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Back pain
Musculo-skeletal system
Back pain is a general term referring to any complaint affecting the spine or the muscles and tissue connected to it. Back pain is common and one of the main reasons for absence from work in the UK. It is estimated that four out of every five adults will experience back pain at some time during their life, and that it costs the NHS about £1billion per year.

Although painful, it is not normally serious. In most cases the pain lasts from a few days to a few weeks. 90% of people who have back pain will recover within 6 weeks.
Common forms of back pain include lumbago, sciatica and slipped discs, but back pain can also affect the neck, arms and even the legs. Lumbago affects the lower back and is the most common form of back pain. Sciatica is a pain in the lower back that can be felt down the legs and is caused by nerves that have been twisted or pushed out of place. Problems affecting the spinal column also account for many cases of back pain, especially slipped discs. These occur when the cartilage that separates and cushions the bones in the spine (the vertebrae) pops out of place.
There are many obvious causes of back pain such as lifting heavy loads incorrectly, bending the spine too much, twisting awkwardly, having a fall or being overweight. Even standing up or sitting down for too long can account for many cases of back pain. Incidences of back pain are increasing and modern life is the main culprit. Cars, public transport, deskbound jobs and our more sedentary lifestyle have changed the way we use our bodies. The result is that our muscles and spines are weaker than they used to be and the risk of back injury has increased.
Pain in the back, particularly in the lower back or the neck that gets worse with movement is the first indicator of back pain. Back spasms - sudden, uncontrollable muscular contractions - may also occur and can be very painful. Stiffness in the back muscles after long periods of inactivity, such as first-thing in the morning, also indicates the onset of back pain.
The majority of cases will not require treatment and will clear up within a few days or so; staying active, despite the pain, will help the pain go away sooner. Heat rubs will provide some pain relief when rubbed onto the affected area. Pain killers taken by mouth or rubbed onto the skin, such as ibuprofen, can also be effective in relieving pain. Physiotherapy may be needed for severe back pain and will involve stretching exercises that have been designed to strengthen the spine and back muscles naturally.
When to consult your pharmacist
Visit your pharmacist if you develop back pain. Your pharmacist will ask you questions about your age, the location of the pain, whether the pain developed suddenly or slowly and whether the pain gets better or worse when you move or rest, to try to establish the cause of the back pain. If the pharmacist suspects that your back pain is a symptom of a more serious complaint, or if you have been experiencing back pain for a long time, you will be advised to see your doctor.

If it is back pain, there are many products that a pharmacist can recommend that can be bought without a prescription that will bring relief. Sprays, rubs, liniments and gels containing cooling agents, products to ease pain and inflammation such aspirin derivatives, ibuprofen and piroxicam, plasters containing belladonna to relieve spasm, can all be applied to the affected area to relieve the pain. Rubbing the area will itself help bring pain relief.

If you are unable to apply or prefer not to use these preparations, pain killers in the form of tablets or capsules containing paracetamol, aspirin or ibuprofen are also available over the counter. For the short term treatment of acute, moderate pain which is not relieved by paracetamol, ibuprofen or aspirin alone, the pharmacist may recommend codeine or dihydrocodeine. However, it is important that these two medicines are taken for no more than 3 days as they may cause addiction.

It is important that you tell the pharmacist if you are taking any other medicines as some of these products will interact with them and so should not be used together.

Your pharmacist will also ask if you have any other illnesses or if you could be pregnant and will be able to recommend a product suitable for you.
When to consult your doctor
Although back pain is normally the result of a strain to your back, it may be a symptom of a more serious illness. Visit your doctor as soon as possible if you have back pain as a result of a fall or injury, if the pain occurs high in your back or moves to the chest, if it affects your genitals or bottom, if you have a fever, a swelling on your back or have experienced weight loss, or if you notice any changes that affect your going to the toilet.

If you are under 20, you should also see your doctor as back pain is rare in young people. Back pain may be a sign that an existing illness is getting worse. Contact your doctor if you are being treated for osteoporosis, cancer or AIDS.

The doctor will examine you and be able to diagnose the cause of your back pain. If a problem with the bones or discs is suspected you may be referred to have an X-ray or scan. If the back pain is due to poor posture you may be advised to visit a physiotherapist, osteopath or chiropracter.
Living with back pain
It may sound strange, and it may be difficult at first, but the best thing to do for acute back pain is to try to remain active. Resting for a day or so in an attempt to reduce pain is only likely to make the pain last longer. The sooner you start normal activities, the faster recovery is likely to be. Take things easy at first, make movements that are the least painful, do gentle stretch exercises and gradually build up your level of activity. Do not stay in the same position for prolonged periods.

Use simple analgesics such as paracetamol or ibuprofen to help ease the pain as you start to exercise, but do not take them for long periods. Applying hot or cold packs, or rubbing in liniments or topical anti-inflammatories to the area of discomfort may also help ease pain.

When recovered, continue your exercises. Do as many exercises and sports as you can. The more exercises and the more varied the exercises, the stronger your back will be. Try to maintain a good posture when sitting or standing, do not slouch, keep your head and neck in line with your spine and try to contract your stomach muscles to give support to the spine. If your work involves long periods in front of a computer, ask your health and safety officer to make sure that your chair and computer screen are positioned correctly. Take regular screen breaks, get up and move around.

To avoid back pain recurring learn to lift heavy objects properly and try to lose any excess weight.
Advice to carers and partners
While it will be necessary to be sympathetic and to help someone with back pain, it is important that you do not do everything for them. Encourage the person to remain active as best they can, join in with them when exercising.
Useful Tips
  • Bend the knees and keep your back straight when lifting heavy loads. Do not attempt to lift objects that are too large or too heavy to be lifted with reasonable ease
  • Back-strengthening exercises which focus on correct posture, like the Alexander Technique, will help keep the spine and back muscles strong and supple. This minimises the risk of a strain or spinal injury
  • A correct sitting posture (with your bottom towards the back of the chair) will help keep the back in its correct, natural position. Likewise, sleeping on a firm mattress will help support the spine
  • There are chairs, mattresses and other products available that are specifically designed to help ease back pain
  • Do not take pain killers regularly or for long periods, and do not exceed their recommended dosage
Further information
BackCare is a national charity that aims to reduce the impact of back pain on society by providing information, support, promoting good practice and funding research.

BackCare - the Charity for Healthier Backs

16 Elmtree Road


TW11 8ST

Helpline: 0845 130 2704