Back pain is a common condition that affects most people at some point during their life. Most cases of back pain are associated with pain and stiffness in the lower back.
Types of back pain
Back pain is classified in two main ways:
- specific back pain – pain that is associated with an underlying health condition or damage to the spine
- non-specific back pain – where the pain is not caused by serious damage or disease, but by sprains, muscle strains, minor injuries or a pinched or irritated nerve
Causes of specific back pain include:
- sciatica – a condition caused by a nerve in the back (the sciatic nerve) being irritated or compressed
- slipped disc – where one of the discs of the spine (see box, left) splits and the gel inside leaks out
- ankylosing spondylitis – a condition where the joints at the base of the spine become inflamed
This article focuses on non-specific back pain.
Back pain can also be classified according to how long the symptoms last. For example:
- acute back pain – the pain does not last longer than six weeks
- chronic back pain – the pain lasts for more than six weeks
How common is back pain?
Back pain is a very common condition and can affect adults of all ages.
It is estimated that one in five people will visit their GP in any given year because of back pain. And 80% of adults will experience at least one episode of back pain at some point in their life.
Chronic back pain is less common than acute back pain, but it is still very widespread. In England, chronic back pain is the second most common cause of long-term disability (after arthritis). After stress, it is the leading cause of long-term work-related absence. A recent study found that one in every 10 people reported having some degree of chronic back pain.
The rates of reported cases of back pain in England have doubled over the past 40 years – a trend that is seen in almost all Western nations. There are a number of theories to explain the rise in the number of cases.
One theory is that the rates of obesity, depression and stress are now higher than they were in the past. These conditions are all risk factors for chronic back pain. Another theory is that people are now more willing to report symptoms of pain to their GP than they were in the past. See Back pain - causes for more information.
The outlook for back pain can vary considerably between individuals. Some people have minor episodes of acute back pain before making a full recovery.
Other people have long periods of mild to moderate back pain that are interrupted by periods of severe pain, which makes them unable to do their normal daily activities.
An Australian study which looked at people who visited their GP because of back pain found that:
- 40% were completely free of pain within six weeks
- 58% were pain-free within 12 weeks
- 73% were pain-free within one year
Psychological and social factors play an important role in the expected outlook for back pain, particularly for chronic back pain.
For example, people who have a positive frame of mind and report enjoying a good quality of life tend to make a faster recovery than those who report symptoms of depression and are unhappy with one or more aspects of their life.
Treatment options for back pain include painkillers, spinal manipulation, acupuncture and exercise classes. Some cases of chronic back pain may also benefit from additional psychological treatment for the reasons discussed above.