Back Pain

Below is advice to reinforce what we may discuss in clinic, this is intended  to be used as a simple guide and should not replace professional medical consultation. If you are worried about your symptoms we encourage you to consult your GP.

What can cause back pain?

Common causes are:

  • Posture - sitting at a desk for a long time, using tablets/phones for a long time, sitting on very soft surfaces like sofas/beds to read/watch television

  • An injury

  • Deconditioning, this is a reduced capacity to resist loads, which may result from reduced physical activity, bed rest, casts, paralysis, cessation of an activity.

  • (Rarely) a nerve injury/ irritation potentially as a result of:

    • bony changes such as arthritis and bony spurs

    • a slipped/bulging/herniated disc

    • ‘Sciatica’ is an example of injury/ irritation of the nerve that runs from the lower back/ pelvis to the feet potentially causing pain in the back pain, buttock pain, lower limb pain, pain radiating down the back of the leg to the foot

    • These conditions tend to cause additional symptoms, such as numbness, weakness or a tingling sensation and may require further investigation.

Managing Back Pain

 

Managing back pain

 

Back pain, especially lower back pain is very common, usually not the result of serious damage, and improves within a few weeks or months.

In most cases the pain is not caused by anything serious and will usually get better over time.

  • It is important to note that the pain you feel is not directly related to the seriousness of the ‘damage’. Severe pain does not necessarily mean severe injury.

There are things you can do.

 

Identify what makes it worse

 

It’s important to identify what makes your back worse and what makes it better (activities, postures, compensations, time of day).

This can be a little time-consuming, but it is extremely beneficial to the treatment and management of back pain. Some activities can then be stopped or adapted until your back has recovered and can tolerate the activity again.

This does not mean slowly stopping you from doing all the things you enjoy but aiming to develop awareness and understanding and good habits to stop the cycle of pain and re-aggravation and to develop strength and confidence in your back again.

 

Homecare tips for back pain

 

Do

 

✔︎ If you have been prescribed medication from your medical professional, continue to follow their recommendation

✔︎ Try hot/cold  

  • This means something like a heat pack, a hot-water-bottle, or ice-pack on the painful area

  • Keep on area for no more than 10 minutes at a time to allow the temperature of your skin to return to normal before reapplying as necessary

  • If using any hot/cold packs cover in a towel/t-shirt or use over clothes

✔︎ Keep moving!

  • You may find walking slowly, stopping and starting, as in a supermarket makes your back worse- for most people a short rapid-paced walk, even if just 10-15 minutes to begin with, gives relief

  • Aim to do this at least once a day

✔︎ Try to continue your daily activities - if you can still manage to do them, keep going

✔︎ Try putting a pillow under your knees at night,

  • if you sleep on your side, you can still prop your topmost knee with pillows underneath

✔︎ Walking is a great accessible starting point for managing your back pain, some other activities may be helpful for some but not others:

  • You may find swimming and cycling less painful as they are not as weight-bearing however, for some people they are worse because of the body posture

  • You may find yoga and pilates helpful for improving flexibility, conditioning and strengthening however, stretching may not be recommended yet, if you have sprained a muscle, or find that stretching increases your pain. If you find you are more sore the day after, stretching may not be for you at the moment

✔︎ Do try activities- guided classes can give you a feeling of support and help keep your recovery consistent, if an activity is making your back pain worse, try not to be disheartened, it may just not be the right activity for your back pain

✔︎ Seek advice if you are unsure

It is very easy to start believing that the back pain will never go away.

✔︎ Try to remain objective 

  • Questions to ask yourself -

    • What evidence do I have that it will never go away?

    • Is the severity of the pain impacting my thoughts about recovery?

    • Is my belief that this is how I’ll be from now-on based on facts?

    • Have I recovered from pain in the past?

    • Am I doing anything to help?

    • Am I accessing help to recover?

    • Have I learnt ways to help manage so far?

  • It can be difficult- pain is very wearing and if it is stopping you doing things, it can have a profound effect on your mood. People who manage to stay positive despite their pain tend to recover quicker

Back pain usually gets better within a few weeks or months, If you have not made changes, there are still options to consider, If you have made positive changes and things have not improved or got worse:

❗️See a GP if

  • the pain does not start to improve within a few weeks

  • the pain stops you doing day-to-day activities

  • the pain is very severe or gets worse over time

  • you're worried about the pain or struggling to cope

 

Don’t

 

✘ Sleep on your front,

✘ Bedrest is not advised. Resting for long periods often makes the pain worse. If you feel you have to lie down, try only doing it for intervals

✘ Force through the pain

 

Exercises

 

  • Lying on your back, with your knees bent, gently rock your knees side to side

  • Lying on your back, bring one knee to your chest and hold it with your arms, then alternate

  • As above, bring your knee up to your chest, then draw your leg across the body with your hand

  • Pelvic tilts

    • try drawing your belly button in towards your spine so that your pelvis tilts back, then roll your pelvis forward again.

    • This can be done lying on your back or sitting/standing, if you are lying down with your knees bent, you should feel the small of your back press against the floor/bed when you tilt back and lift away when you tilt forward

    • keep breathing as normal

    • placing your hands on your hips might help you feel the movement

How to prevent back pain

 

Do

 

✔︎ Stay active – doing regular exercise can help keep your back strong; if you are consistently doing less- your back will have a reduced capacity to resist load, but it can be built back up! (adults are advised to do at least 150 minutes exercise per week)

✔︎ Invest in a good mattress and pillows

✔︎ Learn pelvic tilts, this can help to engage your abdominal brace (core) to reduce the risk of hurting your back

  • try drawing your belly button in towards your spine so that your pelvis tilts back, then roll your pelvis forward again.

  • This can be done lying on your back or sitting/standing, if you are lying down with your knees bent, you should feel the small of your back press against the floor/bed when you tilt back and lift away when you tilt forward

  • keep breathing as normal

  • placing your hands on your hips might help you feel the movement

✔︎ Take care when lifting – We all know we should bend our knees, but it is important that we then use our legs and buttocks when straightening back up!

    • try squeezing your bum muscles as you rise to push your hips forward when you straighten back up, this will use your strong gluteal muscles, instead of straining your back

 

Don’t

 

✘ Don’t stop doing prescribed exercises

  • Even if you feel you have fully recovered from an episode of back pain, if your exercises and stretches were giving you relief, keep using them - they were most likely given to you to strengthen and condition your back and are therefor part of maintaining your healthy back

✘ Don’t sit for long periods - no more than 30 minutes, even if all you can manage is standing up and sitting down again, it helps

Posture when sitting, using computers or tablets and watching television

  • Try not to force ‘good posture’ for long periods, whether sitting or standing this will become tiring, try getting up instead

 

Treatment for back pain

Effective treatment for back pain aims to ask the right questions to tackle the problem. Starting by reducing your pain, then helping you learn home-care techniques- how to strengthen and adopt best behaviours. Good treatment should also consider your mental health- a healthy outlook aids recovery.

 

Massage Therapy

Massage and manual therapy treatments, such as manipulating the spine and surrounding joints (the hips and pelvis are often overlooked) can help reduce your pain and discomfort, making it easier to tackle exercise and recovery.

Exercise

Homecare exercises or group exercise classes such as strength and conditioning or pilates where you're taught exercises to strengthen your muscles and improve your posture can help to restore function.

Outlook

If you are struggling to cope with the effect of back pain on your life, psychological support, such as cognitive behavioural therapy (CBT) may be beneficial. This can have a huge impact on recovery and remaining injury/pain free. Mental health is often underestimated when dealing with a physical condition.

N.B. Northwest Massage Clinic does not provide CBT services but can make suggestions for self-referral