Blighted by lower back pain? Experts explain key signs, symptoms and treatments
Although rarely serious, back pain is extremely common and can be a real bane. We talk to some experts about causes, avoidance and management
WHETHER it's a dull ache after lugging a heavy bag around all day, a tell-tale twinge while doing some heavy lifting in the garden, or the price of sitting at a desk day in, day out – back pain is never fun to deal with.
It is, however, extremely common. Lower back pain – also known medically as 'lumbago' – is one of the most common reasons why people visit the doctor in the UK, and it's estimated that up to eight in every 10 people are affected by it at some point in their lives.
Fortunately, in the vast majority of cases, back pain isn't triggered by anything serious and will usually improve with time, and there are lots of measure people can take to prevent or relieve symptoms.
There are sometimes occasions, though, when back pain can be a sign of an underlying cause that needs closer attention and management.
So, what are some of the warning signs and what should you do if you're experiencing symptoms? Here, experts explain more...
Why does lower back pain happen?
"Lower back pain, or lumbago, occurs when there is a problem with ligaments, muscles, discs, nerves or vertebrae – the bony structure that makes up the spine," says Dr Luke Powles, associate clinical director of Bupa (bupa.co.uk), who assures that it's an extremely common issue.
"Back pain that develops quickly and lasts for less than three months is called 'acute back pain'," he adds.
Pain that goes on for longer than three months, meanwhile, is classified as 'chronic back pain' – and indicates that any treatment carried out in the initial three months has not been successful. However, this still doesn't mean that there's a serious underlying medical cause – although the pain can be frustrating to live with.
"Three main causes of back pain are force, repetition and inactivity," says Powels. "Heavy lifting can lead to muscle or ligament strain resulting in painful muscle spasms, as can repetitive movements such as twisting or bending the spine. Similarly, bad posture and sitting for long periods of time can have ill-effect."
Powell explains that simple things like incorrect or poor computer positioning and chair height (while working at a desk, for example) can lead to back pain – and if you are faced with these conditions five days a week, you may notice your back pain becoming an ongoing issue.
What are the symptoms?
Pain itself is the most obvious symptom. This can take many different forms, including a dull ache, burning sensations, or sharp shooting or 'pulling' pain. While it's very rarely dangerous, there are signs that there may be something more serious going on – like nerve compression/irritation or damage. So how do you know if this might be the case?
Dr Sarah Brewer, medical director at Healthspan (healthspan.co.uk), says: "Telltale signs include weakness or numbness in one or both legs, severe pain causing immobility, pains shooting down the leg, difficulty with bladder and bowel control or pins and needles at the base of the spine or lower legs."
If any of these symptoms occur, Brewer advises that you tell your doctor straight away. If your symptoms occur following a traumatic injury, it's also vital to get things checked as quickly as possible, just to be on the safe side. "Back pain due to more than a minor injury or fall also needs investigation to rule out a fracture, slipped disc or other problem affecting local nerves," she says.
Plus, if you also experience any sudden severe loss of sensation in the 'saddle' area (around the groin, genitals and buttocks), incontinence, or find that you can't empty your bladder/bowels, seek medical advice immediately, as this can be a sign of a very rare but serious complication of nerve compression in the lower spine.
In some cases, lower back pain may also be associated with arthritis (ongoing stiffness in the morning can be a warning sign here), or other medical problems within the joints or spine. Any pain that's severe, ongoing, getting worse and affecting your mobility should be checked out by the doc.
What can I do to relieve back pain?
Although it may sound counterintuitive at first, rest isn't always the best solution. Often, the best way to manage back pain is to stay active, and in some cases painkillers may help, says Powels.
"Many still believe that long periods of laying down will relieve symptoms, but this is a myth. It may feel relaxing at first, but prolonged periods can make the pain worse," he says.
Powels suggests regular low-impact activities such as walking or swimming, which can increase strength and build up endurance in your back. "Include exercises into your routine that build muscle strength in your abdomen and back; strengthening your core will help alleviate the pressure on your back," he advises.
Of course, if you have an acute injury, it's always best to seek suitable advice before embarking on any new exercise regime. A physiotherapist, for example, will be able to assess the problem and advise on the course of action to take and any activities to avoid while your injury heals. Pilates can be very effective for building core strength and keeping mobile.
Thinking about your set-up at work and making positive changes can make all the difference too. "Good posture when standing for long periods of time, while ensuring your chair has good support, are quick and easy ways reduce stress on back muscles," says Powels.
"Walking and taking regular breaks can also alleviate the pain, but returning to the same position may bring the pain back, so try to change positions at your desk or swap your regular desk for a standing desk. "
Some people find relief through alternative therapies, and possibly herbal remedies too. However, it's important to bear in mind – just because supplements and herbal remedies are 'natural' doesn't mean they're always suitable. If you are taking any other medications, you should always check with your doctor or pharmacist that it's safe to take any new supplements at the same time.
If you are interested in herbal remedies, Brewer suggests Devil's Claw JointAid Tablets (£16.95 for 60 tablets, healthspan.co.uk), which is derived from the root tuber of a South African plant and is a traditional herbal medicine used to relieve back pain.
Brewer explains that it contains unique, anti-inflammatory, analgesic compounds such as harpagoside and harpagide that are believed to help reduce pain, inflammation and possibly improve mobility.
She also recommends, if it's suitable for you, trying a St Paul's Wort supplement – a Chinese medicine from the plant Sigesbeckia orientalis, which has been used for thousands of years to treat rheumatic conditions such as backache and joint pains.
Lifestyle changes might help too, such as taking positive steps to avoid and manage stress (which is a key factor in many types of pain), maintaining a healthy weight or taking sensible steps to lose excess weight, and making efforts to improve your sitting and standing posture.
Brewer also suggests sleeping on a comfortable mattress, using just one pillow and wearing flat shoes.
If the pain doesn't subside within a couple of weeks, is getting worse or not responding to self-management or over-the-counter painkillers, visit your GP and/or check in with a physiotherapist.