Back Pain

Unfortunately, the statistics show that most of us will experience back pain at some point in our lives. Take a look at these facts and figures to help you understand more about back pain.

• The largest single cause of disability in the UK, with lower back pain alone accounting for 11% of the total disability of the UK population. (NHS UK, 2016)
• 80% of all people will experience back pain at some point in their life (NHS & ACA)
• 90% of cases will resolve within 4-8 weeks (NHS & GoodBody)
• 54% of Americans who sit for work – experience back pain (APTA)
• 99% of back pain is not from a serious cause and should resolve (Physiotas)

There can be a lot of good lessons learned from the statistics and positive reassurance. Yes – a high percentage of people will experience back pain, however, it is normal, and you should recover. Back pain is a global issue and seems to affect most populations in similar ways.

The back is an incredibly strong and durable structure and is made up of many different components. All of the different parts of the back contribute towards your function and all of these vital parts can develop discomfort. Here is a simple anatomy guide to inform you about your back!

Vertebrae

There are 24 separate vertebrae in the back. They are divided into 3 sections known as the cervical (neck), thoracic (upper and mid-back), lumbar (lower back) and then 2 separate lower sections known as the sacrum and coccyx. Each bone is shaped differently and provides protection for the spinal cord and nerve roots.

Spinal Discs

These firm but flexible cartilage structures sit between our vertebrae. They allow the spine to move in all directions. They also act as shock absorbers for the spine. Discs have high water content and a firm but jelly-like centre which allows the discs to move in multiple directions. The outside of the disc is strong and durable.

Muscles

There is a vast array of muscles in the back which help the spine to move but also to support it. Deep muscles which help to stabilise and perform accessory movements are located along the length of the spine and across the spine. Larger more visible muscles such as the trapezius on the neck and upper back and latissimus dorsi sit over the surface of the back and cover a large area.

Nerves

Nerves are the structures that operate our muscle and movement but also supply sensation and touch to our skin. The nerve roots exit from the vertebrae and then feed off through the body into their destinations.

Ligaments & Tendons

These are connective tissues which help to hold our body together. Tendons attach muscle to bone and are strong and stiff in nature. Ligaments are strong and elastic and they help attach bone to bone.

It is important to remember when you have back pain that it is not one structure which is responsible for your symptoms – it is typically a collection of multiple tissues.

Some reasons may be more obvious than others for symptoms developing but here is a list of reasons which can cause back pain.

A new activity your body isn’t used to

If your back hasn’t performed certain exercise or tasks before, or you haven’t done it for a long time then the structures of the back will not be used to it. This is the reason your back can become sore after tasks such as gardening or DIY if you don’t do those regularly.

Poor physical condition

If you do not exercise regularly and live a lifestyle with low activity then this increases your risk of developing back pain. Weakness in muscles and tendons combined with sedentary behaviour places pressure on the spine and soreness to develop.

Sitting jobs

As mentioned in the statistics, a high percentage of sitting workers will get back pain. This is simply down to how long your back will stay in static positions causing pain to build and weakness to develop. Take a look at the rest of the guide to see how to prevent this.

Poor lifting technique

A common cause for back pain is moving heavy items and lifting with a poor technique. This places far too much pressure on the spinal discs and can lead to disc bulge.

Sprains and strains

Accidents like falls, trips or impact can cause the back to become symptomatic.

Spinal Irregularities

Conditions such as scoliosis which mean a sideways curve in the spine. Slipping of the spine forwards or back at a single level called spondylolisthesis.

Arthritis

Inflammation of the spine and degeneration.

Sciatica

Back pain which causes a nerve root to become involved and send pain down to one or both of your legs.

To conclude here are the most common misconceptions about back pain.

• “My back is not going to get better” – research shows that 99% of back symptoms are not serious and typically resolve within 6-8 weeks.
• “Moving will make my pain worse” – this was an old way of thinking when back pain was treated with bed rest. Move in any way you can to reduce joint soreness and make your soft tissues stronger.
• “I need surgery or a scan” – back pain very rarely needs surgery. XRAY and MRI do not accurately show the exact cause of your pain and some findings on a scan have been there for years before your pain was.

The type of symptoms that each person will experience will vary depending on the cause. In the early stages of a traumatic back pain which resulted from an injury, the pain levels may be quite intense and will generally affect your mobility.

With back pain which has a more gradual build-up caused by day to day habit – the pain intensity will be less and will allow you to do more. Pain in the back is usually experienced when being over and lifting weight. Performing prolonged tasks for more than 5-10 minutes can also cause your pain to spike.

Back pain can cause sharp and electric type pain but also dull aching type symptoms. Stiffness and restriction of movement in all parts of the spine are possible and the ability to reduce your function is entirely possible. As mentioned in the causes section if developing sciatica, pain can extend down the legs and this may result in tingling and or numbness, and in worse cases loss of power in the leg.

Red Flag Symptoms

These are very rare but can indicate a more serious problem. If you have back pain combined with any of these symptoms: pain in both legs, changes in your toileting (incontinence, retention, increased frequency), numbness of the saddle region, sudden dramatic weight loss, severe night pain and sweating. Report immediately to your GP or A&E – this can indicate a time-sensitive problem which needs immediate action.

Rehab is essential for getting your back better – when your back gets painful it becomes stiff and weak. Exercise is needed to restore you back to your former self.

Exercise such as Pilates and yoga are recommended but so is walking, any movement you are capable of is beneficial for your back pain.

Here are a few simple exercises you can perform when your back is sore to get your back moving and a bit stronger. These can also be done regularly to help maintain a healthy, mobile back.

Seated Pelvic Tilt

Sit on the edge of a seat in an upright posture ad hands-on-hips Tilt your pelvis back so that you slump, then tilt back to an extended upright posture – repeat for 30 seconds.

Lumbar Twists

Lying on your back with your knees bent and feet flat on the floor. Keep your knees together and twist your lower back by moving your knees to each side. Repeat for 30 seconds.

Simple Bridge

Lying on your back with your knees bent and feet flat on the floor. Push through your feet and raise your hips off the floor – take them as high as possible and hold for 3 seconds, slowly lower a repeat for as many reps as you can manage. This keeps the back and legs strong.

Most episodes of lower back pain can get better with pain relief, exercise and changing your activity within a 4-8 week time period – be patient.

However, at any time you aren’t sure or can’t cope, then an assessment from a health professional is recommended. Consider seeing a physiotherapist, osteopath or chiropractor who can give you reassurance and a plan to overcome your back pain.

This may involve hands-on treatment, acupuncture, electrotherapy and provision of rehab exercises

A good, well-balanced diet is key for everyone to live a healthy life – if doing this then it should help support your body to repair properly and keep inflammation low. There are some supplements on the market which may help you reduce back pain and stay mobile.

CBD

Currently a very popular supplement and this involves the non-psychoactive ingredient of cannabis. The body has cannabinoid receptors in the body which help to reduce pain and inflammation. CBD is available in many different forms which can be taken as an oral oil, vape, and creams combined with hot and cold properties.

Ginger and Turmeric

Use these in your diet or take high strength supplements in capsule form. There are active ingredients in both which help to reduce inflammation in the body and this can contribute towards less pain.

Glucosamine

This contributes towards healthy joints in the body by maintaining their smooth surfaces. Available in tablet and capsule form from most online retailers.

There are some interesting pieces of back pain relief equipment on the market. These things may not be a direct fix for your back but they can certainly help alleviate symptoms you may be experiencing and contribute to a speedy recovery!

Foam Rollers

Great for extending the back and loosening off joints – also used to massage sore and tight back muscles. There are many shapes and sizes including long foam rolls, spiky balls and new to the market a Pso Rite which targets specific back muscles.

Percussive Therapy

Theragun and Hypervolt are great tools for massage of the back. Essentially they are a redesigned power drill with a massage attachment. These tools are great for massaging the soft tissues of the back and some come with a spinal fitting which can target either side of the spine muscle without hitting the spine.

Lumbar Rolls

These are used for office seats and car seats to help you sit in a better posture. They are a small roll of foam, placed at the bottom of a seat and it pushes the lower back into extension instead of slumping.