Back pain

Back pain is a common condition and will affect most of us least once in our life.  Robert Mair investigates.

In this article you will find:

What is back pain?

Lower back pain
    Causes of lower back pain
    Spotting the signs of lower back pain
    Treating lower back pain

Upper back pain
    Causes of upper back pain
    Spotting the signs of upper back pain
    Treating upper back pain

Prevention is better than cure

What is back pain?

Back pain is a generic term for pain, ache, tension or stiffness that affects any part of the back from the neck down to below the waist.

It can be split into three different categories:

• Backache – this typically lasts less than a week
• Acute – this lasts for less than 3 months
• Chronic – this generally lasts for a much longer, develops gradually and usually causes long-term health problems

The back itself is a complex structure made up of many different parts. These include:

• 24 small bones called the vertebrae
• Discs that allow the spine to bend (intervertebral discs)
• Ligaments that hold the discs and vertebrae together
• Tendons that connect muscles to the vertebrae
• Muscles
• The spinal cord, which connects the brain to the body’s nervous system
• Nerves

The back is also sub-divided into four areas:

• Cervical: This is found at the top of the spine, and includes the vertebrae directly behind the skull
• Thoracic: This is a section of twelve vertebrae found in the middle of the back, below the cervical region. It is the largest part of the spine.
• Lumbar: This section is the most common source back pain, largely because it is the load-bearing part of the back. Any pain here can be excruciating and can also affect the sciatic nerve.
• Sacral and coccyx: This is the bottom of t,he spine, with the coccyx being like a tail bone without a tail

Due to the nature of the back, pain can affect all of these different parts. It is also one of the most common health complaints in the world. In the UK, 7 out of 10 people will complain about lower back pain at some time in their lives.

Back pain can be caused by, or be the result of, different factors depending on the area of spine affected. It is usually split into two areas:

• Lower back pain
• Upper back pain

Lower Back Pain

Lower back pain is the most common form of the two complaints and affects the part of the back from the lumbar to the coccyx. However, pain may affect an area between the bottom of the ribs and the tops of the legs.

A small amount of pain in the lower back can cause a lot of discomfort, and spread to other parts of and also to the legs – especially if the damage is nerve related with conditions such as sciatica.

Causes of lower back pain

Lower back pain may be caused by:

• Symptoms of flu
• Poor posture (sitting or standing)
• A difference in leg lengths (most people have this but don’t realize)
• Osteoarthritis
• Degenerative or slipped discs
• Fractures
• Rheumatoid arthritis
• Paget’s disease (enlarged or misshapen bones)
• Prostate cancer

Spotting the signs of lower back pain

The exact nature of the back pain will depend on what other symptoms you have. For example, backache as a symptom of ‘flu’ is usually accompanied with feeling run down and a fever.

Most minor backache’s caused by muscular tension last for only a few days as the muscle relaxes and recovers of its own accord.

If back pain persists, however, get it checked out by your GP as it may be a symptom of a more serious underlying problem. If it is, your GP will refer you on to a specialist.

You should seek medical attention reasonably urgently if:

• The back pain is so severe it interrupts your sleep
• The back pain occurs immediately after a fall
• You suffer from osteoporosis or a condition in which bones fracture easily
• You have a fever
• Unexplained weight loss
• Any noticeable swelling in the back
• Pain in other parts of your body
• Loss of bowel or bladder control
• Numbness

Treating lower back pain

The most common advice given to anybody suffering with back pain is to carry on as normal. Using muscles in moderate activity such as walking or everyday tasks relieve the symptoms of back pain.  You can speed up the body’s natural recovery process by:

• Using painkillers (e.g. paracetamol)
• Using anti-inflammatory drugs (e.g. ibuprofen) or muscle relaxants
• Getting remedial massage, osteopathy or seeing a chiropractor
• Acupuncture
• Getting specific specialist treatment for a known underlying problem
• Applying a cold compress (e.g. bag of frozen peas wrapped in a towel) for 10 minutes at a time, a couple of times a day to reduce the inflammation
• Applying a heat press (e.g. hot water bottle wrapped in a towel) to warm up the muscles encouraging them to relax

Your attitude plays an important role in recovery too. Research shows that positive individuals tend to recover more quickly.

In extreme cases, surgery may be required.

Upper back pain

Upper back pain affects the cervical or thoracic part of the spine. It is less common than lumber pain because these vertebrae aren’t load-bearing and are designed to support the head and protect the vital organs inside the chest respectively. That said any discomfort in the upper part of the back can be just as serious and painful as the lumber.

Generally, there is only a small risk of damaging the upper back, and it is unlikely to degenerate over a period of time.

Causes of upper back pain

Upper back pain is usually caused by one of the following:

• Muscular irritation
• Ligament damage
• Lack of strength in the back
• Poor posture (sitting or standing)
• Repetitive motion e.g. extensive use of modern mobile/smart telephones
• Trauma (such as a fall for example)

Upper back pain can also be caused by a spinal disc hernia or degenerative disc disease. In women over 50 years old, it could also be a symptom of osteoporosis.

Spotting the signs of upper back pain

Pain or discomfort in the shoulders is the biggest sign of upper back pain and it will usually come on following years of poor posture or periods of repetitive strain.

Treating upper back pain

Upper back pain can usually be treated by one of the same methods as identified for lower back pain above.

Prevention is better than cure

How you stand, sit, lie down and lift all have an impact on your back. Try not to place too much pressure on your back in any activity.

Exercise improves the strength of the back and therefore reduces the likelihood of injury in the first place. Regular walking and swimming can keep you reasonably fit with activities like pilates or yoga improving flexibility.

Always consult your GP before considering undertaking any exercise you don’t usually do especially as the associated risks get greater as we age.