Back pain is very common and in most cases gets better on its own within a few weeks. Low back pain is the most common, but of course, back pain can affect any part of the back: middle, upper or lower.
In most people, a specific cause cannot be found and it's most often due to a strain or sprain. This can arise from a specific event of lifting heavy objects with incorrect positioning, or over time from overuse or incorrect posture. Let's go through some of the other causes: sciatica and a slipped disc are common conditions causing low back pain, where pain occurs as nearby nerves get trapped. It's possible to get a fracture in one of the bones of your back, called your vertebra, after an injury or related to a medical condition. Back pain can very rarely be a sign of cancer and so it is always important to pay attention to any significant concerning signs of back pain. We'll talk you through what to look out for.
If your pain is not improving after a few weeks despite care and exercise at home, if the pain is getting worse or it is affecting your daily activities, you should see your doctor to discuss this. Concerning signs that suggest you should book an urgent appointment with your doctor are lack of control when peeing or pooing, numbness around the buttocks and back passage, numbness on both legs, weakness of your lower legs, fevers or night sweats without obvious cause, weight loss, or back pain that wakes you up at night. If you get back pain without injury and you are under 18 or over 50 years old, you should request an urgent appointment with your doctor.
With back pain without a severe or immediate injury, it's important to keep moving and stretching regularly to reduce pain and stiffness. Exercises like swimming, yoga and walking are particularly good for strengthening the muscles in your back and improving your posture. Keep a good posture in mind when lifting or moving objects, to avoid straining your back. Keep your weight distribution even, keep legs apart, and bend at the knees, not the back. Take care to avoid twisting while lifting. If you spend hours at a laptop or PC, keep in mind your posture and take regular breaks to stretch out and straighten up. If the pain is more immediate and in the few days after injury, it is sensible to try applying a cold compress on the area, such as a bag of frozen peas wrapped in a towel, for no longer than 20 minutes. After a few days, it might be beneficial to switch a cold compress to a warm one. A hot water bottle can be applied to improve soreness and provide some muscle relief. If you can tolerate anti-inflammatory medication such as ibuprofen or naproxen (prescribed by your doctor), this can be very good for muscle pain and inflammation.
If you see your doctor, they will ask about your symptoms, examine your back and discuss possible treatments options with you. This will commonly include physiotherapy, as this is one of the best ways to improve your back pain and muscle strength, and prevent further injury. Your doctor may prescribe you stronger painkillers or muscle relaxants to help you manage your symptoms. If they think there is a serious or life-threatening condition, they will refer you directly to hospital. Otherwise, they may organise some blood tests and further imaging of your back to understand what the problem is. If they need specialist input, they may refer you to an orthopaedic doctor, who deals in bone problems, a rheumatologist, who deals with inflammatory conditions and joint problems, or to a spinal surgeon.