Back pain

Approximately 8 out of 10 people will experience an episode of back pain at some point in their life. It is common for some people to experience more regular episodes of back pain. It is important to remember although back pain can be very scary and painful it is rarely serious, and your back is strong and robust. Also, most back pain will normally resolve without any treatment within 6-12 weeks.

Common causes

A number of factors have been associated with back pain. These include:

A sprain/strain e.g., lifting something awkwardly or something that is too heavy for what you are physically used to doing.
A sudden increase or decrease in your normal activity or exercise levels.
Other conditions such as osteoarthritis, rheumatoid arthritis or fibromyalgia.
Following a period of increased stress, worry or low mood.
Following a period of poor sleep, fatigue or feeling run down.
Other lifestyle factors such as being overweight and smoking.
A flare up of longstanding back pain.

Common symptoms

These include:

Pain in your lower back area which may travel into your buttocks, thighs or hips.
Stiffness after a period of rest or reduced movement e.g., first thing in the morning.
Difficulty moving e.g., getting up from a chair or out of bed, or bending and lifting.

You may experience constant or intermittent (come and go) symptoms, that are aggravated by certain activities and reduced by others.

What can I do to help it?

In the first few days after an onset of back pain changing or reducing your usual activities may help. However, there is strong evidence that keeping active and gradually returning to all your usual activities and exercise will help you recover.
It is normal to experience some pain during your recovery, but it does not mean you are causing harm or damage to your back.
Try to stay at work or return as soon as you are able. Your employer, GP or health practitioner will be able to advise on how to return to your normal work duties.

Try some of these self-help tips to aid your recovery:

Apply a heat or icepack to the painful area – for up to 15 minutes. Never apply heat or ice directly to the skin.
A short course of simple pain medication as advised by your pharmacist or GP may help reduce pain and allow you to move more comfortably.
Keep moving. Regular movement and exercise is safe and helpful for back pain. It is important to build up gradually – the exercise or activity you enjoy most, is likely to help your recovery.
If sitting causes pain and your job involves long periods of sitting, adopting varied and relaxed postures may be helpful.
Good sleep habits and managing stress may help you cope better with your pain.

Facts about Back pain

Back pain is RARELY linked to serious tissue damage or a life-threatening condition.
X-rays and scans often DO NOT show the cause of your pain.
Backs DO NOT go ‘out of place’ and are very strong.
Your back can become stronger and healthier with regular movement and exercise.
Gradually loading your back by including bending and lifting movements is SAFE and can make your back stronger.
There is NO perfect posture, slouching will NOT damage your back.
Improving your sleep and general health is all also important for your back pain.
Treatments such as surgery, injections and strong medications are NOT very effective in the long term and often have negative side effects.
Your back pain can often improve with the right management. So even if you have had it a long time regardless of your age, DO NOT give up and get a good plan that you can stick to.

10 facts you should know about back pain

When should I seek medical advice?

Call your GP surgery if

Your pain is getting worse.
You have tried the self-help tips for 3-4 weeks and your symptoms have not improved.
You have any of the following symptoms
- An unexplained onset of back pain accompanied by a history of Tuberculosis, HIV, cancer or rheumatoid arthritis.
- Feeling unwell with your back pain and have a fever or significant sweating that is keeping you awake at night.
- Feeling unwell with your back pain and have a history of cancer, loss of appetite or unexplained weight loss.

There are occasions, where you may have a combination of back and leg pain. These symptoms can be distressing, but don’t necessarily require medical attention.

When to seek immediate medical advice

Cauda Equina Syndrome is an extremely rare but serious back condition. It can cause permanent damage and disability. It is important to seek immediate medical advice if you have a combination of the following symptoms:

Pain in both legs accompanied by weakness and/or a loss of feeling/pins and needles.
Loss of feeling/pins and needles between your inner thighs or genitals.
Numbness in or around your back passage or buttocks.
Altered feeling when using toilet paper to wipe yourself.
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.
Not knowing when your bladder is either full or empty.
Inability to stop a bowel movement or leaking.
Loss of sensation when you pass a bowel motion.
Change in ability to achieve an erection or ejaculate.
Loss of sensation in genitals during sexual intercourse.

To see this information in another language click here. You can print out and keep this information to help you explain your symptoms.

Watch this video When should you seek urgent help for your backpain? (macpweb.org)

Do I need an X-Ray or scan?

X-rays or scans or are not usually required to diagnose back pain.
X-rays or scans are not able to tell us how much pain you are experiencing. They often show normal age-related changes and often this does not change how you manage your pain.
X-rays and scans best used where a serious injury (e.g., a broken bone) or conditions such as cancer, infection or cauda equina syndrome are suspected.

Do I need a fit note?

If you’re off work sick for seven days or less, your employer will normally ask you to complete a self-certificate for sick leave as soon as you return to work.
If you're off work sick for more than seven days your employer will normally ask for a fit note (or Statement of Fitness for Work) from your GP.
You can read more information here https://www.nhs.uk/common-health-questions/caring-carers-and-long-term-conditions/when-do-i-need-a-fit-note/