Back pain
It can happen walking up a hill, lifting a suitcase or even watching TV. There is a feeling of something going 'click' in the lower part of the spine. It may start as a little twinge, but it's likely to get worse over the next 24 hours.What does it feel like?
At first there will be a lack of flexibility in the back,
then some pain on walking or bending with gradual stiffness spreading throughout the body.
Back pain can progress so virtually every movement is painful. Lying down may give some relief, but turning over can be difficult.
Getting out of bed may involve rolling onto the floor and raising yourself to a crawling position before teasing your body to its feet.
How long does it last?
Back pain can last up to six weeks and in 90 per cent of cases is likely to come back again within a year.
Who gets back pain?
A survey by the Department of Health found that 40 per cent of UK adults had back pain in the previous year, with 15 per cent in continuous pain. A conservative estimate is that 11 million working days are lost each year as a result of back pain.
It strikes men and women equally. Young people tend to have short episodes of back pain that resolve quickly. With older people, the pain is more likely to be long term (chronic).
Some people are more at risk because of their jobs. Back pain is more common in manual jobs and unskilled workers. You are at higher risk if you drive more than 25,000 miles a year.
People who work on the telephone for more than two hours a day without a headset and supermarket cashiers are also likely to be hit by back pain.
How is back pain diagnosed?
Dr Jeremy Sager, GP, says: 'First, it's important to make sure that your problem is back pain and not something more serious.'
- The pain should be in the lower back, be related to movement and be present all the time.
- It shouldn't involve the legs.
- It should have begun suddenly and not have come on over time.
- You should feel well, apart from the back pain.
- There should be no sudden loss of weight.
What else could it be?
- Back pain can be confused with sciatica, which is caused by the degeneration of an intervertebral disc. In sciatica leg pains accompany the back pain.
- Kidney problems and pelvic and abdominal diseases can also cause back pain.
- Although very rare, tumours can occur in the spine or lungs and cause back pain.
Always visit your GP so they can diagnose your symptoms.
What causes back pain?
Dr Loic Burn, a GP and author of books on back pain, says: 'There is no known single cause for back pain, which makes it difficult to name a specific treatment or method of prevention.
'Heavy lifting, for instance, can be a cause of back pain, but it is in a minority of cases. Basically we don't know what causes back pain.'
How is back pain treated?
Doctors used to advise complete bed rest for backache. Now this advice has changed: evidence shows the more active you can remain, the quicker your recovery.
Dr Burn says: 'The best medical advice is to take painkillers at once at the full dosage.'
Dr Sager agrees: 'You should take paracetamol or ibuprofen at the maximum dose. There is no use in pussyfooting about, you have to really attack the pain.
'Being as active as you can and taking painkillers cannot do you any harm and you will be back to living a normal life more quickly.'
Evidence also shows that manipulation techniques work for back pain, particularly if given in the first two weeks of pain.
Dr Burn says it doesn't matter who does the manipulation, as long as they have been trained. This means the person is a registered chiropractor, osteopath, physiotherapist or doctor.
'There are also medical treatments that involve epidural or spinal injections, but they don't always work.
'Spine-fusing surgery [where vertebrae are joined] is a last resort and only given to one in 10,000 patients. It is a very radical step considering we don't understand the causes of back pain and the results aren't always wonderful.'
What about alternative therapies?
Dr Burn is happy for his patients to try complementary therapies such as the Alexander Technique, yoga, shiatsu, acupuncture and massage. There is limited evidence that these therapies work, but some people find they help.
'Since we don't know the cause of back pain, we have to be open-minded on methods of treatment and look at every case on its merits.'
While it's fine to try different therapies, Dr Burn says 'if it doesn't work, move on to other things. The best approach is to stay active and be proactive in looking for something that stops the pain.'
A cure for back pain may be years away, but the fact to remember, he says, is the more active you are, the more likely you are to beat that pain in your back.
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