Back Pain

Back pain is a very common problem and will affect many of us at some point during our lives.

The good news is that in most cases it isn’t a serious problem, and it might just be caused by a simple strain to a muscle or ligament.

As far as possible, it’s best to continue with your normal everyday activities as soon as you can and to keep moving.

Being active and exercising won’t make your back pain worse, even if you have a bit of pain and discomfort at first. Staying active will help you get better. Taking painkillers can help you do this.

The spine, which is also called the backbone or spinal column, is one of the strongest parts of the body and gives us a great deal of flexibility and strength.

It’s made up of 24 bones, known as vertebrae, one sitting on top of the other. These bones have discs in between and lots of strong ligaments and muscles around them for support. There are also the bones in the tailbone at the bottom of the back, which are fused together and have no discs in between.

On either side of the spine, running from top to bottom, are many small joints called the facet joints.

The spinal cord passes inside the vertebrae, which protect it.

The spinal cord connects to the brain through the base of the skull and to the rest of the body by nerves that pass through spaces between the bones of the spine. These nerves are also known as nerve roots.

As you grow older, the structures of your spine, such as the joints, discs and ligaments, age as well. The structures remain strong but it’s usual for your back to get stiffer as you get older.

Often back pain doesn’t have one simple cause but may be due to one or more of the following:

• poor posture
• lack of exercise resulting in stiffening of the spine and weak muscles
• muscle strains or sprains.

As well as the things listed above, there are also specific conditions which are linked with pain felt in the back. It’s important to remember that severe pain doesn’t necessarily mean there’s a serious problem. Some common conditions are listed below.

Spondylosis

As we grow older, the bones, discs and ligaments in the spine can naturally weaken as they age. This happens to all of us to some degree as part of the ageing process, but it doesn’t have to be a problem and not everyone will have pain from this.

As we grow older the discs in the spine become thinner and the spaces between the vertebrae become narrower. Little pieces of bone, known as osteophytes, may form at the edges of the vertebrae and facet joints.

The medical term for this is spondylosis and is very similar to the changes caused by osteoarthritis in other joints.

Keeping the spine supple and the muscles around the spine and pelvis strong, will reduce the impact of spondylosis.

Sciatica

Back pain is sometimes linked with pain in the legs, and there may be numbness or a tingling feeling. This is called sciatica.

This is due to a nerve in the spine being pressed on or squeezed. For most people with sciatica, the leg pain can be the worst part and occasionally they may have little or no back pain at all.

In most cases sciatica is caused by a bulging disc pressing on the nerve. Discs are designed to bulge so we can move our spines about easily, but sometimes a bulge can ‘catch’ a nerve root and cause pain that travels all the way down the leg and foot.

Most people recover fairly quickly, although in some cases it might take a number of months.

Starting gentle exercise as soon as you can will greatly help with sciatica. It is also a very good idea to see a physiotherapist.

Spinal stenosis

Sometimes back pain is linked with pain in the legs which starts after you start walking for a few minutes, and then tends to get better very quickly when you sit down. This is known as spinal stenosis.

This can happen from birth or can develop as we get older.

Problems are caused when something presses on the small space in the middle of the spine, where the nerves are. This space, which is called the spinal canal or nerve root canal, can be squeezed by bone or ligament.

Symptoms often affect both legs, but one may be worse than the other. The pain usually gets better when you sit down and rest, and some people find they have less pain if they walk a little stooped. Like sciatica, the main problem tends to be leg pain more than the back pain.

In most cases, neither sciatica nor spinal stenosis are serious problems. However, if the symptoms cause you a lot of trouble and greatly affect your quality of life then you should see your doctor for further advice and to discuss what else can be done.

Other causes

Other rarer causes of back pain include:

• bone problems such as a fracture – often linked to thinning of the bones, which is known as osteoporosis
• an infection
• a tumour