All about back problems

Back problems are very common.

Most back problems start for no obvious reason, which can be very frustrating. Your back problem may cause aching, hot, burning, shooting, or stabbing pains in your back and sometimes into one or both of your legs. You may also get pins and needles.

The spine is strong and back problems are rarely due to any serious disease or damage.

Back problems should settle within 6 weeks of following the advice provided here.

You will not normally need an X-ray or an MRI scan.

For more information and guidance see

Nice Guideline NG59 Low back pain and sciatica in over 16s: assessment and management

which states:

Young people and adults with low back pain with or without sciatica do not have imaging requested by a non-specialist service unless serious underlying pathology is suspected.

The reasoning behind this is imaging does not often change the initial management and outcomes of someone with back pain. This is because the reported imaging findings are usually common and not necessarily related to the person’s symptoms. Many of the imaging findings (for example, disc and joint degeneration) are frequently found in asymptomatic people. Requests for imaging by non-specialist clinicians, where there is no suspicion of serious underlying pathology, can cause unnecessary distress and lead to further referrals for findings that are not clinically relevant.

What should I do?

  • Keep moving, even if slowly at first.
  • Keep living and working normally. This is important and is the best way to get better.
  • Don’t worry if your back still hurts at work, consider doing light tasks at first,speak to your manager about work concerns that you may have.
  •  Don’t sit down for too long, change positions regularly wherever you are.
  • Avoid bed rest during the day.
  • Stay active and remember to re-introduce activities like heavy lifting gradually.
  • Exercise really helps your back and can relieve pain, start with light fitness training.

Moving will make you stronger, keeping active is the best thing you can do.

 

*Important Information – please read before self referring to TIMS*

A rare but serious back condition called Cauda Equina Syndrome can lead to permanent damage or disability and will need to be seen by an Emergency Specialist Spinal Team.

 

If you have any combination of the symptoms below seek medical help immediately

  • Loss of feeling / pins and needles between you inner thighs or genitals
  • Numbness in or around your back passage or buttocks
  • Altered feeling when using toilet paper to wipe yourself
  • Increasing difficulty when you try to urinate
  • Increasing difficulty when you try to stop or control your flow of urine
  • Loss of sensation when you pass urine
  • Leaking urine or recent need to use pads
  • Not knowing when you bladder is either full or empty
  • Inability to stop a bowel movement or leaking
  • Loss of sensation when you pass a bowel motion
  • Change in ability to achieve an erection of ejaculate
  • Loss of sensation in genitals during sexual intercourse.

If any of these warning signs develop following the onset of your back pain you should attend your nearest Accident and Emergency Department. To help you explain your symptoms print out and keep the Cauda Equina Syndrome reference card.

This video produced by the Manipulative Association of Chartered Physiotherapists gives further information. When you should seek urgent help for your back pain.

What about pain relief?

Painkillers may help you keep moving, so sensible use of painkillers will help, not harm your back. However, if you are already taking medication for something else or have other health problems, check with your local pharmacist before taking painkillers. Always follow the instructions on the packet.

Initially it may be helpful to use a covered icepack to ease your pain – never apply ice directly onto your skin. Alternatively heat can be soothing, so a covered hot water bottle may also be used. You should not use heat /ice for more than 15 minutes, three to four times a day.

What about work, sports?

You will recover faster if you can stay at or get back to work as early as possible. Don’t worry if your back still hurts; consider doing light tasks at first if this helps you get back to work easier and quicker. Try to stay active and  remember to keep moving. Speak to your manager at work about any concerns you may have. You should try to do your normal activities as much as possible and use painkillers as needed. With regard to sports, start with light fitness training, and play when you feel ready.

Useful links for back pain

  • Information leaflets developed by TIMS giving advice on:

  • Exercise video developed by TIMS:

    This video have been developed by the clinical teams in Tyneside Integrated Musculoskeletal Service (TIMS) to support the management of patients in our service. If you have not been referred to this resource by TIMS you follow the advice at your own risk.

    • Back Class
      A comprehensive set of back exercises to increase strength, stability, range of movement and function of the Lumbar spine.
  • Other sources of information