Back Care Awareness Week runs from the 6-12 October 2014. In recognition of this, orthopaedic spinal surgeon Mr James Langdon discusses how to manage back pain, something most of us experience in our lifetimes.
What causes acute onset back pain?
Back pain is common. Fortunately, most back pain is not due to any serious problem, but instead comes from the working parts of your back – the muscles, ligaments and small joints. For many people this is as a consequence of their back being out of condition.
How to manage back pain?
The acute pain usually improves within days or a few weeks, at least enough for you to get on with your life. What you do in the first few days is important, as resting for more than a couple of days may actually prolong the pain and disability. Your back is designed for movement. The sooner you get it moving and return to your normal activities, the sooner you will start to feel better.
If you experience an episode of back pain you should try to stay mobile. The back is a large muscle that responds best to being used. You are likely to find painkillers helpful in achieving this. Start with over-the-counter medication. Taken regularly, paracetamol and ibuprofen can be an extremely effective combination. Some people will need to see their GP for some stronger medication.
Many people find physical therapy treatment helpful (physiotherapy / osteopathy / chiropractic treatment). This may include massage, manipulation or acupuncture. Physical therapy treatment can be particularly useful for people who do not start to get better quickly.
When should I be concerned?
An acute episode of back pain can be very frightening, and this convinces many people that their pain is the result of a serious problem. Understandably many people get anxious about their back pain. Unfortunately, anxiety and stress can increase the amount of pain people feel, and in the long-term this can leave your back feeling vulnerable. Fortunately it is unusual for someone to have a serious underlying problem.
However, you should seek medical attention for your back pain if it:
- Is accompanied by pain, weakness or numbness in your legs
- Is not getting better and you are feeling unwell (such as sweats, fevers, or weight loss)
- Wakes you in bed at night
- Is getting worse rather than better
- Has not started to improve after a few weeks.
If your back pain is associated with difficulty passing or controlling urine, or if you experience numbness around your genitals or back passage then you should seek urgent medical attention.
What should I do if I am concerned?
It is important to remember that only a few people with back pain have an underlying problem, such as a slipped disc. Investigations can be helpful in detecting serious spinal pathology, but are often unhelpful in people with ordinary back pain.
For people who are concerned about their back and leg symptoms then an assessment can be carried out by a back specialist. This would involve a consultation, physical examination, and possibly further investigation. An MRI scan is usually the investigation of choice for those that do require further investigation. If you are not able to go into a MRI scanner, alternative investigations such as CT or bone scans may be used instead. Sometimes X-rays are also useful.
Mr James Langdon is a consultant orthopaedic spinal surgeon at Spire Harpenden Hospital. If you have any concerns about your back or any back-related problem such as sciatica, then Mr Langdon would be able to see and assess you and advise on further investigation and treatment.