Back pain

Back pain is an extremely common complaint - it's estimated that over 60% of people suffer from it at some time in their lives. And it's one of the main reasons for taking time off work.   The causes of back pain   Back pain can strike anyone at any age, although figures show you are most vulnerable if you're between 45 and 59. But the seriousness of the condition varies. If the pain lasts for less than three months, you have what is called acute back pain. If your problem goes on for longer, you're suffering from chronic back pain.   Simple back pain   If you experience acute back pain, it's quite likely to have a simple cause ¡V this is the case with 95% of all cases of acute back pain. Most people who suffer from this sort of back pain are adults up to 55 years old who are otherwise healthy. The pain is short-lived, and has quite a simple physical cause - though it may well be due to strain over time, rather than the result of overdoing it just once. The pain is based in the lower back, and maybe also in the buttocks and thighs. It will come and go at different times, and depending on what you are doing. You may get simple back pain if: you have a poor posture you don't get enough exercise you stand or bend down for long periods your chair doesn't provide enough back support your mattress doesn't provide enough back support you lift, carry, push or pull loads that are simply too heavy for you, or you go about these tasks in the wrong way you trip or fall over   Nerve root pain   Nerve root pain accounts for fewer than 5% of all cases of back pain. Here the pain is caused by compression of the nerves that run up the middle of the vertebrae in your back. It is usually caused by a damaged disc, or because a vertebra has slipped out of line with the others. The pain will normally be in your lower back, plus more severe pain down one or both of your legs to your calves, feet or toes.   More serious problems   In a relatively small number of cases, back pain may have a more serious underlying cause. This includes abnormality of the spine, an infection or collapse of the vertebrae, fibromyalgia (a condition that affects the muscles), tuberculosis or cancer. These kinds of problem are more likely to be the case if your back pain starts gradually, gets worse over time, and seems unrelated to how active you are. You'll also be very likely to have other symptoms including, for example, incontinence or general tiredness or lethargy. You're also more at risk if you have had certain other conditions, especially tuberculosis or cancer, in the past.   When to see a doctor   Most attacks of simple back pain last only a few days and get better on their own. But you should see a doctor straightaway if you have any of the following symptoms as well as your back pain: fever redness or swelling on your back pain down your legs and below your knees numbness or weakness in one or both of your legs loss of bladder or bowel control You should also see a doctor if: your pain lasts longer than a week it's the result of an injury, a fall or blow to your back, or you're under 20 or over 55 years old, and the pain lasts for more than a few days   Diagnosis   In most cases, your doctor will only need to discuss your symptoms and examine you. Your doctor is likely to refer you for more tests only if your pain lasts longer than six weeks, or if he or she suspects there is some underlying cause of the pain. These tests might include: X-rays CT (computerised tomography) scans MRI (magnetic resonance imaging) scans A myelogram (a special kind of X-ray) Blood tests Your psychological well-being can also play a role in back pain. If your condition turns out to be chronic, your doctor may refer you for psychological and social assessment.   Treatment   Activity   Research shows that bed rest doesn't help simple back pain - it's much better for you to return to normal physical activity as soon as possible. Staying active may hurt more at first, but it helps your back to heal quickly, and reduces the risk of the problem occurring again. If you really can't cope, and feel you have no option but to take to your bed, try to limit it to two or three days before you are up and about again.   Painkillers   Paracetemol or ibuprofen are usually enough to relieve simple back pain. Muscle relaxants such as diazepam may help if you have muscle spasms, but don't take them for more than a week. And try applying a hot water bottle or an ice pack to the painful area - these can both offer some relief.   Manipulation and exercises   Osteopathy and chiropractic - treatments involving manipulation of your spine - may provide short-term relief for simple back pain within the first six weeks. However, you should only consult an osteopath or chiropractor who is a registered practitioner. Back exercises and physiotherapy may be helpful if your pain lasts longer.   Complementary approaches   The Alexander Technique may help improve your posture. Acupuncture can help with the pain. And, because back pain can sometimes be a sign of emotional problems, counselling may also be helpful.   Surgery   If you have a chronic back problem that isn't helped by manipulation, exercises or medication, surgery may solve or help the problem. If your pain is caused by a , say, damaged disc, this could be surgically removed.   Managing back pain   Good back care can greatly reduce your risk of back pain. To look after your back, make sure you: take regular exercise use a chair with a backrest, and sit with your feet flat on the floor or on a foot rest sleep on a firm mattress Also, follow these tips for lifting and carrying things: Lift only a manageable weight, or ask for help. When lifting, bend your knees, keep your back straight and your feet apart. Do not lift and twist at the same time. Lift and carry objects close to your body. Bend your knees, not your back, when you put things down   How your back works   Your spine is made up of many small bones called vertebrae. These are separated by discs, which allow the spine to bend. This structure of vertebrae and discs is supported along its length by muscles and ligaments. Your spinal cord threads through the centre of each vertebra, carrying nerves from your brain to the rest of your body.   Further Information   BackCare http://www.backpain.org/ The Back Pain Guide http://www.bbc.co.uk/health/backchat National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/health_and_medical/disorders/ American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/   Healthwise (Health Information Resource Centre) Tel : (852) 2849 2400 Fax : (852) 2849 2900 Email : info@healthwise.org.hk Homepage : http://www.healthwise.org.hk/ This leaflet is for information only. For a detailed opinion or personal advice, please consult with your own doctor     Download PDF File