This page provides you with information and self-help advice for managing musculoskeletal back problems.
Back pain is a common condition, and in most cases, it is not usually caused by a serious problem. Back pain usually gets better within a few weeks. During this time, it is important that you stay active, and limit bed rest.
When you should seek urgent help for your back pain
Please watch the video below and visit this website for more information on serious pathology related to back pain.
This video has been taken from the MACP (musculoskeletal association of chartered physiotherapists) website.
When to speak to a health professional
These symptoms are very rare but you should contact a doctor if you experience any of them:
- Difficulty passing urine or having the sensation to pass water that is not there.
- Numbness / tingling in your genitals or buttocks area.
- Loss of bladder or bowel control.
- Impaired sexual function, such as loss of sensation during intercourse.
- Loss of power in your legs.
- If you are experiencing pain that runs down the back of both legs.
- Feeling unwell with your back pain, such as a fever or significant sweating that wakes you from sleep.
Self help and recovery
Research shows that most back pain can be successfully treated with a combination of:
• remaining as active as the pain allows
• simple painkillers if needed, and
• advice from a healthcare professional like a physiotherapist.
If simple painkillers and staying active are not helpful, then other treatments may be recommended.
In most cases, it is not possible to identify the exact cause of back pain. It is important to know that any kind of structural damage is rare.
While it can be painful and upsetting, this type of back pain usually gets better quickly. It can be managed through advice and remaining active. Many physical or psychological factors can cause back pain and often a combination of these are involved.
They could be:
• Physical factors, such as ‘protecting’ the back and avoiding movements, or a simple strain.
• Psychological factors, including a fear of damage or not getting better, feeling down or being stressed.
• More general health and lifestyle factors, like being tired and rundown, not getting enough good quality sleep, being overweight or not getting enough physical activity
• Social triggers, such as difficult relationships at work or home, low job satisfaction or stressful life events, like a family death or illness.
• Of course back pain may also be caused by accidental injury or severe overstrain.
Crucially, it’s important to know that all pain is 100 per cent real and never ‘all in your head’, even when factors like stress or mood are involved.
Each of the factors can turn up the volume on your pain and gaining a greater understanding of when that can happen puts you in a stronger position to recognise them and learn how to turn down the dial again.
Sometimes there are specific causes for back pain, especially when there is leg pain, pins and needles or numbness too. This can be caused by irritation or compression of the nerves in the back.
Please visit this website for more information on serious pathology related to back pain.
Is back pain caused by a 'slipped disc'?
The short answer is no. Whilst the term is widely used, it is not accurate and it can be very unhelpful for people with back pain or back and leg pain and make them more fearful of moving and doing normal activities.
Discs are designed to help the spine take loads and transfer pressure as we move around. In fact movement and loading helps to keep the disc healthy and strong. Their design makes it impossible to ‘slip a disc’ and equally impossible for a practitioner to ‘put the disc back’.
A disc can be strained under sudden or repetitive overload, in the same way as other joints in our body. This can cause pain locally in the back or referred pain into the buttock and legs. It usually gets better without doing anything. It can also respond well to taking simple painkillers and keeping active, doing as much of your normal activity as possible.
Useful websites:
Coping with long-term back pain can be difficult, but it can be managed with help from a physiotherapist. Some people find that their back pain returns from time to time, which can be frustrating. However, a physiotherapist can help you plan how to manage these occurrences.
For more information please visit this link and this page for accessing more support with your persistent pain.
Keeping active can also help with dealing with life stressors, so ensure you are finding ways to stay active regularly.
The importance of sleep in tackling back pain has become increasingly clear in recent years. This is because it reduces stress and improves your overall feeling of well-being, making you less susceptible to the triggers of pain in the first instance and helping you to cope when it does occur. Aim for 7.5-8 hours a night and try to aim for a regular routine, as far as possible. It is also very important to know that there is no best position or type of mattress – whatever feels most comfortable for you is best.
In addition, controlling your weight through healthy diet is an important factor in the recovery from your back pain. There is a link between back pain severity and length of symptoms and increased BMI and waist circumference measure. This goes in line with reducing or stopping smoking and excessive use of alcohol, which may help reduce your back pain and recurrence of back pain.
Stress can exacerbate existing back pain, so if you able to, identify and manage the causes of your stress.
Exercise has been shown to be one of the most helpful treatment for back pain. It doesn’t matter what type of exercise you do, as long as you remain active. So, choose something that you like to do it, and keep at it!
Softening exercises for your lower back muscles
Back flexibility exercises
More exercises can be found here.
You can also make use of the following exercises where appropriate:
- Lower back mobility programme - word document or PDF
- Lower back pain programme - word document or PDF
- Upper back strengthening programme - word document or PDF
- Upper back mobility programme - word document or PDF
Hands-on treatments have been shown to have a small benefit to back pain, and only when used as part of a whole treatment programme which includes exercise.
Similarly, injections may be beneficial as part of a treatment programme, but not on their own and are more helpful with certain back conditions than others. Injections may be tried if the exercises and other treatments have not helped.
Official guidance does not recommend treatments such as traction, acupuncture, and various electrical treatments for back pain.
Within physiotherapy there are specialists in the care of back pain, who can offer advice and treatment tailored to your needs.
What happens when I see a physiotherapist for back pain?
A physiotherapist will do a full and thorough assessment of you. This will include:
• taking a detailed history of your pain,
• details about your medical and family history of back pain
They will then do a physical assessment to see how you move and how your muscles, nerves and joints are working.
They will discuss with you the options available, and the best treatment programme that fits your needs.
This may include a range of options such as:
• a home exercise programme for strength and mobility
• advice on pain management
• manual (hands-on) treatment if indicated as addition to main management programme.
Your physiotherapist will monitor your progress with the treatment plan and help to you get back to your normal daily life.
Scans can help for a small number of people and in certain situations. However, most of the time it shows us things that are normal for the age of your spine and are not related to your pain. These sorts of findings will not help the back get better. This is why your GP or clinician may say that it is not needed.
When should you self refer?
Most back pain will settle naturally in time with little or no help, but occasionally you may need some extra help to get your back better. Most people do not need further treatment or investigations, and your physiotherapist is ideally placed to advise if you do. If the above self-help information is not improving your symptoms within 6-8 weeks or if your symptoms are getting worse, then see a healthcare professional. To do this, you will need to fill in our self referral form.
Please find below information on back conditions and some other useful information:
Please note: The information on this page is not a replacement for professional help but may aid you and any further information or advice given to you by a medical professional. If you are accessing this site for self-help information in the absence of professional advice, please be aware that the advice and/or exercises may not be suitable for you. If you have any concerns or in the event of any problems, please seek professional advice.