Back Pain: An Introductory Guide
Back pain is a widespread phenomenon and has been shown to cause more disability than any other condition*.
The care industry may be particularly at risk, with back pain affecting both care workers and care recipients alike.
Despite training in safe manual handling, care workers perform an active and physical role, increasing the risk of symptoms.
Either due to ageing, illness or disability, those receiving care may also be impacted.
While this article aims to provide an introduction to the topic, it shouldn’t replace a GP or physiotherapist consultation for accurate diagnosis and treatment.
What Causes Back Pain?
Back pain can begin for a variety of reasons and is often the result of lifestyle factors, such as posture and daily routine. Commonly, back injuries are caused by simple strains or sprains.
Many sufferers in the care industry may bend and lift repetitively throughout the day, increasing stress on the back, leading to pain.
For those receiving care, spending more time in the bed or chair due to immobility can lead to back stiffness and underlying structural effects. Such lifestyle factors, if not addressed, often result in discomfort.
Therefore the first step to addressing any symptoms is to reflect on any aggravating factors that may be contributing to the problem. Treating your back pain might be as simple as modifying your daily routine to minimise postures and positions which provoke the symptoms.
What Structures Might Be Responsible?
Back pain can originate in a range of structures. Here are the most common:
Discs – Discs are fluid filled structures that sit between each vertebra (bone) in our spine, acting as shock absorbers while allowing us to move. As we age, these discs lose some of their fluid, reducing in height, and are prone to bulging or tearing when we adopt poor postures.
Nerves – ‘Slipped discs’ can sometimes put pressure on one of your spinal nerves, causing pain in the back and down the leg (sciatica). Our nerves transmit messages to and from our brains, providing our skin with sensation and our muscles with instructions to move. When we have a back problem and our spinal nerves are affected, numbness, pins and needles or a loss of muscle strength can result.
Joints – We have joints between each vertebra that connect our spine. Just like our elbows or knees, these joints are designed to move to give our backs flexibility. Like most joints in our body, they are subject to wear and tear (osteoarthritis) which can lead to inflammation, stiffness and pain.
Muscles – Factors such as repetitive lifting, a poor sitting posture, or a sedentary lifestyle may cause muscles to become weak and tight. In the case of weakness, the muscles might not provide adequate support, place pressure on adjacent structures. With tightness, small knots can form in the muscle fibres, gradually producing pain.
Symptoms of the Condition
Symptoms often depend on the structure causing the problem:
Pain – this can either be a sharp pain, linked to a specific movement, or a more generalised, low-level ache. The symptoms might be diffuse and hard to isolate or shoot into a specific area. If you have pain travelling into your leg, it’s advisable to consult your GP.
Stiffness – when we experience pain, the body’s immediate reaction is to send muscles in the affected area into spasm to protect the injury. Soon after the onset of pain, you may find it difficult to move. Similarly, in a chronic back condition, muscles and joints may become tight, further restricting mobility.
Numbness and pins and needles – for lower back pain, numbness or tingling may be felt in the leg (s) or feet and can signify the involvement of a nerve. If you suffer from these symptoms, consult your GP for further assessment (if you experience numbness or tingling around your genitals or buttocks, read the ‘special note’ below).
Weakness – Weakness can originate from two sources. If nerves are become irritated and fail to communicate with muscles as normal, weakness can ensue. Chronic back pain may also eventually lead to muscle imbalance and weakness. If you have obvious weakness in your leg or foot, consult your GP for further assessment.
SPECIAL NOTE: You should contact your GP or NHS 111 immediately if:
- Numbness or tingling around your genitals or buttocks
- Difficulty peeing
- Loss of bladder or bowel control
- Chest pain
- A high temperature (fever) of 38C (100.4F) or above
- Unexplained weight loss
- A swelling or a deformity in your back
- It doesn’t improve after resting or is worse at night
- It started after a serious accident, such as after a car crash
Diagnosing Back Pain
When you visit your doctor or physiotherapist, you’ll be asked a series of questions to establish how and when your symptoms occurred and uncover any patterns in their presentation.
You’ll also be asked about any pertinent medical history and/or medication you’re taking. This questioning should also cover any activities of daily living that have become problematic.
The practitioner will then ask you to perform a series of movements aimed at reproducing your symptoms. This will help clarify which structure may be at fault and direct treatment accordingly.
Back Pain Advice
Whereas in the past, back pain sufferers were prescribed bed rest, evidence now suggests that keeping active (within pain thresholds) is key to a fast recovery.
Relative rest means that you should avoid intensive activities, but still change position regularly to counter stiffness and pain, thereby assisting the healing process.
With really acute back pain, this could be as simple as getting up to have a short walk around the house before lying down on the bed to perform gentle back exercises.
Your GP may recommend medication during an episode of back pain, along with hot and cold compresses to ease any symptoms.
How to Treat the Symptoms
For most episodes of back pain, it’s advisable to start with gentle movements to assist the healing process.
This is especially true for more severe symptoms, with exercises focusing on simple movements to avoid provoking pain:
- Child’s pose
- Knee rolls
- Half cobra
- Core muscle activation
For pictures and exercise instructions, click here to visit the NHS website. If you’re unable to perform these exercises due to severe pain, or they make your pain worse, stop doing them and visit your GP.
If your back pain is less severe, you may try to increase your general activity levels by walking more, taking the stairs instead of the escalator, or trying pursuits like swimming, yoga and pilates.
Low impact gym activities may also be beneficial, such as the static bicycle and cross trainer.
How Long Will My Back Pain Last?
The majority of back pain episodes heal by themselves within two to three months and in the vast majority of cases, aren’t caused by anything serious.
With the correct intervention, recent back symptoms will be easier to treat and resolve faster, while chronic back pain might take longer to recover.
Once your back pain has resolved, it’s important to initiate preventative measures to stop it returning. This could include:
- Increasing your general activity levels
- Improving your posture when sitting and lifting
- Performing daily back stretches
- Attending exercise classes
- Adopting a healthy diet to assist weight loss
Hopefully, this introductory guide provides initial tools to manage your condition. However, if you’re worried, suffer any of the symptoms listed in the special note above, or have experienced pain for longer than 6 weeks, either contact your GP or NHS helpline on 111.
* Read more about the global burden of back pain here.