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 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.
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:
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.
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:
Sometimes, you may wake up with back pain and have no idea what has caused it.
Some common causes of back pain include:
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:
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.
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.
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 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.
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.
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.
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 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