All about back pain
Back pain typically affects the lower back and will affect most people at some stage in their lives. Back pain can also affect the neck or the mid back. Back pain can be short-term, lasting a matter of days or weeks or long-term.
About back pain
Back pain is very common, affecting about 80% of people at some stage in their lives. While back pain can affect people at any age, it is most common in people aged 35 years and older.
A back has many joining structures that include joints, ligaments, tendons and bones with the main support being the spine. The spine is made up of 24 different bones, which are referred to as the vertebrae, including the bones on the coccyx and sacrum. Your spine is able to bend due to the discs that are between the vertebrae, which act as shock absorbers. Your spinal cord threads down through the central canal of each vertebra and carries nerves to the rest of your body from your brain.
Your lower back area may experience stiffness, soreness and tension. This kind of pain is referred to as ‘non-specific’ back pain and will significantly improve after a few days.
Depending on how long your symptoms last your back pain may be referred to as either ‘chronic’ or ‘acute’:
- Acute back pain lasts less than six weeks
- Sub-acute back lasts six weeks to 12 weeks
- Chronic back pain lasts longer than three months
Causes of back pain
The causes of back pain are difficult to determine, though it’s often related to a strain in one of the interconnecting structures in the back, as opposed to a nerve problem. While for many people the specific problem is difficult to identify, there are a various factors that can increase your risk in developing back pain or aggravating it. These factors include:
- Poor posture
- Experiencing a trip or fall
- Anxiety and stress
- Excess weight
- Prolonged sitting, standing and bending
- Pulling, carrying, lifting and pushing heavy loads and objects in an unsuitable or unsafe way
Other more serious causes of back pain include:
- Fracture in your back
- Slipped disc, which is when a disc bulges out putting pressure on your spinal nerve
- Osteoporosis, which is a medical condition referring to the bones becoming brittle and weak
- Osteoarthritis, which is when the joints between the vertebrae are affecting due to wear and tear
- Degenerative disc disease, which is when the discs in your spinal cord become worn down over time
- Spinal stenosis, which refers to the narrowing of the spinal canal through the spinal cord passes
- Rheumatoid arthritis, which is an inflammatory condition that causes inflammation in the lining of your joints and surrounding areas
- Spondylolisthesis, which refers to when one of your vertebrae slips forward and out of position
In very rare cases, back pain may also be the cause of cancer or an infection.
Red flags – serious cases
It is recommended that you see your health professional as soon as possible if you experience back pain and one of the below problems:
- Ongoing and constant pain at night
- Loss of bowel or bladder control
- The back experience redness or swelling/inflammation
- A high temperature and fever
- Pain below the knee and your legs
- Experience weakness and numbness around your buttocks and one or both of your legs
- Worsening and spreading pain in your spine
These symptoms are all referred to as red flags and are a sign that you should seek immediate medical help to ensure the cause of pain is not more serious.
Diagnosis of back pain
Further testing of back pain is not recommended unless you are experiencing one of the red flag symptoms. Other tests may be recommended by your chiropractor or physiotherapist at Sydney Spine & Sports Centre (S3C) to find out if your have a more serious underlying cause for your back pain. If this is the case, your general practitioner may send
you for one of these tests:
- Blood test
- CT scan, which is a test that uses x-ray equipment and computer software to develop images of the inside of your body
- MRI scan, which is a test that uses radio and magnet waves to develop images of the inside of your body
Treatment of back pain
On the recommendation of your chiropractor or physiotherapist and based on the severity of your symptoms and level of pain in your back, you may be sent to your GP for prescribed medication or referred to a specialist if a more serious and underlying cause of back pain are suspected.
An experienced chiropractor or physiotherapists who has a clinical interest and focus on the spine can treat most back pain very successfully. The chiropractors and physiotherapists at Sydney Spine & Sports Centre (S3C) have this focus on the spine. We use the highest evidence based standards in both diagnosis and treatment for back pain.
There are a number of things you can do yourself to help relieve low back pain, including:
- Avoid lifting heavy objects or twisting for up to six weeks or until you no longer experience pain
- Apply hot or cold packs to the area that is experiencing pain. Most pharmacies supply specially designed hot and cold packs. It’s important to not that you should not apply ice directly to the skin, ensure that it is wrapped in a tea towel before application
- Continue your regular daily activities and stay active. Evidence has found that by staying active this fastens the recovery period and reduces the chances of disability and chronic pain. Prolonged bed rest has also been proven to lead to making the back pain worse, therefore limit the time spent in bed after the first few days
To relieve acute low back pain, it is often enough to take anti-inflammatory or non-prescription painkillers or use creams, gels and lotions that contain anti-inflammatory ingredients. It’s important to note that you should not take anti-inflammatory medications and apply anti-inflammatory creams at the same time as this could cause them to interact. Before taking medication, seek advice from a pharmacist or your general practitioner. In some cases if your pain is severe or chronic, your general practitioner may prescribe stronger medications.
Chiropractic and physiotherapy
This should be the first port of call for anyone suffering neck pain, mid back pain or low back pain. It is important to seek a chiropractor or physiotherapist who has a clinical focus in the spine and uses evidence based guidelines to treat back pain.
While treatment can be managed with the treatments outlined above, there are about 10% of cases that require other treatments due to ongoing problems. A last resort for these patients is surgery to treat underlying causes of pain. Our chiropractors and physiotherapists will discuss this with you.
Prevention of back pain
Considered back care can reduce the chance of getting low back pain. To take care of your back, try:
- Exercise regularly, great examples are walking and swimming
- Good posture with your shoulders back so you don’t slouch
- Bending properly from your knees and hips, not back. This is particularly important when you are lifting heavy objects
- Reducing your stress levels by trying relaxation techniques