Back Pain
Back pain is something most of us will experience at some stage during our lives and is the most common reason for missed days at work.
Back pain affects primarily the lower back and the good news is, that in most cases, the cause of pain is not serious and can be resolved in a few days or weeks. However, some symptoms can be more serious requiring a full assessment and diagnosis by an experienced Physiotherapist or GP. This article will help you to determine when self-help is enough or when it is best to seek further advice.
If you are experiencing back pain, our Physiotherapy and Occupational Health teams are here to help by providing comprehensive treatment and advice. On-site workplace or workstation assessments are also available which is the best starting point for back pain at work. For further information call or email [email protected]
Understanding Your Back
Your spine is made up of 24 separate bones called vertebrae which are connected together by a series of ligaments and soft tissue. The lower part of your spine is joined to the sacrum which is part of your pelvis.
The curves, shapes and various sizes of the vertebrae (along with the discs found in between them), help to evenly distribute the weight of your body on the spine and creating the flexibility necessary to bend or rotate your back.
A complex group of muscles is attached to the spine which allows you to move your back. There are also postural muscles that help to maintain the shape and curves of your spine, keeping them in the correct position, as well as help to keep you upright.
The spinal cord passes through the center of each vertebra. The cord ends in your lower back where it becomes a series of strands called the "cauda equina" (horses tail). Either side of each vertebra is spinal nerve exits from the spinal cord which pass sensory and motor signals between your brain and a certain part of your body which the nerve innervates.
What Causes Back Pain?
The most common cause of back pain, especially lower back pain, is a combination of poor posture and lack of movement, typically seen with people who sit for long periods. This is known as mechanical back pain and is not a serious condition. However, it can be uncomfortable and frustrating to experience a constant ache or pain in your back.
Physiotherapy is ideal for treating mechanical back pain. Along with advice on correcting your posture, appropriate exercises, and self-treatment techniques, your back pain should resolve in a few days or weeks.
However, there are more complex causes of back pain, for example, disc prolapse, joint impingement, ankylosing spondylitis, osteoporosis, arthritis, or fracture which require a more detailed assessment.
Symptoms of Lower Back Pain
When you first start to develop postural back pain it manifests itself as a low-grade ache normally combined with stiffness in your lower back. Symptoms tend to be relieved with light exercise or by avoiding long periods of sitting, for example at weekends. But if symptoms are ignored, the pain will become constant, just to varying degrees. The level of stiffness may also increase.
Occasionally symptoms may be related to conditions other than poor posture, for example, prolapsed disc, fracture, facet joint impingement, or nerve root compression. You may experience any of the following symptoms:
- Pins and needles or numbness in the buttocks, lower limbs or feet
- Pain going down the back or front of your leg
- More severe back pain, especially when bending forward
- Excessive levels of stiffness in your lower back
These symptoms need to be properly assessed by an experienced Physiotherapist. They will diagnose the cause of your back pain and provide appropriate treatment, management, and advice.
A very small percentage of back pain can be caused by more serious conditions like cauda equina, where the nerves at the bottom of your spinal cord are being compressed. If you experience any of the following you should seek immediate medical advice:
- Unsteady when standing or walking
- Difficulties passing or controlling bladder or bowels or numbness in either area
- If you have a previous history of cancer or osteoporosis
- Back pain accompanied by unexplained weight loss or fever
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Back Pain and Poor Posture
Poor posture is normally the result of weak or imbalanced core muscles which help maintain the spine in the correct position-- like guidelines of a tent. When these muscles are weak it is very difficult to keep your spine in the correct or neutral position, especially when sitting for long periods. Eventually, the soft tissue structures around the spine become overloaded, initially manifesting as a dull ache across your lower back, but if the overload is not reduced, eventually pain and stiffness will develop.
Other muscles may also be contributing to developing poor posture and physiotherapy for back pain..
