Back pain

What is the cause of my back pain

The majority of the causes of back, neck, arm and leg pain are not life threatening or serious. It is also far more common that it can be treated without an operation. However there are certain things that it is very important that you should look out for . If you experience any of these you should contact your doctor and let them know.

  • A loss of sensation or change in your ability to move your bowels or empty your bladder.
  • Any significant leg pains, weakness and pins and needles.
  • Feeling unwell with a raised temperature.
  • Pain that wakes you up in the middle of the night persistently
  • Noticeable weight loss suggesting poor general health
  • A significant injury with a sudden onset of the problem
  • If you have any of the above red flag features you must seek a doctors opinion.

The most common cause of back pain is “non specific back pain”. This is pain for which it is often difficult to find the actual cause and may come from the muscles and ligaments of the spine. Often there may be some “wear and tear” which contributes to this. When we are not able to stand or move the spine normally, sit or stand incorrectly, this can put an increased strain on the muscles and ligaments that we use to stabilise the spine and this can result in pain.

If you start to experience pain, simple pain killers and a short period of rest of less than 48 hours may be of benefit. Resting or inactivity for longer than that has been shown to be detrimental to your back. If you are struggling to regain your normal function and the pain is interfering with your lifestyle you may want to consider some form of manual therapy such as physiotherapy.

Again if you notice any worrying signs or you notice that your pain is deteriorating or changing then do consider talking to your doctor. When talking to someone about your back pain think about what makes the pain worse, what makes it better, what positions aggravate it and which make it better. Often by understanding the pattern of the pain it is possible to tell where the pain may be coming from. For example ask yourself is the pain more in my back, buttock or leg.

Try to remember if there was an injury that set off your pain. There often is not but how the injury happened can give us information of what the most likely problem is. For example an injury when bent over is often a disc problem. It is not always possible to identify one source of pain and in fact because the spine is made up of bones, discs, ligaments muscles and nerves, an injury to one may cause changes to other parts of the spine which can in turn contribute to the pain that you experience.

Typically if you are worse bending over, are able to sit for longer than you can stand and when you cough or sneeze your pain is brought on and made worse – it is likely that one of your discs could be the cause of the problem.

If bending backwards is more painful and there is marked stiffness then the pain could be coming from the facet joints. Typically people report that they are very stiff first thing in the morning or after sitting for long periods and that once they are able to stretch out and get moving things get a little better.

Generally so long as you do not have any of the worrying features mentioned above it is not unreasonable to try any treatment. This can include exercises, stretches, acupuncture, pain management with pain killers, cognitive behaviour therapy, physical treatments including physiotherapy, chiropractic and osteopathic.

This is not an exhaustive list. The important thing is that if the treatments are not working then maybe it is worth thinking of another type of treatment and discussing the problem with your GP. If your pain changes or becomes worse this is another reason to stop and seek advice.