Low Back Pain

Low back pain is very common and rarely caused by something serious. It is very much like the common cold, or a headache. There are lots of different factors that contribute to low back pain that can involve physical aspects, lifestyle aspects and mental aspects. For example, if we are a bit stressed, a bit run down, not sleeping well and not exercising enough but spending long periods sitting or bending and lifting then we can develop back pain.

The best approaches for helping low back pain often contrast with the thoughts of the general public, so hopefully this page will help debunk some of those myths and get you on the road to improving your symptoms.

What do we know?

  • Back pain is very common and normally gets better over a few days or weeks.
  • Although the pain may last longer than a few weeks, or may come and go, this does not mean your back problem is serious
  • Back pain is rarely due to serious disease or damage
  • Your spine is one of the strongest parts of your body and is surprisingly difficult to damage
  • It responds as any other joint would, think ankle sprain. We worry because we can’t see it like we can see an ankle though.
  • The amount of pain felt is not related to the amount of damage- think of a paper cut
  • Scans correlate poorly with symptoms. Most people without low back pain have changes on scans and x-rays which do not cause any pain at all
  • With the right information, support and treatment, most people can manage their own back pain
  • Maintaining and then gradually increasing your daily activity can help you to recover sooner. Return to movement and work as soon as possible improves recovery
  • Exercise is the best treatment. And long term getting strong is key

Have a watch of this Chartered Society of Physiotherapy information video about back pain to busy some myths about how to best manage it.

What can I do to help?

Pain relief

Managing your pain with regular pain relief can also be beneficial to allow you to move normally and complete the exercises sent to you by your Physio without high levels of pain. Some people also find heat helpful to manage the pain.

Exercise

Regular exercise and fitness helps us to keep the back fit and healthy. There is good evidence that any form of physical activity can help people with back pain. The best idea is to find an activity that you enjoy and will be more likely to continue in the long-term.

Keep moving

The best thing that you can do if you have an episode of back pain is to stay active. It is important to remember that the amount of pain does not correlate to the extent of damage. There is good evidence that staying at work or returning to work as soon as possible, even if this is on light duties, and returning to all usual activities is important in aiding recovery. Local exercise activity on the island is amongst the best for children and adults alike and there are plenty of resources you can find at “Go Do Active“.

Avoid long periods of inactivity

Avoiding bed rest/long periods of inactivity (but not overdoing it) can help to prevent your symptoms getting worse.  Keeping the back moving with gentle exercises can help to manage the pain by preventing it from stiffening up. Changing position regularly can also help to manage the pain.

Physiotherapy

When you see the Physiotherapist they may discuss these points with you to find out what works best for you. They may also use manual, manipulative or soft tissue (hands on) treatment and will always provide you with exercises depending on what is found during their assessment and which functional goals you are working towards.

The NICE Guidelines  are an excellent evidence based approach to the treatment of low back pain and are a guide to the best advice for patients and healthcare professionals. For those patients with prolonging symptoms or those with ‘red flags’ it is always important to have further investigation.

What are reg flags?

When combined with severe low back +/- leg symptoms, any combination / number of these warning signs could be symptoms of Cauda Equina Syndrome. Although this is rare it is essential that if any of the following symptoms develop you must seek emergency medical help. Initially attempt contacting your on-call GP and if this is not possible then attend the local Accident and Emergency Department.

  • Loss of feeling / pins and needles between in / around your genital/back passage region. (The area you wipe after toileting)
  • Increasing difficulty when you try to urinate
  • Increasing difficulty when you try to stop or control your flow of urine
  • Loss of sensation when you urinate or open your bowels
  • Since the onset of your symptoms leaking urine / recent need to use pads
  • Not knowing when your bladder is full / empty
  • Inability to stop bowel movements / leaking of your bowel
  • Changes in your sexual function since your symptoms
  • Loss of sensation in genitals during sexual intercourse.

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