Managing Back Pain

Back pain is one of the most common complaints we see at Pure Sports Medicine so experts: Medical Director John Etherington and Physiotherapists Gaby Pimentel and Erin Lahay offer their advice on back pain, what to look for and what to do if you do experience it.

If you’ve experienced back pain, you will know that it can be debilitating and affect us living our lives as we want to. It can make routine activities difficult to achieve, like your weekend tennis practice or morning run, or even just getting from A‑B on your daily commute. 

But back pain is manageable, and this article aims to equip you with more knowledge about back pain, who to speak to and when if you suffer from it and how you can look after your back to prevent pain in the future. 

It is Common

Back pain is common throughout the population at all ages particularly in people who are completely sedentary. The World Health Organisation estimates that 60 to 70% of the population in industrialised countries will experience non-specific back pain in their lifetime. The University of Queensland reports that every year, between 6.3% and 15.4% of us will have our first-ever episode of low back pain and up to a third of us will have an episode in any given year. 

It is Not Inevitable

This is most common between the ages of 35 and 55. So, contrary to popular belief, back pain does not inevitably get worse as you get older. Indeed, many forms of back pain are more common in the younger age group and pain and function gets better as you age. 

It Gets Better

Back pain can be troublesome but is frequently benign. It is believed that 60% of those who suffer from acute low back pain recover in 6 weeks and up to 80 – 90% recover within 12 weeks. There is a significant risk of recurrence and so having a personal management strategy for episodes of low back pain is important. 

When to Seek Help

Most episodes, although troubling, will therefore be self-limiting but you should be aware of features which can indicate more serious causes of back pain and seek immediate professional help. These features include: 

  • Numbness or tingling around your genitals or buttocks 
  • Difficulty passing urine 
  • Loss of bladder or bowel control 
  • Chest pain
  • Back pain associated with a high temperature of 38°C or above 
  • Back pain associated with unexplained weight-loss 
  • A swelling or deformity in your back 
  • Pain which does not improve after resting or is worse at night 
  • Prolonged stiffness in the morning – usually greater than 1 hour after getting up 
  • Pain which started after a serious accident, such as after a car accident 

In the elderly, back pain can occur as a result of a fracture of the spine due to osteoporosis – which is lowering of the density of the bones. This can occur even after minor falls or accidents and can lead to progressive, but slow, loss of height. If you think this may be happening seek advice from your doctor who will be able to address many of your concerns, Often nothing more is required than simple painkillers, which settles the pain within a few weeks. However, you may need investigations to confirm the diagnosis and the presence of osteoporosis. Treatment, if needed, is simple to take in the form of regular medication. 

You should also seek professional help if the pain: 

  • does not start to improve within a few weeks 
  • stops you doing your day-to-day activities, including work and physical activity 
  • is very severe or gets worse over time 
  • you’re worried about the pain or are struggling to cope

Preventing and Managing Back Pain

Keep fit and active. Regular physical activity improves fitness, strength, balance and well- being. It also improves pain and function. Physiotherapy and exercises classes such as Yoga or Pilates can be very helpful. Smoking is very bad for the back as it is for general health – any time is a good time to stop and your GP can advise on smoking cessation. 

Back pain can be troublesome, provoke anxiety and limit your work and physical activity but is usually self-limiting and responds well to continued physical activity and the right forms of mobility and strengthening exercises. It very rarely requires surgery. It is important to remain positive and approach the condition as a temporary set-back. A pharmacist can advise you on painkillers and anti-inflammatory medication, which can be useful in the short-term, but the mainstay of treatment is exercise. 

If you continue to struggle — then manual therapy from the physiotherapist, exercise classes (including specific strength and conditioning programmes) and cognitive behavioural therapy (under professional supervision) can be very helpful.