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Back pain

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Learn more about back pain: introduction

Back pain is very common and normally improves within a few weeks or months.

Pain in the lower back (lumbago) is particularly common, although it can be felt anywhere along the spine – from the neck down to the hips.

In most cases the pain isn't caused by anything serious and will usually get better over time.

There are things you can do to help relieve it. But sometimes the pain can last a long time or keep coming back.

How to relieve back pain

The following tips may help reduce your backache and speed up your recovery:

  • stay as active as possible and try to continue your daily activities – this is one of the most important things you can do, as resting for long periods is likely to make the pain worse
  • try exercises and stretches for back pain; other activities such as walking, swimmingyoga and pilates may also be helpful
  • take anti-inflammatory painkillers, such as ibuprofen – remember to check the medicine is safe for you to take first and ask a pharmacist if you're not sure
  • use hot or cold compression packs for short-term relief – you can buy these from your local pharmacy, or a hot water bottle and a bag of frozen vegetables wrapped in a cloth will work just as well

Although it can be difficult, it helps if you stay optimistic and recognise that your pain should get better, as people who manage to stay positive despite their pain tend to recover quicker.

Getting help and advice

Back pain usually gets better on its own within a few weeks or months and you may not need to see a doctor or other healthcare professional.

But it's a good idea to get help if:

  • the pain doesn't start to improve within a few weeks
  • the pain stops you doing your day-to-day activities
  • the pain is very severe or gets worse over time
  • you're worried about the pain or are struggling to cope

You can see your GP, who will ask about your symptoms, examine your back, and discuss possible treatments. They may refer you to a specialist doctor or a physiotherapist for further help.

Alternatively, you may want to consider approaching a physiotherapist directly. Some NHS physiotherapists accept appointments without a doctor's referral, or you could choose to pay for private treatment.

Read more about how to find a physiotherapist.

Treatments from a specialist

Your GP, specialist or physiotherapist may recommend extra treatments if they don't think your pain will improve with self-help measures alone.

These may include:

  • group exercise classes – where you're taught exercises to strengthen your muscles and improve your posture
  • manual therapy – treatments such as manipulating the spine and massage, usually carried out by physiotherapists, chiropractors or osteopaths
  • psychological support, such as cognitive behavioural therapy (CBT) – this can be a useful part of treatment if you're struggling to cope with the pain

Some people choose to see a therapist for manual therapy without seeing their GP first. If you want to do this, you'll usually need to pay for private treatment.

Surgery is generally only considered in the small number of cases where back pain is caused by a specific medical condition.

Causes of back pain

Often it's not possible to identify the cause of back pain. Doctors call this "non-specific" back pain.

Sometimes the pain may be a result of an injury such as a sprain or strain, but often it occurs for no apparent reason. It's very rarely caused by anything serious.

Occasionally back pain can be due to a medical condition such as:

  • slipped (prolapsed) disc – where a disc of cartilage in the spine presses on a nearby nerve
  • sciatica – irritation of the nerve that runs from the pelvis to the feet

These conditions tend to cause additional symptoms – such as numbness, weakness or a tingling sensation – and they're treated differently to non-specific back pain.

Preventing back pain

It's difficult to prevent back pain, but the following tips may help reduce your risk:

When to get immediate medical advice

You should contact your GP or NHS 111 immediately if you have back pain and:

  • numbness or tingling around your genitals or buttocks
  • difficulty peeing
  • loss of bladder or bowel control
  • chest pain
  • a high temperature (fever) of 38C (100.4F) or above
  • unexplained weight loss
  • a swelling or a deformity in your back
  • it doesn't improve after resting or is worse at night
  • it started after a serious accident, such as after a car accident

These problems could be a sign of something more serious and need to be checked urgently.

Content supplied by NHS Choices

Learn more about back pain: causes

It's not always possible to identify the cause of back pain but it’s rarely anything serious.

Most back pain is what's known as "non-specific" (there's no obvious cause) or "mechanical" (the pain originates from the joints, bones or soft tissues in and around the spine).

This type of back pain:

  • tends to get better or worse depending on your position – for example, it may feel better when sitting or lying down
  • typically feels worse when moving – but it's not a good idea to avoid moving your back completely, as this can make things worse
  • can develop suddenly or gradually
  • might sometimes be the result of poor posture or lifting something awkwardly, but often occurs for no apparent reason
  • may be due to a minor injury such as sprain (pulled ligament) or strain (pulled muscle)
  • can be associated with feeling stressed or run down
  • will usually start to get better within a few weeks

Medical conditions that cause back pain

Conditions that can cause back pain include:

  • slipped (prolapsed) disc (a disc of cartilage in the spine pressing on a nerve) – this can cause back pain and numbness, tingling and weakness in other parts of the body
  • sciatica (irritation of the nerve that runs from the lower back to the feet) – this can cause pain, numbness, tingling and weakness in the lower back, buttocks, legs and feet
  • ankylosing spondylitis (swelling of the joints in the spine) – this causes pain and stiffness that's usually worse in the morning and improves with movement
  • spondylolisthesis (a bone in the spine slipping out of position) – this can cause lower back pain and stiffness, as well as numbness and a tingling sensation

These conditions are treated differently to non-specific back pain.

Very rarely, back pain can be a sign of a serious problem such as:

  • a broken bone in the spine
  • an infection
  • cauda equina syndrome (where the nerves in the lower back become severely compressed)
  • cancer

If you see your GP with back pain, they will look for signs of these.

Content supplied by NHS Choices