A guide to back pain

Lower back pain is a common problem that can affect anyone. It’s usually nothing to worry about, and in approximately 90% of cases, it’s temporary and the pain subsides without intervention, but others may find it more troublesome. In some instances, back pain can last for weeks if not months, or it might keep coming back – which could indicate a more serious problem.

In this article, you’ll find information about the causes of back pain, steps to try and avoid back pain, and how to cope if you’re experiencing it.

Causes of back pain

There are many factors that can cause back pain, so the root cause may not always be obvious. Some recognised causes include:

• Suffering from an injury – such as a muscle or ligament strain
• Certain medical conditions, such as:
  • Ruptured or bulging discs: A bulging disc can press on nerves coming out of the spine and down the legs. That can cause sciatica – shooting pain from back to legs, often made worse by coughing and sneezing.
  • Ankylosing spondylitis: A long-term autoimmune condition where the spine and other areas of the body become inflamed.
  • Osteoarthritis: This process of wear and tear can affect the lower back. This is the commonest cause of back pain in older people.
  • Osteoporosis: A health condition that makes bones fragile and easy to break. This can affect the spine, causing back pain.
• In certain cases, back pain can be an indication of a serious problem, such as an infection, a broken bone, or cancer.

Risk factors for lower back pain

Although anyone can suffer from back pain, there are certain factors that can increase the risk of it developing:

• Age: Back pain is more common around the age of 30 or 40.
• Smoking: Smokers appear to have an increased risk of developing back pain. Smoking leads to coughing, which can result in herniated disks and potentially resulting in back pain. Smoking also decreases blood flow to the spine and can increase the risk of osteoporosis.
• Lack of exercise: Unused muscles such as glutes can become weak and stiff, causing back pain, which is particularly common for those who sit for long periods.
• Weight: Individuals with excess weight may develop back pain as this puts strain on the back.
• Not lifting properly: People whose jobs involve lots of listing or standing seem to be prone to back pain. This can be made worse if people use their back rather than legs to life heavy objects.

Warning signals

It’s important to note that back pain paired with other ‘red flag’ symptoms can be an indication of a serious health problem. These could include:

• Age: Back pain for the first time in an under 18-year-old or over 50-year-old
• Inability or reduced control of urine and/or bowel motions
• Accompanying leg pain

Other red flags include:

• Unexplained weight loss
• A high temperature

If any of the above symptoms are present along with back pain, you should book a doctor’s appointment, or get help from 111, either over the phone or online.

Dealing with back pain

There are ways to ease back pain yourself, such as:

• Staying active and continuing with daily activities as much as you can. Even if it feels more comfortable to lie down, try to refrain from doing this for long periods of time to avoid a longer healing process.
• Taking simple, anti-inflammatory medicine, such as ibuprofen. Paracetamol on its own isn’t recommended for alleviating back pain.
• Using an ice pack to reduce pain and swelling.
• Using a heat pack or hot water bottle to tackle joint stiffness and muscle spasms.
• Doing physical activities, such as walking, swimming, yoga or pilates.
• Doing simple back stretches to prevent aches and pains.
• The use of a foam roller or massage ball can be effective here for myofascial release.
• Get psychological help if it’s really getting you down, as long as this doesn’t make your symptoms worse

Preventing back pain

Ultimately, taking the necessary steps to prevent back pain is much easier than treating it. So, what can you do to lessen the risk?

• Strengthen your back by staying active: This can be done by doing muscle-strengthening and stretching exercise at least two days a week, or by attending regular yoga classes, which can help stretch your muscles and improve your posture.
• Practice good posture: Stand tall with your head up and shoulders back and avoid slouching when standing or sitting. Also, switch positions occasionally to avoid your muscles going stiff. A 2011 study of 800,000 people found that people who sit the most, compared to people who sit the least, have a great risk of disease and death.
• Lift correctly: To prevent back injuries, make sure to lift objects with your legs, and not your back. Keep your back straight, bending your knees or hips. If the load is too heavy for you to lift on your own, ask for help.
• Leading a healthy lifestyle: Maintain a healthy weight by eating a balanced diet and exercising regularly to help reduce your chances of developing back pain, as losing excess weight can reduce the strain on your back.
• Getting plenty of calcium and vitamin D: This helps to keep your bones strong and helps to prevent osteoporosis. You can do this by getting outside as much as you can, by adapting your diet, and taking supplements if required.

When should you see a GP?

Not all back pain will require you to be seen by a GP, however, you should book an appointment if:

• The back pain doesn’t improve after following the previous self-help tips for a few weeks
• The back pain is getting worse
• You’re unable to do your day-to-day activities
• You’re struggling to cope or worrying about the pain

At an appointment, your GP is likely to take a medical history, and then examine and check your reflexes. Xrays are rarely useful, so your GP is unlikely to request one and will probably refer you to physiotherapy for persistent pain. Be sure to ask about complementary therapies such as osteopathy or acupuncture, as they may know a locally requested practitioner. The evidence for these interventions is mixed, but they may help and are safe.

In certain cases, this can be a vicious circle, causing both the pain and anxiety to get worse. If you’re dealing with mental health conditions – such as anxiety or depression – you can refer yourself to an IAPT (Improving Access to Psychological Therapies) service through the NHS. Certain talking therapies, such as cognitive behavioural therapy (CBT), counselling, and guided self-help can help symptoms to subside – both from an emotional and, subsequently, a physical standpoint.

Want to monitor your health and overall wellbeing? Download the Evergreen Life app and take the available questionnaires to start your wellness journey.

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