Back pain commonly affects your 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 lifetime.
Back pain is extremely common – about four in five people are affected at some point in their lifetime. You can get back pain at any age, but it's most common between the ages of 35 and 65.
Your back has many interconnecting structures, including bones, joints, muscles, ligaments, nerves 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. However, it's usually related to a strain in a muscle, tendon or ligament, or damage to one of the other structures in your back. This is known as ‘mechanical back pain’. Back pain caused by a more serious, underlying condition is unlikely unless:
This factsheet will focus on lower back pain.
If you have lower 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. In nine out of 10 people, it improves on its own within four to six weeks.
Back pain may be called either acute, sub-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:
It's important to seek immediate advice from your GP about these symptoms to ensure there is no serious, underlying cause for your pain.
For most people with back pain, there is no specific problem or condition that you or your doctor can identify as the cause. This is known as non-specific lower back pain. There are a number of factors that can increase your risk of developing back pain, or aggravate it once you have it. These include:
Sometimes, damage to parts of your spine can be the cause of back pain. This includes:
Back pain may also be caused by an infection or cancer, but these causes are rare.
Your GP will usually be able to diagnose lower back pain from your symptoms and by examining you, and there will often be no need for further tests. If your symptoms don't improve after a few weeks, or you have other symptoms, he or she may refer you to have tests, which might include:
These tests are used to find out if your back pain has a specific cause.
If your back pain is non-specific, your GP may recommend you try self-help measures. He or she may also prescribe medicines or refer you for physical therapy if you need it.
If your GP suspects your pain has a specific cause, he or she may refer you to a back clinic or to see a specialist.
There are a number of things you can do to help relieve back pain.
Taking an over-the-counter painkiller (paracetamol) or anti-inflammatory medicine (such as aspirin or ibuprofen) can relieve back pain and help you to stay active. 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, your GP may prescribe stronger medicines such as a codeine-based painkiller or stronger anti-inflammatory medicine. He or she may prescribe a muscle relaxant such as diazepam if there is a lot of spasm. 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.
Your GP may refer you for physical therapy such as physiotherapy, chiropractic treatment or osteopathy to help with your back pain. Treatment can involve exercises, posture advice, massage and techniques known as spinal mobilisation and spinal manipulation. A physiotherapist (a health professional who specialises in maintaining and improving movement and mobility) can help you design a programme to help you exercise and stretch.
Treatment courses usually last up to 12 weeks.
Back surgery is only considered if you still have severe back pain after you have tried all other treatments. Surgery may also be considered if there is a disk that is causing significant nerve compression.
Some people find that acupuncture can help relieve back pain. Your GP may refer you for a course of up to 10 sessions over a 12-week period.
Your GP may refer you to a pain-management programme, where different methods, including talking therapies, can help you manage and deal with your symptoms.
You should always talk to your GP before trying any complementary therapy.
Good back care can greatly reduce your risk of getting back pain. To look after your back, make sure you:
Produced by Rebecca Canvin, Bupa Heath Information Team, May 2013.
For answers to frequently asked questions on this topic, see FAQs.
For sources and links to further information, see Resources.
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.
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