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.
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.
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:
Spinal Stenosis – A narrowing of the spinal canal which can be symptom free. Sometimes the narrowing can compress the spinal nerves contributing to back and leg pain.
Myelopathy – A rare but serious problem affecting the spine is myelopathy. If you are experiencing symptoms of, upper limb / lower limb weakness, loss of dexterity, unsteadiness or disturbance of gait discuss with your GP.
Scans and Low Back Pain. Evidence from NHS England #BestMSKHealth Collaborative on when scans are needed and when they are not necessary.
Diffuse Idiopathic Skeletal Hyperostosis – A condition that causes ligaments to become calcified and hard. For many people it doesn’t cause any symptoms and it may only be noticed by your doctor by chance when X-rays are taken for another reason.
Escape Pain for Backs
Escape Pain for backs is an education and exercise programme for people with low back pain.
We are now able to offer sessions in Newcastle and Gateshead. The session will provide you with the support required to exercise appropriately and provide advise and education for the management of your back pain.
If you are interested in attending Escape Pain for Backs please complete a self referral form stating you would like to be considered for an escape pain class.
Information on what to expect from the Escape-pain for backs programme can be found using the I have back pain link.
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.
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