Back pain is common and the largest single cause of sickness absence in the UK. Although it can be very painful, it is normally not serious.

In most cases, the pain lasts from a few days to a few weeks and usually clears up after about six weeks.

In the majority of cases, the cause of pain can be linked to the way the bones, muscles and ligaments in the back, work together.

The structure of the back

The back is a complex structure consisting of bones (vertebrae), discs, ligaments, nerves and muscles.

The lower back bares the entire weight of your upper body (plus any extra weight you are carrying), and is under continue pressure, especially when your are bending, twisting and lifting.

Back Pain

Pain in the lower back is a symptom of stress or damage to your ligaments, muscles, tendons or discs. In some cases the back pain can spread to the buttocks and thighs.

In most cases the back will heal itself and staying active and continuing with your usual activities will normally promote healing.

In severe and persistent cases it is important to seek medical advice so that a correct diagnosis can be reached and appropriate treatment given, as treatment may depend on the underlying cause in some cases. For example, pain caused by some types of arthritis may be treated by specific medicines.

The symptom of low back pain is a pain or ache anywhere on your back, in between the bottom of the ribs and the top of the legs.

Visit your GP as soon as possible if you begin to experience back pain together with any of the following symptoms:

• a fever,
• weight loss,
• inflammation or swelling on the back,
• constant back pain that does not ease after lying down or resting,
• pain that travels to the chest or pain high up in your back,
• pain down the legs and below the knees,
• you have had a recent trauma or injury to your back,
• loss of bladder control or inability to pass urine,
• loss of bowel control,
• numbness around the genitals, buttocks or anus
• It is advised you seek medical advice if you are experiencing back pain and:
• you are under 20 years old or over 55 years
• you have taken steroids for a few months,
• you are a drug abuser,
• you have or have had cancer, or
• you have a low immune system due to chemotherapy or another medical condition e.g. HIV/AIDS

A diagnosis is made from discussing the symptoms with your GP or therapist and a physical examination.

In most cases, no tests are needed as X-rays or scans of the back are not always helpful because they do not show anything unusual if you have simple back pain.

You will only be sent for tests if the pain lasts for longer than six weeks, you have had an injury or blow to your back or if your doctor suspects there may be an underlying cause for the pain.

Most cases of back pain will improve on their own within a few days or weeks. Staying as active as possible will help relieve symptoms even if you are in a lot of pain.

Current recommended treatment for lower back pain includes:

• continuing with your normal activities wherever possible,
• the use of over-the-counter painkillers,
• the use of anti-inflammatory medicines and stronger painkillers (consult your pharmacist or GP first),
• the use of a muscle relaxant may be prescribed but only for a few days,
• if you are in severe pain, keep any bed rest as short as possible (maximum of 72 hours), as complete rest does not help recovery,
• doing exercises to strengthen your muscles and improve your posture,
• applying a cold compress (bag of frozen peas wrapped in a damp tea towel) to reduce the initial inflammation, applying heat (heating pad, hot water bottle or hot shower) after a few days to ease muscular pain.

It is advised that you continue to work, or return to work as soon as possible.

You can also consider seeing a qualified physiotherapist, osteopath or chiropractor as some of the treatments they provide may provide short term comfort, or shorten the episode, for some people with acute back pain or nerve root pain.

To avoid back pain, you must reduce excess stresses and strains on your back, and ensure that your back is strong and supple.

Take regular breaks from prolonged or repetitive postures.

Being generally healthy e.g. giving up smoking, avoiding excessive weight and being physically fit, will not prevent back pain, but it will help you deal with it better and may help your back recover more quickly.

(Adapted from Back Pain Patient Information Leaflet produced by the Department of Health. Available in full online at: http://www.cks.library.nhs.uk/patient_information_leaflet/back_pain )