Back pain is very common and usually improves
within a few weeks or months.
Pain in the lower back (lumbago) is particularly
common, although it can be felt anywhere along
the spine, from the neck down to the hips.
In most cases the pain is not caused by anything
serious and will usually get better over time.
There are things you can do to help relieve
it.
But sometimes the pain can last a long time
or keep coming back.
The following tips may help reduce your back
pain and speed up your recovery:
stay as active as possible and try to continue
your daily activities – this is 1 of the
most important things you can do, as resting
for long periods is likely to make the pain
worse;
try exercises and stretches for back pain;
other activities such as walking, swimming,
yoga and pilates may also be helpful;
take anti-inflammatory painkillers, such as
ibuprofen – remember to check the medicine
is safe for you to take and ask a pharmacist
if you're not sure;
use hot or cold compression packs for short-term
relief – you can buy these from a pharmacy,
or a hot water bottle or a bag of frozen vegetables
wrapped in a cloth or towel will work just
as well;
Although it can be difficult, it helps if
you stay optimistic and recognise that your
pain should get better.
People who manage to stay positive despite
their pain tend to recover quicker.
Back pain usually gets better on its own within
a few weeks or months and you may not need
to see a doctor or other healthcare professional.
But it's a good idea to get help if:
the pain does not start to improve within
a few weeks;
the pain stops you doing your day-to-day activities;
the pain is very severe or gets worse over
time;
and if you're worried about the pain or struggling
to cope.
If you see a GP they will ask about your symptoms,
examine your back and discuss possible treatments.
They may refer you to a specialist doctor
or a physiotherapist for further help.
Alternatively, you may want to consider contacting
a physiotherapist directly.
Some NHS physiotherapists accept appointments
without a doctor's referral, or you could
choose to pay for private treatment.
A GP, specialist or physiotherapist may recommend
extra treatments if they do not think your
pain will improve with self-help measures
alone.
These may include:
group exercise classes where you're taught
exercises to strengthen your muscles and improve
your posture;
manual therapy treatments, such as manipulating
the spine and massage, which are usually done
by a physiotherapist, chiropractor or osteopath;
and psychological support, such as cognitive
behavioural therapy (CBT), which can be a
useful part of treatment if you're struggling
to cope with pain;
Some people choose to see a therapist for
manual therapy without seeing a GP first.
If you want to do this, you'll usually need
to pay for private treatment.
Surgery is generally only considered in the
small number of cases where back pain is caused
by a specific medical condition.
It's often not possible to identify the cause
of back pain.
Doctors call this non-specific back pain.
Sometimes the pain may be from an injury such
as a sprain or strain, but often it happens
for no apparent reason.
It's very rarely caused by anything serious.
Occasionally back pain can be caused by a
medical condition such as:
a slipped (prolapsed) disc – where a disc
of cartilage in the spine presses on a nearby
nerve;
and sciatica – irritation of the nerve that
runs from the pelvis to the feet.
These conditions tend to cause additional
symptoms, such as numbness, weakness or a
tingling sensation, and they're treated differently
from non-specific back pain.
It's difficult to prevent back pain, but the
following tips may help reduce your risk:
do regular back exercises and stretches – a
GP or physiotherapist may be able to advise
you about exercises to try;
stay active – doing regular exercise can
help keep your back strong; adults are advised
to do at least 150 minutes of exercise a week
avoid sitting for long periods;
take care when lifting – read some safe
lifting tips;
check your posture when sitting, using computers
or tablets and watching television – find
out how to sit correctly and get tips for
laptop users;
ensure the mattress on your bed supports you
properly;
lose weight through a combination of a healthy
diet and regular exercise if you're overweight
– being overweight can increase your risk
of developing back pain
You should contact a GP or NHS 111 immediately
if you have back pain and:
numbness or tingling around your genitals
or buttocks;
difficulty peeing;
loss of bladder or bowel control – peeing
or pooing yourself;
chest pain;
a high temperature;
unintentional weight loss;
a swelling or a deformity in your back;
it does not improve after resting or is worse
at night;
it started after a serious accident, such
as after a car accident;
the pain is so bad you're having problems
sleeping;
pain is made worse when sneezing, coughing
or pooing;
and the pain is coming from the top of your
back, between your shoulders, rather than
your lower back.
These problems could be a sign of something
more serious and need to be checked urgently.
It's not always possible to identify the cause
of back pain but it's rarely anything serious.
Most back pain is what's known as "non-specific"
(there's no obvious cause) or "mechanical"
(the pain originates from the joints, bones
or soft tissues in and around the spine).
This type of back pain:
tends to get better or worse depending on
your position – for example, it may feel
better when sitting or lying down;
often feels worse when moving – but it's
not a good idea to avoid moving your back
completely, as this can make things worse
can develop suddenly or gradually;
is sometimes the result of poor posture or
lifting something awkwardly, but often happens
for no apparent reason;
may be caused by a minor injury such as sprain
(pulled ligament) or strain (pulled muscle);
can be associated with feeling stressed or
run down;
will usually start to get better within a
few weeks;
and medical conditions that cause back pain.
Conditions that can cause back pain include:
a slipped (prolapsed) disc (a disc of cartilage
in the spine pressing on a nerve) – this
can cause back pain and numbness, tingling
and weakness in other parts of the body
sciatica (irritation of the nerve that runs
from the lower back to the feet) – this
can cause pain, numbness, tingling and weakness
in the lower back, buttocks, legs and feet
ankylosing spondylitis (swelling of the joints
in the spine) – this causes pain and stiffness
that's usually worse in the morning and improves
with movement
spondylolisthesis (a bone in the spine slipping
out of position) – this can cause lower
back pain and stiffness, as well as numbness
and a tingling sensation
These conditions are treated differently to
non-specific back pain.
Very rarely, back pain can be a sign of a
serious problem such as:
a broken bone in the spine;
an infection;
cauda equina syndrome (where the nerves in
the lower back become severely compressed);
and some types of cancer, such as multiple
myeloma (a type of bone marrow cancer).
If you see a GP with back pain, they'll look
for signs of these.
Back pain will usually improve within a few
weeks or months.
There are several things you can try to help
reduce your pain in the meantime.
There are also some specialist treatments
that may be recommended if it's thought simple
measures are not likely to be effective on
their own.
See a GP or a physiotherapist if your pain
is not improving despite trying simple treatments.
Treatments you can try yourself:
Stay active:
One of the most important things you can do
is to keep moving and continue with your normal
activities as much as possible.
It used to be thought that bed rest would
help you recover from a bad back, but it's
now known that people who remain active are
likely to recover quicker.
This may be difficult at first, but do not
be discouraged – your pain should start
to improve eventually.
Consider taking painkillers if the pain is
stopping you from carrying on as normal.
There's no need to wait until you're completely
pain-free before returning to work.
Going back to work will help you return to
a normal pattern of activity and may distract
you from the pain.
Simple back exercises and stretches can often
help reduce back pain.
These can be done at home as often as you
need to.
A GP may be able to provide information about
back exercises if you're unsure what to try,
or you may want to consider seeing a physiotherapist
for advice.
Doing regular exercise alongside these stretches
can also help keep your back strong and healthy.
Activities such as walking, swimming, yoga
and pilates are popular choices.
Painkillers:
Non-steroidal anti-inflammatory drug (NSAID)
tablets, such as ibuprofen, can help relieve
back pain.
Many types are available to buy from pharmacies
or supermarkets without a prescription.
But NSAIDs are not suitable for everyone,
so check the box or leaflet to see whether
you can take the medicine first.
Speak to a pharmacist if you're not sure.
If you cannot take NSAIDs, alternative medicines
such as codeine may help.
This is a stronger painkiller that should
ideally only be used for a few days, as it
can cause addiction if used for longer.
Paracetamol on its own is not recommended
for back pain, but it may be used alongside
stronger painkillers such as codeine.
Muscle relaxants may be prescribed by a GP
if you have painful muscle spasms in your
back.
Some muscle relaxants such as diazepam can
make you feel drowsy, dizzy or caused blurred
vision.
Do not drive, cycle or operate machinery if
you have these types of side effects.
Hot and cold packs:
Some people find that heat (such as a hot
bath or a hot water bottle placed on the affected
area) helps to ease the pain when back pain
first starts.
Cold (such as an ice pack or a bag of frozen
vegetables) on the painful area can also help
in the short erm.
However, do not put ice directly on your skin,
as it might cause a cold burn.
Wrap an ice pack or bag of frozen vegetables
in a cloth or towel first.
Another option is to alternate between hot
and cold using ice packs and a hot water bottle.
Hot and cold compression packs can be bought
at most pharmacies.
Relax and stay positive:
Trying to relax is a crucial part of easing
the pain as muscle tension caused by worrying
about your condition may make things worse.
Although it can be difficult, it helps to
stay positive and recognise that your pain
should get better.
People who manage to stay positive despite
their pain tend to recover quicker.
Specialist treatments:
Exercise classes:
A GP may suggest attending an NHS group exercise
programme if they think it might help to reduce
your pain.
These programmes involve classes, led by a
qualified instructor, where you're taught
a mix of exercises to strengthen your muscles
and improve your posture, plus aerobic and
stretching exercises.
Manual therapy is the name for a group of
treatments where a therapist uses their hands
to move, massage and apply careful force to
the muscles, bones and joints in and around
your spine.
It's usually done by chiropractors, osteopaths
or physiotherapists, although chiropractic
and osteopathy are not widely available on
the NHS.
Manual therapy can help reduce back pain,
but it should only be used alongside other
measures such as exercise.
There's also some evidence that a therapy
called the Alexander technique may help with
long-term back pain.
However, the National Institute for Health
and Care Excellence (NICE) does not currently
recommend this treatment.
Psychological support:
A GP may suggest psychological therapy, in
addition to other treatments such as exercise
and manual therapy.
Psychological therapies such as cognitive
behavioural therapy (CBT) can help you manage
your back pain better by changing how you
think about your condition.
While the pain in your back is very real,
how you think and feel about your condition
can make it worse.
If you've been in pain for a long time, a
specialist treatment programme that involves
a combination of group therapy, exercises,
relaxation, and education about pain and the
psychology of pain may be offered.
Surgery and procedures:
Surgery for back pain is usually only recommended
if there's a specific medical reason for your
pain, such as sciatica or a slipped (prolapsed)
disc, and other treatments have not helped.
Nerve treatment:
A procedure called radiofrequency denervation
may sometimes be used if:
you've had back pain for a long time;
your pain is moderate or severe;
and your pain is thought to originate from
the joints in your spine.
The procedure involves inserting needles into
the nerves that supply the affected joints.
Radio waves are sent through the needles to
heat the nerves, which stops them sending
pain signals.
You're awake while the treatment is being
done and local anaesthetic is used to numb
your back.
You will not need to stay in hospital overnight.
As with all procedures, radiofrequency denervation
carries a risk of complications, including
bleeding, bruising, infection and accidental
nerve damage.
Discuss the risks with your surgeon before
agreeing to treatment.
Spinal fusion surgery:
Spinal fusion surgery is another type of surgery
for back pain.
It may be recommended if there's significant
damage to the bones in your back (vertebrae).
Spinal fusion surgery can be used to fuse
2 vertebrae together to strengthen them.
This can also help to reduce any related nerve
pain as it stops the damaged vertebrae squeezing
the nerves that pass through the spine.
It's possible that this type of surgery could
cause permanent damage to some of the nerves
in your back.
This may lead to some partial paralysis in
your legs and bowel or urinary incontinence.
This complication is estimated to happen in
around 1 in every 200 procedures.
Treatments not recommended:
A number of other treatments have sometimes
been used for non-specific back pain (back
pain with no identified cause) but are not
recommended by the National Institute for
Health and Care Excellence (NICE) because
of a lack of evidence.
These include:
belts, corsets, foot orthotics and shoes with
"rocker" soles;
traction – the use of weights, ropes and
pulleys to apply force to tissues around the
spine;
acupuncture – a treatment where fine needles
are inserted at different points in the body;
therapeutic ultrasound – where sound waves
are directed at your back to accelerate healing
and encourage tissue repair;
transcutaneous electrical nerve stimulation
(TENS) – where a machine is used to deliver
small electrical pulses to your back through
electrodes (small sticky patches) attached
to your skin;
percutaneous electrical nerve stimulation
(PENS) – where electrical pulses are passed
along needles inserted near the nerves in
the back;
interferential therapy (IFT) – where a device
is used to pass an electrical current through
your back to try to accelerate healing;
and painkilling spinal injections (although
these can help if you have sciatica).
[Source: nhs.uk]
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