Back pain

Introduction 

Watch this...

We asked Philip Sell, consultant orthopaedic and spinal surgeon, what he would want to know if he was suffering from back pain.

Listen...

Listen to a 15-minute audio clip of real people talking about how back pain affects their lives. By award-winning Radio 4 presenter and reporter Dominic Arkwright

Back pain is a common condition and in the UK, it is the largest cause of work-related absence. Back pain can be very uncomfortable, but it is not usually serious.

Back pain can affect anyone, regardless of age, but it is more common in people who are between 35 and 55 years of age.

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

The structure of the back

The back is a complex structure consisting of:

  • 24 small bones (vertebrae), that support the weight of your upper body and form a protective canal for the spinal cord.
  • Shock-absorbing discs (intervertebral discs) that cushion the bones and allow the spine to bend.
  • Ligaments that hold the vertebrae and discs together.
  • Tendons to connect muscles to vertebrae.
  • A spinal cord, which carries nerve signals from the brain to the rest of the body.
  • Nerves.
  • Muscles.

The lower part of your back is known as the lumbar region, which is made up of five vertebrae, known as L1, L2, L3, L4 and L5. The lumbar supports the entire weight of your upper body (plus any extra weight that you are carrying), and it is under constant pressure, particularly when you are bending, twisting and lifting.

Lower back pain

Lower back pain, also known as lumbago, affects seven out of 10 people at some time in their lives. Lower back pain is a pain or ache on your back, in between the bottom of your ribs and the top of your legs.

Lower back pain can come on suddenly or gradually, and is sometimes the direct result of a fall or injury. The complex structure of your lower back means that even small amounts of damage to any part of the lumbar region can cause a lot of pain and discomfort.

Pain in your lower back is usually a symptom of stress or damage to your ligaments, muscles, tendons or discs. In some cases, if a nerve in your back is pinched or irritated, the pain can spread to your buttocks and thighs. This is known as sciatica (go to 'Useful links' for more information).

In most cases of back pain your back will heal itself, and staying active and continuing with your usual activities will normally promote healing. Back pain will usually last from a few days to a few weeks. Pain that lasts longer usually clears up after about six weeks.

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

Last reviewed: 08/09/2008

Next review due: 08/09/2010

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Lorraine D said on 22 March 2010

I have suffered with back pain on and off for years and have found the best treatment has been through a Osteopath and Acupuncturist. I have nothing against traditional medicine as I suffer with severe osteoarthritis in my knees and am on long term pain killers for this condition but it never hurts to explore other treatments and if you find a great osteopath as I have you will only be treated for as long as necessary to relieve the pain

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jarmila said on 04 February 2010

I suffer lower back pain 1 year almost. As I do a lot of heavy lifting at work I didnt pay much attention. 2 months ago it something blocked in my back and for 2 days I could hardluymove my right leg and right arm. I had very intensive pain along my whole leg and my whole arm. After 2 daysit wasnt so bad, but I feel that pain all the time. It is no so intensive, but it is. 2 weeks ago I started to have shooting pain in my wrists, knees, ankles and fingers and around these areas. I have spasms in my hand and leg sometimes. I have also neck pain and headache which is not very stong but it is constant almost.
I had an appointment with my GP today. I spent in his "office" around 4 minutes. After 4 minutes of typing to PC he said it is muscle pain and he recommend me to take pain killers.
As a child and teenager I practiced a lot of sport so I really know how muscles hurt. This is far away from that.
I am very dissapointed with treatment which I get from my GP. I am in this country almost 2 years, and I registered to GP only 2 weeks ago because the pain is really strong sometimes.
I work here since second day I come to this country and I pay my tax so I supose I should get the same treatment as everyone who was born in this country.
I am not happy with doctors recomendations to take more pain killers. It doesnt help. I dont know what to do next.
If you have any advice I appriciate that. Or any opinion, positive or negative. Thanks

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jarmila said on 04 February 2010

I suffer lower back pain almost 1 year. 2 months ago something blocked in my back, and I couldnt move my right leg and arm for 2 days properly. I could feel in my right leg and arm itching and strange pain. Last 2 weeks I have constant pain in my ankles, wrists, knees and fingers. And i suffer by shootin pain around all these joints. Today I had an appointment with the doctor. I live here in England for 2 years and this was my first appointment. Doctor was very kind, our meeting took aproximately 4 minutes and he said it is only musle pain and I should take more pain killers.
I am exhausted by this pain. I dont know what to do next. Pain killers helped only for a while but now they dont help at all.
I do a lot of lifting at my work and as a child and teenager I did a lot of sport so I know really how muscles hurt.
I am VERY dissapointed with my GP treatment. I work here, I pay my tax, and I deserve treatment as anybody else who was born in this country, and I suppose I didn get that kind of treatment.
I am fed up of eating pain killer. My constat pain has some kind of reason, and I wanted to see my doctor for trying him to find out what it is.

By the way I am from Slovakia.
Thanks for your opinion(positive or negative) and advice.

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jarmila said on 04 February 2010

I suffer lower back pain almost 1 year. 2 months ago something blocked in my back, and I couldnt move my right leg and arm for 2 days properly. I could feel in my right leg and arm itching and strange pain. Last 2 weeks I have constant pain in my ankles, wrists, knees and fingers. And i suffer by shootin pain around all these joints. Today I had an appointment with the doctor. I live here in England for 2 years and this was my first appointment. Doctor was very kind, our meeting took aproximately 4 minutes and he said it is only musle pain and I should take more pain killers.
I am exhausted by this pain. I dont know what to do next. Pain killers helped only for a while but now they dont help at all.
I do a lot of lifting at my work and as a child and teenager I did a lot of sport so I know really how muscles hurt.
I am VERY dissapointed with my GP treatment. I work here, I pay my tax, and I deserve treatment as anybody else who was born in this country, and I suppose I didn get that kind of treatment.
I am fed up of eating pain killer. My constat pain has some kind of reason, and I wanted to see my doctor for trying him to find out what it is.

By the way I am from Slovakia.
Thanks for your opinion(positive or negative) and advice.

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Maria Kh said on 01 February 2010

I had lower back pain on the left side.

The MRI report mentioned sacralization of the L5 as the cause.

Also, the doctor told me that development of a transition vertebrae between L5 and sacrum is the cause.

Would anybody please throw light on how sacralization causes the pain; I mean the mechanism of the pain.

I tried understanding through many websites but couldn't get it cleared.

Thanks.

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Jan46 said on 27 October 2009

I have suffered lower back pain for many years then earlier this year under my new GP I finally received the correct diagnosis - Degenerative Disc Disease. The bottom 2 discs have shrunk hence the reason for it becoming more painful over the past few years, I have been prescribed pain killers eventually surgery which really frightens me, I am a single parent of an eight year old & find it very frustrating that I cannot do the things I should be doing with him due to the constant pain. My GP has stated that I have not to do anything that will cause stress on my lower back which is a multitude of things down to carrying shopping due to this every day life/work is becoming a struggle however I just grit my teeth & get on with it the best I can. I have searched various sites re this condition re what other treatment would help ease the pain as I not a fan of taking medication on a daily basis however I am unsure which applies to me as there are varying degrees of this condition, I would be grateful of any advice someone with this condition can give me.

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geelamch said on 21 October 2009

i would be interested in any comments on the condition affecting the c2 and c3 discs in the neck area .I had sugery due to a compression in this area around two years ago ,however after initial success it has returned with a vengeance.I cannot afford to take another year from work and would be grateful to hear if any one else has this condition.
i was being treated pre surgery with large doses of morphine however this merely renders you (stupified)
and results in no life quality.
My main symptom is the loss of use of my right arm and subsequent pain ,at 44yrs old with a family and due to my employment i do not know how much longer i can continue .I would love any advice.
geelamch

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Charles Tully said on 18 October 2009

I suffered whiplash injuries affecting my neck and lower back and nothing I did in three years helped so I consulted an osteopath who said it was my terrible posture knocked loose by the accident. After clicking things free she started me on Alexander Technique lessons to improve my alignment and to reduce the amount of tension I held which had made things worse. Within a couple of months the pain was history and normal activities resumed.
I don't think people realise the far reaching affects seemingly simple injuries can have and the sooner they are sorted the better.

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MarcusMaher said on 13 October 2009

I found sections of these articles very interesting and relevant, thanks.

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Ireena said on 03 September 2009

Exercises helps to manage osteoarthritis pain. Exercises are helpful for decrease low back pain, recover faster, prevent re injury to back, and reduce the risk of disability from back pain.
Take your doctor's advice before attempting any exercises, if you are already experiencing back pain.
There is no need of any special equipment for doing exercises to reduce low back pain.and it is also not complicated.
Strong abdominal muscles are helpful in maintaining good posture and keep spine in right position .Exercises stretches and strengthen the muscles of abdomen and spine which prevents back problem.
Lie flat on back. bring your chin to chest, at the same time Hug knees to chest and ,do it for two times for 15 seconds.
By lying on stomach, use your arms to push your upper body off the floor, let your back relax and sag. hold for five seconds.do for 5 times.
Do walking, swimming,bicycling for 20 to 30 minutes in a week for alternate days.
Prone hip extension exercise is done by lying on stomach.with your legs straight out behind you. first tighten up your buttock muscles and then lift one leg off the floor about 5-7 inches.for 4-5 seconds keep your knee straight.then lower your leg and relax.do it for 3 times with another leg.
Avoid such types of exercises like twisting hip,any quick and bouncy movement, lying on stomach with legs extended and lifting together.
Do good activities like swimming,biking,walking,aerobics exercise on machines.

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Wilk67 said on 22 August 2009

My 12 year old daughter has been suffering with back pain since January. It's now the end of August - when will she get a diagnosis and treatment? It appears the NHS is not interested in back pain in children - I don't believe prescibing Iboprufen for six weeks is an adequate treatment for a child especially when it doesn't work.

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User309562 said on 14 August 2009

MLH22 mad me laugh:-))). You're really right about it. And you have well described upper back pain. I'm experiencing the same for a while. It's complicated. Would be great to have this info here. Thanking you in advance.

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MLH22 said on 28 May 2009

How about upper back pain? I have hardly ever seen any video or information on pain in the upper back. Has it got a different term? It certainly is not related to spine as such. The one that is due to weakness or muscles or nerves around the area starting from neck through shoulders down to where the rib ends. It would be nice to know how to keep that part healthier and not sprain it every now and then. thanks,

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