Back Pain FAQs

Back Pain FAQs

Lower Back Pain FAQ

Back Pain FAQs

At London Spine Specialists we receive many questions relating to back pain and what can be done to treat it and prevent its occurrence. Below we outline some common questions as well as ways to help prevent back pain. If you have any further questions we recommend contacting our team who will be happy to help.

Back Pain FAQs

How Common Is Back Pain?

Back pain is a very common condition and can affect adults of all ages.

It is estimated that one in five people will visit their GP in any given year because of back pain. And 80% of adults will experience at least one episode of back pain at some point in their life.

Chronic back pain is less common than acute back pain, but it is still very widespread. In England, chronic back pain is the second most common cause of long-term disability (after arthritis). After stress, it is the leading cause of long-term work-related absence. A recent study found that one in every ten people reported having some degree of chronic back pain.

The rates of reported cases of back pain in England have doubled over the past 40 year. There are a number of theories to explain the rise in the number of cases.

One theory is that the rates of obesity, depression and stress are now higher than they were in the past. These conditions are all risk factors for chronic back pain. Another theory is that people are now more willing to report symptoms of pain to their GP than they were in the past.

What Should You Look Out For?

The outlook for back pain can vary considerably between individuals. Some people have minor episodes of acute back pain before making a full recovery.

Other people have long periods of mild to moderate back pain that are interrupted by periods of severe pain, which makes them unable to do their normal daily activities.

An Australian study which looked at people who visited their GP because of back pain found that:

  • 40% were completely free of pain within six weeks
  • 58% were pain-free within 12 weeks
  • 73% were pain-free within one year

Psychological and social factors play an important role in the expected outlook for back pain, particularly for chronic back pain.

For example, people who have a positive frame of mind and report enjoying a good quality of life tend to make a faster recovery than those who report symptoms of depression and are unhappy with one or more aspects of their life.

Treatment options for back pain include painkillers, spinal manipulation, acupuncture and exercise classes. Some cases of chronic back pain may also benefit from additional psychological treatment for the reasons discussed above.

What Are The Causes of Back Pain?

Most cases of lower back pain are known as ‘non-specific’ because they are not caused by serious damage or disease, but by sprains, muscle strains, minor injuries, or a pinched or irritated nerve.

Back pain can also be triggered by everyday activities at home or work, and by poor posture. For example, back pain may be triggered by:

  • bending awkwardly
  • lifting, carrying, pushing or pulling incorrectly
  • slouching in chairs
  • standing or bending down for long periods
  • twisting
  • coughing
  • sneezing
  • muscle tension
  • over-stretching
  • driving in hunched positions
  • driving for long periods without taking a break

Sometimes, you may wake up with back pain and have no idea what has caused it.

What Are The Common Causes?

Some common causes of back pain include:

  • pregnancy
  • gynaecological problems in women, such as pelvic inflammatory disease (PID)
  • different types of arthritis, such as osteoarthritis
  • stress-related tension
  • viral infections
  • bone disorders
  • bladder and kidney infections
  • osteoporosis (weak and brittle bones)
  • a trip or fall
  • a trauma or injury, such as a fracture
  • lack of exercise
  • obesity
  • sleep disorders

What Are The Causes Of Serious Back Pain?

The bulging or rupture of one or more of the intervertebral discs can sometimes cause serious back pain. This results in the inner jelly-like material (nucleus pulposus) pressing on the spinal cord or nerve roots, which run next to the disc. This is commonly known as a ‘slipped disc’, but is more accurately described as a ‘prolapsed’ (bulging) or ‘herniated’ (ruptured) disc.

The pain will usually be in your lower back, but you may also experience pain in you buttocks, thigh, calves, feet and toes, due to irritation of the sciatic nerve, which runs down both legs. Occasionally, the pain is also accompanied by pins and needles, numbness and weakness.

Intervertebral discs tend to dry out and weaken with age, or following an injury. This results in the discs becoming less flexible, which means they do not cushion the vertebrae as well as they did before. This is a common cause of stiffness and pain, particularly in the elderly. It also tends to be worse early in the morning.

Persistent lower back pain can also be caused by a number of rare conditions, such as:

  • congenital (inherited) spinal defects
  • bone diseases
  • shingles (an infection that affects the nerves)
  • fibromyalgia
  • cancer that has spread to the spine

How To Prevent Back Problems

  • Exercise your back regularly. Walking, swimming (especially backstroke) and using exercise bikes are all excellent ways to strengthen your back muscles.
  • Always bend your knees and your hips, not your back.
  • Never twist and bend at the same time.
  • Always lift and carry objects close to your body.
  • Try to carry loads in a rucksack and avoid sling bags.
  • Maintain a good posture. Avoid slumping in your chair, hunching over a desk or walking with your shoulders hunched.
  • Use a chair with a backrest. Sit with your feet flat on the floor or on a footrest. Change how you sit every few minutes.
  • Quit smoking. It is thought that smoking reduces the blood supply to the discs between the vertebrae and this may lead to degeneration of these discs.
  • Lose any excess weight.
  • Choose a mattress suited to your height, weight, age and sleeping position.

Lifting & Handling

One of the biggest causes of back injury, particularly at work, is people lifting or handling objects incorrectly. Learning and following the correct method for lifting and handling objects can help prevent sciatica.

  • Think before you lift. Can you manage the lift? Are there any handling aids you can use?
  • Start in a good position. Your feet should be apart with one leg slightly forward to maintain balance. When lifting let your legs take the strain, bend your back, knees and hips slightly but do not stoop or squat. Tighten your stomach muscles. Do not straighten your legs before lifting as you may strain your back on the way up.
  • Keep the load close to your waist or as close to your body and for as long as possible, with the heaviest end nearest to you.
  • Avoid twisting your back or leaning sideways especially when your back is bent. Your shoulders should be level and facing in the same direction as your hips. Turning by moving your feet is better than lifting and twisting at the same time.
  • Keep your head up. Once you have the load secure look ahead, not down at the load.
  • Know your limits. There is a big difference between what you can lift and what you can safely lift. If in doubt, get help.
  • Push, do not pull. If you have to move a heavy object across the floor, it is better to push it rather than pull it.
  • Distribute the weight evenly. If you are carrying shopping bags or luggage, try to distribute the weight evenly on both sides of your body.

What Causes Lower Back Pain?

Causative Factors

Poor back-muscle tone, muscle tension or spasm, back sprains, tears in ligaments or muscles and joint problems are the most common causes.

With increasing age, bone density and soft tissue elasticity (ligaments/ tendons/ muscles) decreases. The intervertebral discs, the fibroelastic shock absorbers between adjacent vertebrae begin to lose their fluid and flexibility. This decreases their ability to cushion the vertebrae.

Specific Causes Of Back Pain

Herniated Disc

A herniated disc (otherwise known as a slipped or ruptured disc) is a fragment of the intervertebral disc that has herniated into the spinal canal through a tear or a rupture.

The spinal canal has limited space, which is insufficient for the spinal nerve and the displaced herniated disc fragment. As a result, the disc presses on the spinal nerves and can produce pain. Characteristically patients have lower back pain. They can also have sciatica, with associated pain radiating down the back and or front of the leg(s). The pain can also be associated with areas of numbness and pins and needles.

Collapsed Vertebra

Collapsed vertebrae are more common over the age of 60 years and are associated with a decrease in bone density, or osteoporosis. They can also be associated more rarely with the spread of cancerous disease or metastatic disease.

Spondylolisthesis

Also referred to as spondylolysis, this condition is most prevalent in adolescent athletes. Pain typically emanates out of a stress fracture in one of the bones (vertebrae) that make up the spinal column.

Ankylosing Spondylitis

This is a form of arthritis that affects the lower back. Stiffness, soreness and swelling of the joints form the main causes of back pain.

Pregnancy

As pregnancy progresses the foetus and uterus increase in size. In the last trimester it is often quite noticeable. The expanded abdomen acts as a large weight at the front of the pregnant women which puts added strain on the lower spine. Lower back pain is very common, particularly in the later stages of pregnancy.

In addition during pregnancy there is an increase in the production of oestrogen and progesterone. These lead to increased ligament laxity which further exacerbates the lower back pain.

Other Causes

Other causes of mild or severe back pain include nerve or muscle irritation, bone lesions and injury/trauma to the spine.

Certain degenerative conditions such as arthritis, osteoporosis, viral infections, irritations to joints and discs, congenital abnormalities in the spine are also known to be the causes of lower back pain.

Lastly, lifestyle deformities such as obesity, stress, poor physical condition, inappropriate posture and poor sleeping positions are the other common causative factors

Make An Appointment

If you have any further questions or would like to book an appointment we recommend contacting our team who will be happy to help.

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