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Back pain

A bout of back pain is very common, and in most cases it’s not due to a serious condition. Often the cause of the pain is unknown, and a doctor will advise you to continue normal activities, and take painkillers to alleviate discomfort.

  • Non-specific back pain is the most common type
  • Pain can vary in severity and can indicate serious conditions
  • Muscle relaxants and anti-inflammatories are common treatments 

You can speak to a GPhC registered pharmacist securely through our online video consultation service. They are available between 9.30am-4.30pm, five days a week.

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Possible causes

What causes back pain?

Back pain can have a variety of causes, but most of the time it is non-specific. This means that pain exists without being able to pinpoint what the root of it is. Most people will have this kind of back complaint at some point in their lives.

Nerve root pain (sciatica) is much less common than nonspecific back pain, and occurs when the sciatic nerve is irritated. The pain can be felt in the back and may go as far as the calf. It can take up to six weeks to heal and requires regular stretching. 

Sciatica can be caused by a prolapsed disc, which occurs when the cartilage disc in the spine sticks out and puts pressure on the surrounding nerves.

Other conditions that can induce back pain include ankylosing spondylitis, which is a condition that leads to the joints in the spine swelling.  Spondylolisthesis is a condition where a bone in the spine moves out of position, causing lower back pain and numbness. Rare causes of back pain include cauda equina syndrome (where nerves at the bottom of the spine are compressed causing severe pain), arthritis and cancer in the spine.

Diagnosing the cause of back pain

In most cases, back pain is non-specific; it develops suddenly and there aren’t any other associated symptoms. In these instances, a doctor should be able to diagnose nonspecific back pain quite easily. However, a clinician may want to ask more questions about your history if it is suspected that your back pain is being caused by something else.

A doctor may ask you whether your back pain is causing fever, sweating or weight loss, which could indicate an infection. They may also want to know if you have been involved in a traumatic injury, particularly if it was at a high-speed and if you have been taking corticosteroid drugs for a prolonged period of time. 

A clinician will also want to conduct a physical examination; this may involve asking you to walk to observe your gait, and assess whether the pain has affected your ability to walk. A clinician may palpitate (tap) the area of pain to look for tenderness in the spine. A doctor may also decide to perform some basic physical tests with the leg, knee and hip.

It’s unlikely that a doctor will look to perform any imaging tests for back pain, unless they are  concerned about the possibility of an infection. In which case, a full blood count is usually taken. If pain has persisted for more than six weeks, a clinician may want to take an X-ray of the spine.

There are several warning signs that a clinician will look for that would suggest the back pain is related to an underlying cause. Examples include a gradual pain increase over several weeks, a weakness in the leg muscles because of the pain, symptoms that have affected the bladder, and pain that does not go away when lying down.

Page last reviewed:  11/06/2020
Types of Treatment

What you can do to help back pain

Treatment for back pain varies depending on what the underlying condition is. A doctor will usually recommend that you try to continue to perform daily activities, and stay active as much as possible.

To distract yourself from the pain, you should try to avoid being sedentary. If you have non-specific lower back pain, you should be fine to work. It’s also advisable to sleep on a firm mattress as it can ease discomfort overnight. 

It was previously thought that back pain required rest until the pain subsided, but this has since been disproven in light of trials, which have suggested that moving and conducting physiotherapy can help the body to recover more quickly by strengthening muscles in the lower back. Exercising the back will also reduce the chances of developing a chronic back problem.

How is back pain treated?

There are various medications that are available for non-specific back pain. If you find the pain too much to handle and you want to take painkillers to help ease it, you should do so regularly, and not just when you feel pain, as they will be more effective when used in this way. 

The three most common painkillers that are commonly used are anti-inflammatories, codeine, and muscle relaxants. Codeine is prescribed as an alternative to anti-inflammatories if anti-inflammatories aren’t suitable. If the back becomes very tense, muscle relaxants such as diazepam may be prescribed, but they should not be taken over an extended period.

Treatment for chronic pain is similar to nonspecific lower back pain, but with the addition of an exercise programme, and assistance from a physiotherapist. You may be enrolled in a programme to improve posture control, flexibility and strengthening. Further to this, physiotherapists will likely conduct sessions of therapy whereby massages are given and the spine is manipulated.

In rare cases, and when other treatments have been ineffective, surgery may be an option for a specific problem, such as sciatica or a slipped disc. There is an operation that involves inserting needles into the nerves of the affected joints in the back, and then sending radio waves through them (radiofrequency denervation). However, this is only recommended for people who have had severe pain for a long period of time. 

If you have back pain that’s causing you distress and would like to speak to a doctor about possible treatment options and managing your pain, you can do so using our online video consultation service. Our GMC-registered clinicians are available for consultations between 9.30am and 4.30pm, Monday to Friday. They can issue advice about symptoms and treatments, provide prescriptions, and refer you to specialists, where suitable. 

Page last reviewed:  11/06/2020
Questions and Answers

How long is it normal to have back pain for?

In most cases, back pain symptoms do not last longer than six weeks. If you have continued with normal activities and performed exercises to strengthen the back over this period, the pain should subside.

If your back pain endures for more than six weeks, it could be chronic. Make an appointment to see your GP in these circumstances.

Is back pain serious?

Back pain is not usually serious, but there are certain symptoms which may be indicative of an  underlying condition.

If you experience a feeling of weakness in your legs, or have accompanying fever and a loss of bladder control, seek urgent medical attention.

Can I get treatment for back pain?

Treatment for back pain can be acquired over the counter in the form of painkillers, including anti-inflammatories, codeine or muscle relaxants.

Surgery may be necessary, but this is rare. Usually, a physiotherapist can perform certain exercises with you, to help improve the strength of the back.

How can I prevent back pain?

It’s difficult to predict when back pain will occur, but it’s thought that staying active and regular exercise may help. There’s currently no evidence to suggest that strengthening the back in order to prevent back pain will make you any less susceptible to back problems.

Not lifting heavy objects, and being aware of your posture, can also reduce the likelihood of developing back pain.

Can I speak to a doctor about back pain?

Our GPhC-registered clinicians are available for consultations via our online video service. They can offer advice about managing pain and help determine if your symptoms are an indication of a more serious condition, as well as issue prescriptions and referral to specialists for treatment. You can speak to our clinicians between 9.30am-4.30pm, five days a week.

Page last reviewed:  11/06/2020

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