Published by Bupa's Health Information Team, November 2010.
This factsheet is for people who have back pain, or who would like information about it, including treatments and causes.
Back pain usually affects the lower back. It can be a short-term problem, lasting a few days or weeks, or continue for many months or even years. Most people will have some form of back pain at some stage in their lives.
Back pain is extremely common - about four in five people are affected at some point in their lifetime. Anyone can get back pain at any age, but it's most common in people between the ages of 35 and 55, or over.
Your back has many interconnecting structures, including bones, joints, muscles, ligaments and tendons. Its main support structure is the spine, which is made up of 24 separate bones called vertebrae, plus the bones of the sacrum and coccyx. Between the vertebrae are discs that act as shock absorbers and allow your spine to bend. Your spinal cord threads down through the central canal of each vertebra, carrying nerves from your brain to the rest of your body.
It's often very difficult to know exactly what causes back pain, but it's usually thought to be related to a strain in one of the interconnecting structures in your back, rather than a nerve problem. Back pain caused by a more serious, underlying condition is rare and you're unlikely to be affected unless you are very old or very young.
If you have low back pain, you may have tension, soreness or stiffness in your lower back area. This pain is often referred to as 'non-specific' back pain and usually improves on its own within a few days.
Back pain may be called either 'acute' or 'chronic' depending on how long your symptoms last. You may have:
You should see your GP as soon as possible if, as well as back pain, you have:
These symptoms are known as red flags. It's important to seek medical help for these symptoms to ensure you don't have a more serious, underlying cause for your back pain.
For most people with back pain, there isn't any specific, underlying problem or condition that can be identified as the cause of the pain. However, there are a number of factors that can increase your risk of developing back pain, or aggravate it once you have it. These include:
There may be other, more serious underlying causes of your low back pain, but these are rare. They include:
Low back pain may also be caused by an infection or cancer, but these two causes are very rare.
Your GP will usually be able to diagnose low back pain from your symptoms and there will be no need for further tests. If, however, your symptoms don't improve after a few weeks, or you have some red flag symptoms, he or she may refer you to a back clinic to have:
These tests are used to find out if you have a more specific, underlying cause for your back pain.
If your back pain is non-specific, your GP will recommend you try self-help measures. Alternatively, he or she may prescribe medicines or refer you for physical therapy if your pain is severe or chronic. If, however, your GP suspects you have a specific underlying cause, he or she may refer you to a back clinic or a pain clinic to see if you are suitable to have spinal injections. These are used to find out the exact source of, and also to treat, your back pain but aren't suitable for everyone.
There are a number of things you can do to help relieve low back pain.
Taking an over-the-counter painkiller (such as aspirin or paracetamol) or anti-inflammatory medicine (such as ibuprofen) is often enough to relieve acute low back pain. You can also use creams, lotions and gels that contain painkillers or anti-inflammatory ingredients. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.
If your pain is severe or chronic, your GP may prescribe stronger medicines such as diazepam, morphine or tramadol. However, these aren't suitable for everyone because they can be addictive and cause side-effects. Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.
A physiotherapist (a health professional who specialises in maintaining and improving movement and mobility) may be able to help you design a programme to help you exercise and stretch.
Alternatively, your GP may refer you for physical therapy such as physiotherapy, chiropractic treatment or osteopathy (therapies that are given alongside conventional treatments) to help with your back pain. Treatment can involve exercises, posture advice, massage, and techniques known as spinal mobilisation and spinal manipulation. Treatment courses usually last about six to 12 weeks.
Back pain, even if it's chronic, can usually be treated or managed successfully, but about one in 10 people have ongoing problems. Back surgery is really only considered as a last resort if the pain is related to a specific cause.
Some people find acupuncture can help relieve low back pain. You may be able to have a course of up to 10 sessions over a 12-week period.
Alternatively, you could try a pain-management programme to help you better deal with and manage your symptoms.
You should always talk to your GP before trying any complementary therapy.
Good back care can greatly reduce your risk of getting low back pain. To look after your back, make sure you:
Read our brochure about musculoskeletal services from Bupa which include treatment by physiotherapists, podiatrists, osteopaths and sports doctors.
Our most extensive health assessment delivering an in-depth profile of your health. Includes cardiorespiratory fitness tests and consultations. To book an assessment today call 0845 600 3458 quoting ref. HFS100.
This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the About our Health Information page.
Publication date: November 2010
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