Back Pain

Back pain isn’t usually a sign of arthritis or any other underlying medical condition. It’s much more likely that an awkward movement has pulled a muscle or sprained a ligament. Sometimes we don’t even remember a movement that might have triggered the pain. Unless the back pain is very severe you probably won’t even need to see your doctor.

If the pain is not improving after a week or so it’s possible that you have a more complex problem. Here are some of the reasons for having back pain:

Sciatica, or leg pain can be felt anywhere from the buttock to the big toe. Sciatica can be caused by a ‘slipped’ or prolapsed disc in the spine, which may press on a nerve, causing pain that can take weeks to settle down. You may also notice weakness of the muscles in your leg and pins and needles in the legs.

Spondylosis is a condition caused by arthritis of the back joints and can cause persistent back pain. As we grow older, the discs in the spine become thinner and the spaces between the vertebrae become narrower. Spurs of bone (osteophytes) may form at the edges of the vertebrae and facet joints. These changes are very common and can sometimes cause back pain, though they may not cause any pain at all.

Spinal stenosis
Occasionally back pain is associated with leg pain that comes on after a few minutes walking or with prolonged standing and is relieved when sitting down. This may be caused by the narrowing of the spinal canal or nerve outlets (foramen) caused by osteophytes, a prolapsed disc and/or thickening of one of the main spinal ligaments. This causes squeezing of the spinal cord or nerves.

How can we diagnose back problems?
If your back pain has come on recently, an x-ray will not usually help to identify the cause. This is because x-rays don’t show the soft tissues (e.g. ligaments and muscles) which are the source of most back pain. X-rays may show signs of spondylosis, but this may not be the cause of the back pain. A CT or MRI scan may be carried out if your specialist suspects a trapped nerve or spinal stenosis or one of the rarer causes of back pain such as fracture, inflammation, infection or tumour.

Treating back pain
There is a great deal that you can do for yourself to relieve back pain caused by sprains and strains. Most back pain improves with simple measures, common sense and home treatment. More severe cases may need monitoring and treatment by your back specialist in combination with physiotherapy. Treatment can involve relative rest, back exercises, dietary and nutritional advice, and pain management (see under treatments).