Back Pain

Almost 2 in 3 people suffer back pain each year. And though the vast majority get better within a few weeks, that still leaves some 3 million who don't. For them, temporary acute pain turns into chronic pain.

More working days in the UK are lost to back pain than to any other type of injury or illness.

According to some figures, the incidence of back trouble doubled in the last decade, and doubled also in the decade before that. But this apparently huge increase may well be explained by a growing belief that back problems should be curable. When our grandparents perhaps just rested (and groaned) for a day or so, we go to the doctor for treatment.

Causes of Back Pain

The back is an extremely complex part of the body, and it's involved in almost every movement we make. Even just standing upright means the muscles have to work against the pull of gravity. With this almost constant activity, it's not surprising the back is exposed to a whole variety of stresses and strains.

Some people believe it's better suited to creatures who move around on four legs, rather than those of us who make do with two. Certainly, the pressure of gravity is more evenly distributed when you're on all fours, and that's why back pain sufferers sometimes find it less painful to crawl than walk. Still, back problems do affect animals, most notably horses and some breeds of dog.

The pain you feel in your back is a symptom. Pinpointing the cause though, can be far from easy. Often, but not always, it's a problem with the spine or muscles that support it. But it could also be a gynaecological problem or some kind of kidney disease.

If it's one of the last two, diagnosis is usually reasonably straightforward. It's when trouble stems from the spine or muscles that difficulties begin.

The cause of the damage can be a single, violent incident - a fall, a car accident, or a serious sports injury - when it's relatively simple to identify. More usually, its a gradual build up of small stresses :years of poor posture, repetitive strain from a particular job, even anxiety and frustration that cause the muscles to tense.

You often hear stories about people who have 'put their back out' doing the silliest things :coughing, picking up a handkerchief, even just pouring a cup of tea.

In fact, this is never the whole cause. It's merely the proverbial straw that breaks the camel's back the culmination of a process that's probably been underway for months, if not years.

Where Do You Feel Back Pain?

Back pain is most likely to strike in the lower back, but it can be anywhere along the spine right up to a 'crick' in the neck.

The first 2 or 3 episodes you have may only last a few days, or a few weeks at most. But it's best not to ignore them even though you'll probably feel as good as new once they're over. They have a habit of returning!

Each successive episode may well last longer, and the pain could eventually become permanent. But if you establish the cause of those early attacks, you may be able to prevent a recurrence.

The severity of the pain varies. It can be anything from a dull ache or a feeling of discomfort right up to the most intense pain imaginable. If you're unlucky enough to experience the latter, the slightest movement becomes torture, making it difficult to walk, sit, even to find a comfortable position in bed so you can fall asleep. And turning over can become a long, drawn out process as you rotate inch by painful inch.

Less acute pain may not be quite such torture, but it can still be very distressing and incapacitating, restricting your movements, making it difficult to dress, put your shoes on, and work.

You may also experience what is known as referred pain. Sometimes nerves in the back become irritated - despite the popular phrase, they don't actually become 'trapped' - and you'll feel pain, tingling or numbness down one leg or in the foot.

Dealing with Back Pain

If you suffer from back pain, you well be subjected to a barrage of advice about what you should and shouldn't do, especially what movement and physical exercise you can safely undertake.

But since the causes of pain are so individual, what's good advice for one person may be totally irrelevant for another. It's best to be guided by your own discomfort if something feels OK, then go ahead and do it. if it causes pain, stop it.

Stretching and exercise is good for your back as long as it doesn't hurt and aggravate the symptoms. If you allow the muscles to stiffen up or worse still, become weak through lack of use, any problem you have is likely to be made worse. Seek the help of a professional to show you stretch/exercises.

What to Do During an Acute Attack

It is advisable to seek the advice of your GP or health Care Provider at the on-set of acute pain.

Or probably the best thing to do is lie down with your knees bent it might be the only thing you can do, and even then you might not be totally without discomfort.

You could find that heat (a hot water bottle, for instance) or cold (perhaps a bag of frozen peas wrapped in a tea towel to avoid ice burns) will help, but you need to apply it for at least 20 minutes at a time. If either causes further discomfort, stop using it. Ice is best as this will reduce inflammation.

Most acute attacks clear up spontaneously within 2 or 3 days. if one persists for longer than this, you should contact your GP.

Preventing Back Pain

There are various things you can do to help prevent back pain, or relieve symptoms if you already suffer.

Your Weight

If you're overweight, the excess pounds will be putting unnecessary stress on your joints and muscles. By losing weight you could well find that you reduce your discomfort.

Wearing Suitable Footwear

Wearing the suitable footwear for someone with a back problem is vital. Trainers are usually the best - the ones with cushions in the heals. I pay about �.00 for a good pair. Think about it the first part of you foot that hits the ground is you heal and takes most of the shock.


When you're sitting, try not to slump. Ideally, you should sit with a straight back, supported by the chair, and possibly a cushion at the bottom of the spine.

If you have to sit for long periods because you work in an office, say get up regularly and stretch go to the loo, the coffee machine, or just walk about. If you stay in one position for too long, muscles tend to stiffen up and become strained.

If you have to write a lot, it's best not to use a flat desk because it puts a stressful curve in the back. The old Victorian clerks had the right idea sitting at writing desks angled upwards like lecterns.

When you walk, try to keep the top of your head lifted. And , don't slouch.


Stress too is a frequent source of back pain, because it makes the muscles tense. Try to make a conscious effort to relax. this will make you less vulnerable to the muscular and joint strain which can set off an attack. Attending an Alexander Technique workshop or seeing a teacher will help you improve posture and show you simple ways to not wear your body out.

Lifting and Bending

Lifting is one of the most common ways of hurting your back, and you don't have to be lifting something especially heavy.

If the object is heavy, always get help. But whatever the weight you need to use the correct technique. When you pick something up, and again when you put it down, bend at the knees and always keep your spine straight. Bending your back puts a tremendous strain on it.

If you're doing physical work like, sewing even dusting, try to use both left and right hands equally. That way you don't put excessive, unbalancing strain on one side of the body.


If you suffer from back pain, a firm mattress is usually best (there is no such thing as an orthopaedic mattress so save your money), and a board placed under it can provide extra support. Always try out a bed before you buy it, and be very careful with second hand ones as they may have developed a sag.

Be careful too when making the bed. Leaning over to tuck in a sheet, especially if you're also twisting to reach the ends, can easily put a strain on the back.


If your car doesn't provide enough support for the lower back, try using a lumbar support cushion or a rolled up towel and adjust the seat for maximum comfort. Your hips and knees should be well flexed, with arms relaxed and bent to the wheel.

If you're going on a long journey, take breaks now and again to stretch your legs and relax the back.


Stretch and exercise, if it's the proper kind, can be very good for the back. It strengthens the muscles and keeps them supple. One of the best forms of exercise is swimming the water gives support to the whole body, easing any potential strain. But DO NOT DO THE BREAST STROKE! Therapists do not recommend the breast stroke because it can jar the lower back when you kick and also cranking your neck out of the water when you come up for air.

Always warm up before doing vigorous exercise. This helps to avoid strains and torn muscles.

Back Pain Treatment

Okay before you read on I would like you to read this:

Most people (including myself in the past) are looking for a quick fix. Please forget this idea that there is one - there isn't. I know because I spent thousands in the first year looking for a fix. I/we call this doctor or therapy shopping.

Most therapies can be helpful when you have a ACUTE BACK PROBLEM but not when it is Chronic (Chronic pain means longer than three - six months)

Listed below are the main ones that can help you when you have a chronic back problem.

So how do you manage you back problem long-term?

Pain Management Programmes are the main answer - although there aren't that many in and around the UK. This is why I started the Think Back self-management programme here in East London & Essex. Our local health authority are still slow to react to take chronic back problems seriously. Their excuse is the same old problem - no money.

Think Back self-management programme have been designed to help you manage your back problem yourself by showing simple self care techniques. 

So if you do decide to see a therapist, please remember their in business to make money and their treatment may not offer you a long-term solution.

Because back pain is so individual, and exact diagnosis is so difficult, it follows that treatment too can never be a precise science.

The most common treatments are physiotherapy and forms of manipulation such as osteopathy and chiropractic. There are also various 'complementary' or 'alternative' therapies, and you'll find details of those below. If you do decide to try one of these, it's always best to choose a registered practitioner. That way you can be certain the person is properly qualified.

Surgery is almost always a last resort. Your GP is unlikely to recommend it unless you've already tried everything else.

Before you consider any treatment, consult your GP. He or she knows the full state of your health, the effects of any medication you may be taking for other conditions, and is in the best possible position to advise you. If your condition is chronic (longer than six months) you may need to attend a Pain Management Programme in your area. A PMP will show you a simple multi-disciplinary approach to managing your back problem.


The chartered society of physiotherapy can provide information and advice on the work of physiotherapists. Members of the society have the letters "MCSP" after their name. State registered physiotherapists have the letters "SRP". Practitioners who have these initials will have completed a training course at one of the schools of physiotherapy attached to a hospital. You would normally be referred through your GP, but it is possible to consult one privately (for a list, contact the Organisation of Chartered Physiotherapists in a private practice) 

The Alexander Technique

The Alexander Technique looks at the overall use of the body and increases awareness of movement, balance and posture. It's usually taught on a one-to-one basis, with the teacher making small adjustments to the way you hold and move your body. For a list of teachers who have taken the 3 year course under the auspices of the Society of Teachers of the Alexander Technique, send an A5 s.a.e. to:


Homeopathy is the practice of treating like with like. As with other complimentary therapies, it looks at the person as a whole rather than treating back pain in isolation. Remedies are derived from mineral, plant and animal sources and are administered in small doses. Some chemists stock homeopathic remedies, but it's bet to get a skilled practitioner to assess your condition first rather than trying to prescribe for yourself. Registered homeopaths must be qualified already in ordinary medicine before they can take a diploma in homeopathy.


Reiki is a Japanese Technique for stress reduction and relaxation. For further information contact:


Acupuncture is the ancient practice of inducing healing by restoring balance to a person's energies through the insertion of fine needles. Acupuncture treatment for pain-relief based on physical symptoms alone rarely achieves lasting change, which is why the Traditional 

Acupuncturist attempts to treat the root of the problem. A diagnosis according to Traditional Chinese Medical Theory is made on the basis of all aspects of the person, and seeks to isolate the deepest source of the symptoms. There are usually emotional and spiritual components of chronic disease which need addressing, and so the practitioner will include discussion about lifestyle, diet and outlook as part of the overall treatment strategy in partnership with the patient. Traditional acupuncturists are regulated by the British Acupuncture Council and are entitled to use the letters MBAcC after their name.

Standing at Work

Many users of standing desks have found that their back pain reduced when they started using a standing desk at work. You don't need to stand all day, in fact, it's recommended that you alternate from sitting to standing throughout the day. For more information about standing desks and reducing back pain, visit They also have a great infographic on proper workplace ergonomics.


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