Back Pain

Acute back pain is usually caused by a sprain or strain in the back. It is so common it should be seen as an annoying but normal part of life.

80% of the adult population in this country will have a significant episode of back pain in their life. Around 10% of the population have back pain at any one time.

It can come on quite suddenly, or over time, often without any specific injury to your back.

Persistent back pain can refer to recurrent back pain or pain that has lasted for several weeks.

It lasts for longer than acute pain and it can have a bigger impact on your day-to-day life.

Persistent back pain can range from a mild pain or ache, to a more severe pain, and can be influenced by a range of factors, including sleep, stress, emotions and activity levels.

Persistent back pain usually requires treatment such as specific advice/guidance on exercise and management from a physiotherapist, and sometimes medication. Treatments can include manual therapy or psychological therapy to complement the exercise. In most cases though, your back will heal itself. It is important that you keep active and continue as normal, but if your pain is severe and persistent then you should seek medical advice for diagnosis and the appropriate treatment.

Sciatica is a pain that travels down from your lower back or buttock, to your foot. It usually happens when something irritates the sciatic nerve a bit. 

The sciatic nerve runs down through the back, into the buttock, down the back of the leg and round to the outside of the lower leg and foot.

When the nerve gets irritated, the brain interprets the pain as coming from the buttock or leg instead of the back, where the problem actually is. The pain can be quite a severe shooting pain, sometimes accompanied with pins and needles or numbness.

Regular exercise is vital in keeping back pain at bay by toning your muscles, allowing your body to support your back much better.

People with good fitness levels tend to experience less back pain, so get out of the house and go walking, swimming or cycling for half an hour a day. Exercise classes such as yoga or pilates are also great for your back, and visiting the gym can also help.

Keeping active is also good for you if you're already suffering from back pain. Even if exercising feels painful, it will not harm your back and keeping active is one of the best ways to allow your back to recover.

Big changes have been made to the way back pain is managed in the NHS.

Through this website we are supporting the county's GPs in giving you the help you need to manage your own back. After all, back pain is so common, you're likely to have episodes of acute pain on and off throughout your life.

Your GP will help guide your recovery and prevention of further back pain by using the right pain killers as needed, along with some good advice.

When you need extra help they can help you decide what's best for you. As this website is strictly non-promotional we do not recommend specific practitioners.

Nine out of 10 cases of sciatica will heal without any specialist treatment - and more than seven out of 10 patients will report improvement within four weeks.

Keeping active is very important, but it may often be necessary to take pain killers to allow you to do this.

You shouldn't be afraid of masking the pain as much as possible, as keeping active will not do you any more harm.

Your GP or physiotherapist will be able to recommend activities that will help you keep moving and stop your muscles getting out of shape

It's normal to feel some discomfort during recovery - but this is not harmful. 

Warning signs

Rarely, the discs in your back can press on part of the spinal cord that is responsible for bowel and bladder function. If you suffer from any of the symptoms below, you should visit A&E.

• Loss or decreased sensation around the buttock area.
• Inability to hold on to your urine or bowels.
• Inability to pass urine or get an erection.
• Pain into both legs.
• Progressive weakness in the legs.

You are better continuing with activity, including work, even if you are still in some pain. People who remain active have far better outcomes than those who don't.

If you are struggling with back pain:

• Inform your manager

• Seek professional advice

• Keep mobile

• Stay at work as long as possible, this helps with your rehabilitation and recovery

• Use pain killers to help you carry on – it’s the movement that will get you better, and the pain killers will allow you to move by masking the pain.

 

If you have to go off work sick use that time to get your back better - this might mean going out for walks, to the shops, etc. Don't feel that just because you are off work you should not keep active - you must!

Stay in touch with your workplace. Hopefully your employer will be trying to keep in touch with you as well. Be open-minded about getting back to work as soon as possible. This can be facilitated by changes to your normal job role, hours and even where you work.

The longer you remain off work the more difficult it becomes to get back to work.

Many people spend at least eight hours a day at work so it is important to make sure that your back can cope with the demands placed on it, whether it is a sedentary job or a manual job.

• If you have a sedentary job, you should take regular exercise outside of working hours
• This could include exercise classes, gym, cycling, swimming running, dancing etc.
• If possible you should use any breaks in your working day to do some activity e.g. go for a walk or do some stretches
• Talk to your employers about the importance of encouraging movement and exercise as part of a normal working day – this is likely to improve sickness rates
• If you have a manual job you are likely to be repeating the same movements regularly, therefore it is still important to make sure you do some different form of exercise whenever possible e.g. if you do a lot of lifting or digging at work, do some stretching or swimming outside of work

At Your Desk

Working at a desk all day can take its toll on your back. Having your desk set up comfortably may help.
 

• Try to have your computer screen at eye level in front of you and your chair directly facing it, to avoid unnecessary twisting.

• Have your mouse and keyboard within easy reaching distance so that you don't have to stretch to use them.

• Take regular breaks and get up and walk around the office regularly, to stretch out your muscles and give your back a rest.

Lifting & Handling 

  If you have a lot of lifting to do, or are lifting something you are not used to lifting, seek to use equipment if possible, or request assistance of a colleague

Regular exercise is vital in keeping back pain at bay by toning your muscles, allowing your body to support your back much better.

People with good fitness levels tend to experience less back pain, so get out of the house and go walking, swimming or cycling for half an hour a day. Exercise classes such as yoga or pilates are also great for your back, and visiting the gym can also help.

Keeping active is also good for you if you're already suffering from back pain. Even if exercising feels painful, it will not harm your back and keeping active is one of the best ways to allow your back to recover.

10 things you need to know about back pain

Information leaflet on lower back pain Back pain[pdf] 666KB

Back pain Excerise sheet

Useful Videos

It is important that you apply the advice and guidance provided above for around 8 weeks by which time we would expect you to notice improvement and in some cases complete recovery. If not, we have a team of trained physios who can help.

Self-refer into our service today

Think you need more urgent or emergency treatment? Follow the below guidance to see if you need to see someone quicker. 

Physiotherapy Triage

Physiotherapy Triage Red flag re-direction of patients to A&E/GP consultation

IMPORTANT 'Cauda Equina Syndrome’ although rare, can cause a permanent change to your bladder and/or bowel function, or foot strength.

IF you are suffering with low back pain and if you have any changes regarding the following since your pain started;

• Bladder or bowel function (i.e., Increasing difficulty when you try to urinate, increasing difficulty when you try to stop or control your flow of urine, loss of sensation when you pass urine, leaking urine or recent need to use pads, inabilityof knowing when your bladder is either full or empty, inability to stop bowel movement or leaking, loss of sensation when you pass a bowel motion)
• Loss of sensation/tingling around genitals, back passage, buttocks or inner thighs • Erectile or ejaculation problems or loss of sensation in genitals during sexual intercourse
• Loss of sensation/ tingling or numbness in both legs
• Weakness in foot (i.e. floppy foot or inability to lift front of foot when walking)

If YES call NHS 111 or go to A&E IMMEDIATELY

If you are suffering with low back pain and if you have any of the following;

• History of cancer
• Unexplained weight loss
• Feeling generally unwell/fever/lack of appetite

Please contact with your GP as soon as possible to discuss if other investigations are required rather than self-referring to physiotherapy.

You can also visit your GP for more information and advice on;

• Women's and men's health including pelvic floor and incontinence
• If you have had a series of falls and want to learn more to help avoid them
• If you have reduced mobility and require a stick or frame
• If you require neurological support for example if you have had a stroke or Parkinson's
• If you are housebound
• If you are under 16 years old