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Back Pain

Back pain is rather like that old saying about death and taxes: it affects most people at some point during their lives. One survey suggests that every year, 49 percent of adults in the UK report lower back pain that lasts for at least 24 hours (i), while another claims it’s the second-most popular reason for long-term sickness in most parts of the country (ii).

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Indeed, non-specific lower back pain is believed to be the most common type of back pain, causing soreness, stiffness and tension in people of all ages. The pain may also become more intense during the night or after you’ve been sitting in the same position for a long time (after a long drive, for example).

     
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Back pain affects most people at some point during their lives.

 

What causes back pain?

While it may be very common, the good news is back pain isn’t usually caused by anything serious and most people get better within 12 weeks (acute back pain lasts for less than four weeks, while sub-acute back pain lasts between four and 12 weeks).

One of the main problems with back pain, however, is that it’s often difficult to pinpoint exactly what causes it, as most cases aren’t a result of serious damage or disease but by muscle or ligament sprains, strains, minor injuries and pinched or irritated nerves

These may be caused by a number of things, usually over a period of time, including lifting, carrying, pushing or pulling incorrectly, slouching, twisting, over-stretching and overusing your muscles. Years of poor posture can also contribute to back pain, but it can also happen for no reason whatsoever.

Some people may be more likely to suffer from back pain, including those who are overweight, smokers, pregnant women, people taking certain long-term medications and those who are under stress. One study even suggests that emotional factors such as anxiety and depression may contribute towards back pain (iii).

Some cases of back pain can be caused by damage to parts of your spine, including a fracture, a slipped disc (or herniated disc), degenerative disc disease, osteoarthritis, rheumatoid arthritis or osteoporosis.

Types of back pain

Lower back pain may be the most common type of back pain, but there are also several other types, including neck pain, frozen shoulder, upper or middle back pain, sciatica, whiplash and ankylosing spondylitis.

Neck pain

According to the charity Backcare, neck pain is one of the three most frequently reported complaints of the musculoskeletal system, and nearly 25 percent of people will be affected by it at some time or other.

Frozen shoulder

A condition that causes pain, stiffness and limited mobility in the shoulder, frozen shoulder is also called shoulder contracture or adhesive capsulitis. But unlike some other types of back pain, it can last a lot longer. According to the NHS, one in 20 people may be affected at some point, and the symptoms of frozen shoulder can get worse over a number of months or even years.

The condition is caused when tissue surrounding the shoulder joint becomes inflamed and thickened. Nobody really knows why this happens, but it’s thought that a shoulder injury or shoulder surgery could increase your risk of developing a frozen shoulder. Other risk factors include having diabetes, Dupuytren’s contracture (where one or more fingers contract into the palm of the hand) or some other health problems including heart disease and stroke.

Whiplash

If you’ve suffered a neck injury where your head was suddenly forced forwards, backwards or sideways, the result can be a condition called whiplash. Often associated with road accidents, whiplash describes damaged tendons and ligaments in the neck, causing pain, tenderness, stiffness and limited mobility in the neck, as well as headaches.

In most cases, whiplash improves over time without causing any permanent damage. But some people may experience chronic whiplash, which means they have symptoms that lasts for six months or more.

Thoracic back pain

Also known as upper back or the middle back pain, thoracic back pain affects the area from the base of your neck to the bottom of your rib cage (an area also known as the thoracic spine). Often causing a dull, burning or sharp pain, it’s less common than lower back pain, but a medical review suggests up to 19.5 percent of people may suffer from it at some point during their lifetime (iv).

Sciatica

The sciatic nerve runs from the back of your pelvis right down to your feet (it’s the longest nerve in the body). When this nerve is irritated or compressed –causing mild to severe pain, tingling or loss of feeling from the lower back down the leg and even to your feet – the result is called sciatica.

More commonly affecting the buttocks and legs more than the lower back, sciatica can be caused by a slipped disc (also known as a herniated disk, which is when one of the discs between two bones in the spine, or vertebrae, becomes damaged).

Ankylosing spondylitis

A type of arthritis that affects the spine, ankylosing spondylitis (AS) usually starts to develop in people aged 20-30 and is three times more common in men than in women. According to the NHS, around 200,000 people in the UK have been diagnosed with AS, which is the result of parts of the spine and other joints becoming inflamed.

Experts don’t really know what causes it, but it may be genetic, as some believe AS is linked to a gene called HLA-B27.

How to keep your back healthy

Having a strong, supple back is one of the best ways to prevent back pain. Here are some tips that may help:

  • Regular exercise and being active on a daily basis will help keep your back healthy and strong. Try walking or swimming to strengthen your back muscles, as well as yoga or Pilates to improve flexibility.
  • Make sure your mattress is firm enough to support your back and keep your spine straight. Try putting a stiff board under an unsupportive mattress to see if that works before splashing out on a new one. Also avoid using too many pillows, which may put unnecessary pressure on your neck.
  • Too much body weight can put a strain on your lower back, so make a decision to lose weight if you need to – your back will thank you for it. Doing regular exercise will help you to achieve a healthy weight, as will eating a healthy, balanced diet.
  • Be even more careful about your posture if your job entails sitting for long periods of time. If you do lots of driving, position your side mirrors so that you don’t have to twist your torso, shoulders or neck to see them, and adjust your seat so that you can access the foot controls and keep your lower back well supported. Also don’t forget to take regular breaks if you regularly drive long distances.
  • Also be careful when it comes to lifting heavy objects, especially if you’ve had a back problem in the past or if you have to do a lot of lifting in your job. According to the charity Backcare, the correct lifting technique is to bend your knees and keep the weight as close to your body as possible.
  • Finally, according to the NHS, stress, anxiety and tension can all cause or worsen back pain. So if you’re feeling under a lot of pressure, take steps to manage your stress levels as effectively as possible. For instance, you could try a relaxation technique such as meditation or learn some simple breathing techniques.

Meanwhile, drug-free treatments may also be beneficial. These include hot or cold treatments such as heat pads and patches and ice packs and sprays. Alternatively, try a hot bath or apply a hot water bottle to the affected area, or a handful of ice cubes or frozen vegetables wrapped in a tea towel (don’t allow ice or frozen vegetables come into direct contact with your skin as they can cause a cold burn). Many people also find that alternating hot and cold treatments can be effective.

Should you see your GP?

Experts at the NHS advise that you should visit your GP if you have back pain that doesn’t start getting better after three days, or if you have regular episodes of back pain for more than six weeks.

Meanwhile, get immediate medical help if your back pain is accompanied by one or more of the following

  • Fever
  • Unexplained weight loss
  • Swelling in the back
  • Pain in other parts of your body
  • Loss of bladder or bowel control
  • Tingling and/or numbness in the legs

Natural Remedies for Back Pain

Conventional painkillers may be recommended as a treatment for short-term back pain, but if you prefer a more natural solution, the following may help:

Turmeric

It may be best known as a curry spice, but turmeric –or rather, a substance in turmeric called curcumin – is also thought to have anti-inflammatory properties. Indeed, in Ayurvedic medicine – a traditional system of Indian herbal medicine – turmeric is sometimes used to treat the symptoms of arthritis.

Fish oils

Many people may take fish oil supplements to boost their cardiovascular health. But the omega-3 fatty acids EPA and DHA found in fish oil are also used to relieve inflammation, which can be present in some types of back pain. That’s because omega-3 fatty acids are thought to affect the body’s production of prostaglandins, substances that play a key role in the production of inflammation.

One study, for instance, suggests that long-term use of omega-3 fatty acids may lower your risk of developing rheumatoid arthritis, a disease that causes inflammation of the joints (vi).

Glucosamine

A simple molecule derived from glucose, glucosamine is a key building block for making joint cartilage, including the tissue that supports the discs in the spine. It is widely accepted as a natural treatment for osteoarthritis.

Meanwhile, several therapies may offer relief from back pain, including physiotherapy, acupuncture, chiropractic, osteopathy, t’ai chi and yoga.


References:

(i) Palmer KT, Walsh K et al. Back pain in Britain: comparison of two prevalence surveys at an interval of 10 years. BMJ 2000;320:1577-1578.

(ii) Van Tulder M. Chapter 1: Introduction. Eur Spine J 2006;15(suppl 2):S132-S135.

 (ii) Burton AK, Balague F et al. European guidelines for prevention in low back pain. Eur Spine J 2006:15(suppl 2):S136-S168.

 (iv) Briggs AM, Smith AJ, Straker LM, et al; Thoracic spine pain in the general population: prevalence, incidence and associated factors in children, adolescents and adults. A systematic review. BMC Musculoskelet Disord. 2009 Jun 29;10:77.

 (v) Gobel H, Heinze A, Ingwersen M, et al. Effects of Harpagophytum procumbens LI 174 (devil’s claw) on sensory, motor und vascular muscle reagibility in the treatment of unspecific back pain. Schmerz. 2001;15:10-18.

 (vi) Di Giuseppe D, Wallin A, Bottai M, et al. Long-term intake of dietary long-chain n-3 polyunsaturated fatty acids and risk of rheumatoid arthritis: a prospective cohort study of women. Ann Rheum Dis 2014 Nov;73(11):1949-53

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