What Causes Back Pain?
Common causes of back pain
Many of us will experience back pain at some point. Usually it isn’t caused by a serious problem and could just be a strain to a muscle or ligament. Back pain can come on suddenly as a result of an accident or heavy lifting. It can also develop slowly due to changes to the spine as you get older. While the pain may get worse when you bend, lift, twist, walk or stand it’s important to continue to stay active.
It’s not always easy to identify the cause of your back pain. Back pain may occur due to a variety of factors such as:
- Poor posture
- Not enough exercise which leads to stiffening of the spinal column and weak muscles
- Muscle spasms
- Strains and sprains
When there’s no obvious cause, back pain is referred to as ‘non-specific’. If the pain comes from the joints, bones or soft tissue around the spine, it’s called ‘mechanical’.
Lower back pain causes
Lower back pain, or lumbago, is very common and is often caused by a pulled muscle or ligament. Lower back pain is caused by:
- Sprains or strains due to lifting a heavy object or twisting the spine
- Sudden movements which put too much stress on the lower back
- Poor posture
- Sports injuries
Severe and chronic low back pain can be caused by other conditions including disc problems or issues with your spinal cord.
Back Pain Symptoms
You may feel back pain in a specific area of your back or all over your back. The pain can sometimes move to other parts of the body such as your legs. The type and level of pain is unique to each person and will depend on the cause and location.
Common symptoms of back pain include:
- Higher levels of pain when lifting or bending
- Pain that feels worse when sitting or standing
- Pain in the back which comes and goes
- Feeling stiff when you wake up or after being still for long periods
- Less pain when you are active
If you have more serious symptoms of back pain, contact your GP immediately for medical advice. Symptoms can include:
- Difficulty passing urine
- Loss of bowel control
- Numbness or tingling around your genitals or buttocks
- Severe pain which stops you sleeping
- Unexplained weight loss
Back Pain Conditions
Common conditions that cause back pain
In many cases back pain can be short-term and will get better over time. Even if you have severe back pain, it doesn’t always mean you have a serious condition.
However, sometimes the pain can last for a while or it might keep coming back. If the pain is affecting your quality of life it’s important to see a healthcare professional to get advice.
Mechanical problems which cause back pain include:
- Sprains and strains
- Degenerative disc disease
- Herniated or ruptured discs
- Spondylolisthesis Spinal stenosis (including cauda equina syndrome)
- Fractured vertebrae
Back pain can be caused by inflammatory conditions, such as:
- Ankylosing spondylitis (arthritis of the spine)
- Other types of inflammatory arthritis of the spine
There are a number of medical conditions which can lead to back pain, including:
- Osteoporosis (compression fractures can sometimes occur)
- Kidney stones or infections
- Infections that involve the bones of the spine or the discs between these bones
- Some types of cancer
In some cases, you may need x-rays or CT scans to try and identify the cause of your back pain.
Back Pain Treatment
Ways to relieve back pain
Being active is vital to help with back pain relief. When you don’t move, you can make your back more stiff and painful. By keeping moving you will speed up your recovery.
A physiotherapist can recommend specific exercises to improve your strength and flexibility. The physiotherapist can also massage muscles, bones and joints around the spine. These massages can reduce back pain, though this treatment is not suitable for all back conditions.
You may feel uncomfortable doing back exercises when in pain. However, exercises should help you reduce the pain in the long term. If you are in a lot of pain during or after exercise, you should see your GP or a physiotherapist for advice. They may be able to prescribe you muscle relaxants or pain relievers to help you manage.
Your emotional response to back pain is also important. The more positive you are, the faster your back is likely to get better.
Psychological therapy including cognitive behavioural therapy (CBT). CBT can help you cope with the pain and engage with pain management in a positive way.
Here are some other ways to help relieve your back pain:
- Continue your daily activities and stay active, as too much rest can make the pain worse
- Exercise regularly by gently and then gradually increasing the amount you do. Walking, swimming, yoga and Pilates may be helpful
- Do exercises and stretches for lower back pain
- Use over the counter pain relief to manage the pain
- Use anti-inflammatory creams or gels on the affected area
- Maintain good posture when sitting or in the car and change your position often. Poor posture for a long time can cause upper back pain
- Have massages to decrease stress levels and muscular tension as well as improve circulation
- Put a small pillow between your knees if you’re sleeping on your side. If you’re lying on your back, put a pillow underneath your knees
- You can also get hot or cold packs from your pharmacy to soothe the pain. Remember that cold packs (or ice) should be used on short term injuries, like a sprain or strain. Heat packs can be used on long term muscular injuries or to warm up your back before you exercise.
How to help lower back pain
You can do simple exercises for lower back pain at home which may help. It’s better to start slowly and build up gradually if you’re new to exercise. Your GP or physiotherapist will be able to give you advice about specific lower back pain exercises.
Research has shown that a 12-week yoga programme is effective in treating lower back pain. Yoga classes are available at many sports centres. You need to make sure your yoga instructor is aware of your back pain.
Medications used for back pain
You can manage back pain using over the counter pain relief medications. These medications can be bought from any pharmacy and include:
- Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
- Weak opioids such as codeine found in co-codamol
- Heat rubs or heat patches that contain salicylates, a type of NSAID
Pharmacies will often stock combination products, like co-codamol (codeine and paracetamol) or Nurofen Plus (codeine and ibuprofen). Taking combination medication can help if you want to reduce the number of pills you take for back pain.
Paracetamol on its own is not effective in treating back pain. It’s better to use it in combination with other pain relief.
If you’re taking other prescription medication, speak to your pharmacist to find out if it’s safe to take over the counter pain relief.
If your back pain is persistent, your doctor may prescribe stronger medications to help you manage. These include:
- A short course of muscle relaxants, such as diazepam
- Other NSAIDs
- Other weak opioids, like tramadol
- Medical cannabis, from a doctor that is a specialist prescriber
Remember that medications are only part of your treatment to manage back pain. Try to be as active as possible and take medications when the pain becomes too strong.
Back pain and medicinal cannabis
Research into the effect of medicinal cannabis on pain associated with the back is limited. However, following the legalisation of cannabis for medical purposes in 2018, there has been a rise in people looking towards medical cannabis. When first-line therapies have not proved effective at reducing symptoms, medical cannabis may be considered an option for back pain. For further information and to find out more about medical cannabis, click here to discover more about our multi-award-winning Sapphire Access Scheme. Alternatively, complete an eligibility assessment now. Once complete, one of our clinicians will review your application and advise whether you are eligible for progression to an appointment.