Back pain - it may be common, but it still hurts!
If you think all your friends suffer from back pain, you’re probably right – about 3 out of 4 people get it at some point. Fortunately, the vast majority of cases aren’t due to a serious condition, and should settle over time with no long term complications. Here are some pointers to help you work out if you need medical help, and how you can cope with the problem.
Back pain – what causes it?
Apart from your vertebrae (the bones in your back), your back has dozens of ligaments and muscles supporting it. Between the vertebrae are intervertebral discs, with a tough fibrous coat and a jelly like centre. These provide a combination of support and shock absorption and flexibility for the spin. The strong, non flexible ligaments also provide support, keeping the many vertebrae in alignment. Muscles attach at dozens of points, allowing us to move in a variety of ways. In addition, the spinal cord, carrying all the nerve pathways from the brain to the rest of the body, passes through the middle of the intervertebral discs. Individual nerves leave the spinal cord through gaps between the vertebrae to connect the brain with every part of the body. These nerves are vulnerable as they leave the spinal cord to getting squashed, especially if one of the discs they pass next to ‘prolapses’, allowing the gel-like inside to protrude.
Back pain - should I worry?
The vast majority of back pain is caused by simple wear and tear or strain. However, there are a few very rare causes of low back pain which are due to a serious underlying medical problem. If you have back pain and anything in the list below applies to you, you should go straight to your doctor:
- you’re under 20 or over 55 when your back pain first starts
- you have back pain at the level of your chest (rather than in your lower back or neck)
- you’ve had cancer in the past
- you’ve taken steroid tablets for any length of time (months, rather than weeks)
- you’re having chemotherapy, meaning that your immune system is weak
- you get problems with your bladder or bowels associated with the back pain
- you also have weight loss of fever
- you have numbness around your buttocks, your anus, in your leg or in your foot
Back pain – what can I do?
Doctors used to recommend complete bedrest if you had back pain. We now know this can actually make matters worse, by allowing you to stiffen up. We also used to recommend a very firm mattress, and sleeping on your back. That advice has changed, too. Now we know that the best ways to speed recovery are:
- keep as active as possible
- avoid heavy lifting and anything that causes severe pain
- sleep in the position which is most comfortable for you
- use the kind of mattress you find most comfortable
- set yourself targets to increase the amount you do each day. For instance, start with walking round in your bedroom and bathroom; then round the house; then taking a walk outside
- take painkillers regularly rather than ‘when required’, at least to start with. This will help you to keep active, and won’t stop them working in the future or allow you to do things that damage your back more.
- Talk to your GP about physiotherapy, or consider seeing an osteopath or chiropractor
- Go back to your GP if the pain gets worse, or if it persists beyond a few weeks
- In the longer term, keeping fit is hugely important. Swimming, walking and cycling are all great
- Avoid lifting when you’re in an awkward, twisted position, even if you don’t have back pain
- Always bend from the knees rather than bending forward to lift things from the floor
When ladies’ bits cause back pain
Sometimes, your female organs (especially your womb) can cause back pain. This is more common before the menopause. For instance, a condition called endometriosis (in which the tissue that normally comes out as blood during your periods travels up your fallopian tubes to your ovaries) often causes low back pain. This pain tends to be worse just before and during your periods, and can also cause pain in your pelvis and lower tummy. It can make sex very painful, too.
A mass in your ovaries can sometimes cause low back pain, too. Other symptoms you might get include:
- Feeling full persistently
- Difficulty eating
- Abdominal pain
- Pelvic pain
- Increased abdominal size
If you get any of these symptoms, you should see your GP.
With thanks to 'My Weekly' magazine where this article was originally published.