What is back pain?
- Back pain is one of the most common reasons for lost work time or visiting a doctor, second only to the common cold.
- It is the leading cause of disability worldwide and 80% of adults experience back pain during their adult life.
- There is varying degree of “personal risk” for back pain. For example, if you are in a job which requires a significant amount of physical labour the chance of experiencing more severe back pain (especially if you are not careful in how you perform your job or if you work in crouching or awkward positions) is much higher.
- Pain that persists for six months after the initial injury is known as chronic back pain; this may require different forms of treatment depending on the severity.
- More than 60% of people with back pain recover in 1 to 3 weeks and 90% in 6 to 8 weeks.
- Serious underlying causes account for less than 1% of back pain.
- Currently 4 million Australians have back problems according to the Australian Bureau of Statistics.
What are the symptoms of back pain?
Back pain symptoms include:
- Muscle aches in the back which can spread to other parts of the body depending on the severity of the injury
Stabbing or shooting sensations in the back
- Pain may worsen if the individual engages in physical activity especially twisting, bending, lifting or walking/running.
- Sleeping may become more difficult and you will feel uncomfortable when lying down.
- Back strain is more likely to hurt with movement, while disc herniation pain is more constant and may include pain that
- radiates to the limbs and pain with spinal movement. Back strain tends to be confined to one area and is less likely to radiate.
It is important to be aware of how your pain progresses and monitor it as you recover. A doctor should be contacted if you experience:
- Back pain that persists after a few weeks of rest and recovery
- If the pain spreads to other parts of your body, especially you feel leg pain particularly below the knee
- Pain accompanied by unexplained weight loss
- Pain accompanied by weakness, numbness and tingling in the leg
Rarer forms of back pain can lead to extreme medical conditions, in the case where your back pain:
- Accompanies bladder or bowel issues that were previously not present
- Is accompanied by a fever
- Is the result of a fall, injury or a blow to your back
- Is metastatic pain. Sometimes this can happen years after an original breast or other cancer. This is often described as a deep ache in the spine, that may radiate, is often worse at night and disrupts sleep. It may also be worse with spinal loading (eg sitting or standing).
These symptoms require urgent medical attention.
Who is at risk of back pain?
- Anyone can be affected by back pain; however, it is more common in adults aged 30-40.
- Causes of back pain can include congenital disorders, poor lifting technique, obesity, older age, smoking, depression and anxiety. Arthritis, cancer and auto-immune conditions such as ankylosing spondylitis can also cause back pain.
- Back pain is also often mechanical, caused by bad posture when sitting or using technology.
- One of the most common causes is muscle or ligament strain which is typically a result of performing heavy lifting tasks or sudden awkward movement. This is especially risky while in poor physical condition.
- Another common cause is bulging or ruptured disks which then press on the nerves in your spine which will result in the sensation of pain. However many people with bulging discs can go through life with no pain.
How is back pain diagnosed?
- X-Rays will not detect muscle, nerves or disc issues but will show fractures and bone alignment or arthritis issues.
- MRI and CT scans reveal soft tissue, disc, muscle, tendon ligament, nerve and blood issues.
- Occasionally your doctor may order a bone scan to rule out tumours or compression fractures, while blood tests can help identify infections.
- Electromyography or (EMG) measures the electrical impulses produced by your nerves and how your muscles respond. This is also known as a nerve study and can detect herniated (known as bulged, slipped or ruptured) discs or narrowing of the spinal canal.
What are the standard back pain treatments?
- Most cases of back pain do not require surgery. Proper body mechanics and home treatment is usually an effective form of treatment including physiotherapy, over the counter pain medications such as paracetamol and heat therapy.
- It is best to keep moving with back pain, not stay in bed for hours as previously thought.
- Prevention also plays an important role in reducing the chances of experiencing back pain, so posture retraining, core strengthening and stretching and flexibility exercise can help.
- This will also lead to maintaining a healthy weight which will in turn put less strain on your back muscles and spine.
- Smoking is another risk factor which can lead to back pain as smoking can cause a persistent persistent cough which will jolt your spine regularly.
- It also decreases the blood flow to your back which can lead to osteoporosis.
- Sitting with a back support at your desk and while driving, and sitting for only short periods of time (10 to 15 minutes) before having a standing break can help with back pain, along with ergonomic adjustments.
What about if my back pain persists?
Acute pain generally refers to pain that of 30 days or less
Subacute pain refers to 1 to 6 months
Chronic pain refers to 6 months or more of ongoing pain
At Sydney Pain Management Centre our back pain treatments for chronic pain include:
- Multidisciplinary Pain Programs including pain Physiotherapy and pain Psychology
- Drugs including Panadol, Anti-inflammatory drugs, Muscle relaxants, Antidepressants etc.
- Exercise physiology and pain rehabilitation
- Nerve Blocks/Cortisone Injections
- Radiofrequency Neurotomy
- Implanted nerve stimulators
If you have persistent pain with radiating leg pain or nerve compression you may be referred for surgery.