your doctor.
The following symptoms are very rare, but if you suddenly develop any of them, you should seek medical advice by attending an accident and emergency department as soon as possible.
WARNING SIGNS
• Severe pain in back, buttocks, perineum (the area between your front and back passage), genitalia, thighs and legs, and loss of sensation, pins and needles or weakness in one or both legs
• Saddle numbness (loss of feeling in the body areas that sit on a saddle – buttocks, anus and genitals, inability to feel toilet paper when wiping)
• Recent onset of bladder dysfunction (inability to urinate / difficulty initiating urination / loss of sensation when you pass urine / incontinence/ loss of the full bladder sensation)
• Recent onset of bowel dysfunction (bowel incontinence / constipation / loss of sensation when passing a bowel motion)
• Recent loss of sexual function (inability to achieve erection or ejaculate/ loss of sensation during intercourse)
If you are experiencing any of these symptoms, please seek immediate medical advice by attending an accident and emergency department promptly.