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Information: Back Pain

  • Back pain is very common, neck pain less so.

  • Lower back pain is almost always due to a strain or sprain of the spinal structures such as ligaments, discs, joints or muscles.

  • Back pain symptoms can be frightening but the level of the pain rarely reflects the severity of the underlying problems.

  • Back pain typically settles down although this might take months or longer in some cases.

  • It will not harm you to keep going with normal activities provided you can cope.

  • Serious conditions are rare and show up as “red flags”, symptoms which indicate there is a problem which needs medical attention.

  • Very severe pain, worse pain at night, feeling unwell, loss of weight, bladder or bowel disturbance and gait disturbance are all examples of red flags.

  • Consult your doctor if you have any concerns about your symptoms.

  • If you have severe leg pain, especially below the knee, you may have sciatica and should get a diagnosis from your doctor.

  • Do not rest for low back pain unless you have to due to the pain.

  • Back pain diagnosis is difficult and in many cases the source of your pain will not be identified.

  • In an acute episode (sudden onset of severe back pain) you should reduce your activity, rest if needed, take medications regularly as advised by your doctor, pace your activities to avoid overdoing, keep positive about getting better, do more every day, go back to work and normal activities asap.

  • Do not expect to be pain free after a back pain episode before you go back to work or resume most of your normal day to day activities.

  • Don't expect an Xray or MRI scan for ordinary back pain, they won't change the treatment.

  • General exercises including back exercises have been shown to provide back pain relief and a physio can guide you to do these.

  • Back pain treatment from a physiotherapist, osteopath or chiropractor may be helpful but the scientific evidence for this is not clear.

  • Once the back pain episode has settled down, make sure you go back to your exercise programme to help prevent further episodes.

  • A back pain blog may give you valuable information from first hand experience of others who have gone through back pain problems of varying types.

  • Further useful information is availabe at NHS Choices and the National Institute of Neurological Disorders and Stroke (US).

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