Managing back pain and when to see a doctor

Most of us will experience back pain at some point in our life. In fact, back pain, and particularly lower back pain is thought to be one of the leading causes of disability in the UK, with nearly one in 10 people affected by this condition. 

Types of back pain

There are many different types of back pain. Some are short-term and easily managed at home, but others should be checked out by your GP. The back is a long and complicated part of the body, and pain can occur anywhere from the top of your neck down to the base of your spine. 

Back pain is often caused by activity — either not enough or too much. If you sit in one position for too long your back can become stiff and painful. Engaging in activities you’re not used to, eg digging in the garden, can also cause back pain. Often, back pain is caused by muscle injury, or by activities such as sports or heavy lifting. Twisting or sitting in the wrong position can also cause back pain and is on the rise with more people working from home.

Sometimes though, the cause of back pain is more serious than a muscle injury. A slipped disc is a fairly common cause of back pain and happens when one of the discs sitting between the bones (vertebrae) in your spine is weakened, causing it to bulge out and put pressure on a spinal nerve. 

Sciatica is another problem leading to considerable back pain. It can be caused by a slipped disc but specifically affects the sciatic nerve that runs from your spine, down your legs to your feet. Pain may not be limited to your back but also radiate through your buttocks, legs and feet. 

Caring for your back and avoiding injury

There are lots of things you can do to take care of your back, eg remembering to bend your knees, not your back, when lifting something heavy. Bending your back can increase the risk of a slipped disc.

Your posture is incredibly important when it comes to preventing back pain. The way you sleep, sit, and even stand can cause pain, especially if you tend to slouch. If you sit at a desk all day make sure your chair and workstation are arranged to support your back. If you spend long hours driving, lower back support can be helpful. 

Movement and exercise are the best way to keep your back healthy. If you spend a lot of time sitting down, stand up and stretch regularly. Swimming and walking are good low-impact options to help strengthen your muscles. Exercise will also help to keep your weight down — being overweight puts extra pressure on your back.

Stress can also cause back pain. When you’re stressed your muscles can tense up without you realising, causing stiffness and discomfort. 

If you have back pain, try to keep moving if you can. Heat or cold packs can help, and you can also take painkillers such as ibuprofen and paracetamol. When you have back pain, you may compensate by moving differently, which can strain other parts of your body — painkillers can help you avoid doing this. However, it is important to know your limitations and not overdo it with activities or exercises just because you can’t feel the pain while taking painkillers — you may end up doing more harm than good to your back. 

When is it necessary to see a doctor?

It is not always easy to know when to consult a doctor about your back pain. Generally, if home treatments such as painkillers and heat/cold packs are not having any effect after 72 hours then it’s time to see a doctor. However, there are times when you should seek urgent medical help for back pain, eg:

• If you have severe back pain following an accident or injury
• If you suddenly have intense back pain and severe tummy pain
• If your back pain is accompanied by shooting pains, numbness, tingling or weakness in your arms or legs
• If your child is complaining of persistent back pain

If your back pain is accompanied by a fever or weight loss, it’s best to get checked by a GP as soon as possible. Likewise, if you have any bowel or bladder problems or dizziness. 

If your back pain is caused by a fall or trauma, or if it persists for a long time, then an X-ray or MRI scan may be necessary to check for fractures or other problems. 

A slipped disc or sciatica doesn’t necessarily need medical attention but it can take a few weeks to fully recover. If there is no improvement after four weeks then make an appointment to see your GP. They may prescribe anti-inflammatory medication, steroid injections or physiotherapy. 

Back conditions that need surgery

Occasionally, spinal surgery is required to treat back pain. Spinal stenosis is a condition where the spinal canal narrows. This squashes the nerves and causes inflammation. Surgery isn’t always needed but if other treatments have been unsuccessful your doctor may recommend it. 

Other conditions that may need surgery include severe sciatica, a fracture due to osteoarthritis, cancer and spondylolisthesis, where a bone in your back slips out of position. In most cases, non-surgical treatments will be tried before resorting to surgery.