Back pain

Back pain is very common. Most people can and do deal with it themselves. This article describes the symptoms and some remedies.

Very rarely back pain may be a symptom of more serious disease, here are some warning signs to look out for.

  • Difficulty passing urine or controlling your bladder.
  • Numbness around the anus or genitals.
  • Numbness, pins and needles or weakness in both legs.
  • Unsteadiness on your feet.
  • Severe back pain getting worse over several weeks or if you feel unwell.
Consult your doctor if you have any of the above.

Acute Back Pain Bed rest is only advised if the pain is unbearable and then only for 48 hours at the most. If the pain is that severe, you should consult your doctor. Keeping as mobile as possible speeds recovery by preventing stiffness and reducing spasm. Many doctors recommend a short period of bed rest (usually one or two days at the most) until the initial pain subsides (we no longer recommend lengthy bed rest).

You should also consider taking a simple painkiller, such as paracetamol, aspirin or ibuprofen regularly (Do not take aspirin or ibuprofen if you have stomach problems). The aim of treatment is to get back to normal activity as soon as possible; these medications will help with this.

X-rays are rarely indicated as they are potentially harmful and rarely alter the diagnosis or the way back pain is managed. Most back pain is not serious. A firm bed is usually desirable. Try the mattress on the floor, or use boards.

Use whatever position is comfortable to rest. Many people find lying on their back with pillow(s) under the knees is helpful. Alternatively, lie on your side, possibly cuddling a pillow, with a further pillow between your knees. An ice pack (or packet of frozen peas) can be applied 3 times per day, at 10 minutes per time, over the painful part of the back Do not place ice directly onto the skin. Put the ice in a plastic bag and wrap it in a cloth.

A towel strapped into the curve of the waist will stop the spine from sagging when lying down, and may be more comfortable for your bed rest. When getting out of bed, roll onto your side and then use your arms to push up to the vertical.

General Advice
  • Brace the back and keep it straight if you cough or sneeze.
  • Using the toilet rather than a bed pan is less stressful.
  • Avoid constipation.
  • Sit as little as possible. If it is necessary, use a high straight-backed chair with a small cushion in the lower part of the spine.
  • Use the shower in preference to a bath.
  • Standing up: Move to the front edge of the chair, feet under it. Stand up with the back straight.
When No Longer Acute
Return gradually to your normal activities. Build up your level of activities over a few days or weeks the sooner you get back to normal and back to work the better.

Exercises In the non-acute stages, exercises can be beneficial in aiding recovery and maintaining mobility and strength. Even when your back is painful walking, or using an exercise bike, or swimming can all be of benefit. They should, however, be tailored to you. Below is an exercise that you could try.

Humping and hollowing the back.
  • Press the small of the back down into the floor.
  • Keeping the knees bent, roll your body between shoulders and heels from side to side.
  • Lift your head and upper trunk off the floor to look towards your knees. Avoid straining the neck.
  • Lift the straight knee just above the ground, hold for count of 5, then lower and relax. (The development of the leg muscles in this exercise is important for correct lifting , when they are used).
*** Proceed gently. Do not strain.

  • Do each exercise 5 times, twice per day.
  • Stop for 24 hours if you find it uncomfortable, then try again more gently.
  • When pain has gone, keep mobile by your own hobbies, eg. swimming, tennis, walking, - unless told to do otherwise by your medical advisors. Again start gradually and built up slowly.
Further Treatment
If despite following the above advice your back pain persists or recurs, you may be helped by physiotherapy, osteopathy or chiropractic. Waiting lists for NHS physiotherapy can be long, and there may be certain limitations on which patients they will accept. You can arrange a private referral, by looking through the Yellow Pages. If you look for the following qualifications you can be sure that the therapist has carried out an appropriate training.

Physiotherapists should have M.C.S.P. (Member of the Chartered Society of Physiotherapy) after their name.

Chiropractic - a practitioner should be a member of The British Chiropractic Association, for which there is a list in the Yellow Pages. If you have any queries, you should contact The British Chiropractic Association, 29 Whitley Street, Reading, Berks. Telephone 01734 757557. Fax 01734 757257.

Osteopathy - you should look for MRO (Member of the Register of Osteopaths) after the practitioner's name. This means that the practitioner is a member of The General Council and Register of Osteopaths (GCRO) which has drawn up high standards of training and professional conduct for osteopaths.

Further information can be obtained from the European School of Osteopathy Web site.

How to Avoid Backache in the Future Avoid activities involving prolonged stooping or bending, such as mending the car, vacuuming or gardening. If you are carrying out one of these activities stop frequently and straighten your back to an erect position. If possible kneel when doing an activity.

Be very careful when lifting heavy weights. Bend your knees and keep your back straight.

When standing or sitting try to maintain a straight back rather than slumping. On long car journeys a rolled up towel behind the lower part of your back can help. If standing for long periods wear low heeled comfortable shoes.

Keep fit. Exercise will help you to lose weight. Being overweight aggravates back problems. Only take vigorous exercise after warming up first.

Consider buying the book "The Back Book" published by HMSO (ISBN 011 702 0788).

Further information

BackCare - the charity for healthier backs

This article published on
01 July 2005

Next review date 7/1/2013


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