Good news… you don’t have to put up with that bad back
By ANGELA EPSTEIN
UPDATED: 22:01 GMT, 17 December 2011
Britain is a nation with a bad back. Recent research revealed that 80 per cent of Britons have one or more bouts in their lifetimes, and the condition is the single most common reason we see a doctor.
In most cases, treatment will be as simple as taking a paracetamol and trying to get on with the day. But in some instances, there could a more serious cause.
Dr Catherine Mathews, consultant rheumatologist at The BMI Blackheath Hospital in London, says: ‘In very rare instances, back pain can be symptomatic of something sinister, such as cancer or tuberculosis. If you suffer with back pain, your first stop should always be your GP.
‘If back pain is unrelenting and there whether you rest, are active or lying down, or it disturbs your sleep, you need to get it investigated.’
The good news is that many instances of back pain are easily treatable and need not lead to long-term misery. Here, with the help of leading experts, we find out what your back could be trying to tell you . . .
MY BACK HURTS WHEN I HAVE TO STAND FOR A LONG TIME
IT COULD BE OSTEOARTHRITIS OF THE SPINE
This is a degenerative disease that affects the cartilage which coats the bones at the end of joints. Sometimes, the wear and tear of osteoarthritis also puts pressure on the nerves extending from the spinal column, causing weakness and pain in the arms or legs.
Osteoarthritis of the spine usually doesn’t happen until about the age of 45.
‘As well as causing a dull ache on standing, many sufferers feel it when they set out on a walk,’ says Professor Alan Silman, of Arthritis Research UK. ‘It may ease off after ten minutes or so. Many sufferers also find pain disappears by mid-morning but then creeps up again from mid-afternoon if they have been sitting at their desk for a long time.’
‘Losing weight will help as this will ease pressure on the back,’ says Prof Silman. ‘Any exercise that stretches the back muscles and the muscles of the abdominal wall will help. Try lying on your back with your knees pulled alternatively into your chest. Do this ten times.’
Sitting in one place for a prolonged period also puts pressure on the back.
Physiotherapist Sammy Margo says: ‘When you sit at your desk, make sure your bottom is at the back of your chair. Using a TENS machine [transcutaneous electrical nerve stimulation] such the Lloyds Pharmacy Back Pain Reliever, may also help. This works by passing harmless electrical signals into the lower back from its pads, blocking the body’s pain signals. Try to do about 20 to 30 minutes of aerobic exercise every day, such as swimming, walking or cycling to maintain flexibility.’
STABBING PAIN OR SPASM IN THE SIDE OF THE BACK
IT COULD BE A PULLED MUSCLE
This happens when the back muscles are strained or even torn, usually as a result of a single incident. Sufferers often remember the instant the pain started and relate it to a particular situation.
‘The pain is normally on one side as it will relate to a specific area, rather than emanating from the spine,’ says Margo. If the pain does come from the spine, it could have been caused by nerve irritation to the joints or ligament.
You may need to rest for a day if the pain is really bad, but start moving as soon as you can, otherwise the muscles can become immobilised and the problem gets worse.
‘Use ice, an ice spray or gel for about seven minutes on the affected area, three to four times a day. Do this for the first 36 hours to reduce inflammation, then switch to heat treatment which will help relax the muscles,’ says Margo.
IT’S NOT JUST MY BACK, BUT MY LEGS THAT HURT
IT COULD BE SCIATICA
Leg pain, numbness or weakness that starts in the low back and travels down the sciatic nerve in the leg is known as sciatica. The pain is likely to be constant in one side of the buttock or leg and is made worse by sitting.
Sciatica is commonly caused by a slipped disc, when the spinal discs that act as cushions between the bones of the spine move and press on the nerves. If you have a slipped disc, it may hurt when you cough.
‘Most slipped discs resolve themselves spontaneously as the disc heals itself,’ says Dr Karl Gaffney, consultant rheumatologist at The Norfolk and Norwich University Hospital. ‘It’s important to try gentle exercise such as swimming which won’t put pressure on the back but which will keep you mobile.’
Margo suggests: ‘You can alleviate leg pain at night by sleeping with a pillow between your knees. Hot packs applied to the back such as Thermacare Heat Wraps may help as these provide heat and support to the area.
‘For women, wearing tight knickers or leggings can offer support. If the condition goes on for six weeks or more, your specialist may suggest injections of steroids into the spine to reduce inflammation.’
MY BACK PAIN IS SO UNBEARABLE IT’S MAKING ME FEEL SICK
IT COULD BE KIDNEY STONES
These are tiny grains of waste products that crystallise and collect around the inside of the kidney, causing nausea and back pain. ‘The pain is always on one side and is severe if not overwhelming,’ says Dr Mathews. ‘You can identify your kidneys by putting your hands on the top of your hip bones with your thumb behind your back.’
Pain from small kidney stones may last only a few hours and is likely to stop when the stone is passed into the urine. Stones that don’t pass can be treated by extracorporeal shock wave lithotripsy (ESWL) X-rays. Ultrasound is used to pinpoint the stone, then a machine sends shock waves of energy to break it into smaller pieces so it can be passed.
MY BACK AND NECK FEEL STIFF, PARTICULARLY IN THE MORNING
IT COULD BE ANKYLOSING SPONDYLITIS (AS)
This is a form of arthritis in which the spinal joints and ligaments and the joints at the base of the spine become inflamed.
‘This condition affects more men than women and usually happens in our 20s and 30s. It is also characterised by pain above the buttocks which can sometimes be on one side and sometimes on the other,’ says Dr Gaffney. ‘The pain usually gets better as the day wears on.’
The condition is also associated with people who suffer from psoriasis, and colitis (inflammation of the colon).
Stay active to improve your posture and range of spinal movement, as well as preventing your spine from becoming stiff and painful.
‘Try rotation exercises such as swivelling your hips or twisting your waist,’ says Margo. ‘And practise walking with your hands behind your back as this will make you stand tall.
‘Good posture is really important because it means that even if you stiffen up, you will be doing so in the most supportive position.’
Dr Gaffney says: ‘There is also a new class of drugs called biologics for those with severe pain which work by switching off the infection. However, this is usually a treatment of last resort as there are potentially quite severe side effects.’
Data from: dailymail.co.uk