What is back pain?

Irritation or damage to any area of the back muscles, structures or spine can cause back pain. It commonly occurs in the lower back. The spine consists of many bones called vertebrae, which are joined together. Each vertebrae has a bony joint called a facet joint and between each pair of vertebrae lies a disc, which acts as a cushion and provides shock absorption. Muscles and ligaments assist to provide stability to the spine What causes back pain? Back pain is usually caused by an injury to the back such as overstretching during lifting, bending or twisting. This may result in damage to muscles, ligaments or the discs. Back pain is common and affects most people at some time in their life.

Factors that can contribute to back pain include: • Bad work practices and lifting techniques • Poor posture • Being overweight • Lack of exercise • Pregnancy • Stress • Smoking.

If significant nerve damage is suspected, tests such as a CT scan or MRI might be ordered. Patients with severe injuries may need to see an orthopaedic surgeon or neurosurgeon for further treatment. This may include injections or, in extreme cases, surgery (an operation).

Most back pain tends to improve within a few days to a few weeks, and a therapist such as a physiotherapist, chiropractor or osteopath can assist with exercises, advice and treatment. Bulging discs and pinched nerves may take longer to heal. Few people require surgery.

Home care In the first two to three days you should aim to minimise pain and assist healing.

• Wrap ice cubes in a damp tea towel, use frozen peas or a sports ice pack (never apply ice straight onto the skin) and apply to the back for 20 minutes, every one to two hours when awake.
• Avoid ‘HARM” – Heat, Alcohol, Re-injury and Massage for the first few days as this will increase inflammation and swelling (even though it may feel good at the time.
• Avoid activities you do not really need to do. Sit as little as possible until the pain settles. Avoid extended car travel unless absolutely necessary. Do not sit with your ‘feet up’. When sitting on an upright chair, push your bottom right back into the chair and ensure the hollow of your back is supported.
• When resting, lie on your back, stomach, or on your side, supported by pillows.
• Keep moving. Walk as much as you feel comfortable doing. Initially this may not be far and may require the use of crutches or a walking frame. Walk regularly and gradually increase the distances
• Take painkillers when necessary. Do not expect medications to get rid of the pain completely. Most back pain improves with time. Do not let pain rule your life. Find other ways to do things that are causing you pain. How can I prevent back pain?
• Stay active, control your weight, and keep a good posture at all times.
• Do not smoke.
• Do back exercises to keep your back flexible and strong.
• Speak to a physiotherapist.
• When lifting, use your legs and not your back. Hold objects as close to your body as possible and use both arms.
• If working at a desk, make sure it is set up properly so you have a good posture – do not twist, do not look up or down at the computer screen. Notes: Follow up with: Seeking help Want to know more? Exercises These are likely to be helpful, but get advice if they do not help or aggravate the pain.
• Lie face down – if easy, gradually prop up onto the elbows, as high as is comfortable.

Signs to Look out for:

• Difficulty in passing urine
• Loss of control of bowel & bladder
• Pins & needles in arms or legs
• Unable to stand & walk because of pain
• Unsteadiness when you walk