Things to remember | How your back works | Causes of back pain | Lifestyle Factors | Diagnosis | Prevention | When to seek help | Self-management | Treating ongoing back pain | Where to get help | How we can help | More to explore | Reference | Download PDF | Watch the recording of our webinar on low back pain
If you have back pain, you’re not alone. It’s a common problem experienced by many people. In fact, 1 in 6 Australians reported back problems in 2017-18. That’s close to 4 million people. (1)
Your back is a complex structure that provides support for your pelvis, legs, ribcage, arms and skull. The spine is made up of bones called vertebrae that are stacked together to form a loose ‘S’-shaped column.
Each vertebra is cushioned by spongy tissue called intervertebral discs. These discs act as shock absorbers and give your spine its flexibility. Vertebrae are joined by pairs of small joints known as ‘facet’ joints. A mesh of connective tissue called ligaments holds the spine together.
Complex layers of muscle provide structural support and allow you to move. Your spinal cord runs through the centre of the vertebral column and connects your brain to the rest of your body.
The causes of back pain are not fully understood.
Most people with back pain don’t have any significant damage to their spine. The pain comes from the muscles, ligaments and joints.
Common causes of back pain include:
More persistent back pain may be associated with arthritis of the ‘facet’ joints and degeneration of the discs. However, people with this condition may not experience any pain.
Very rarely back pain can be a sign of a spinal fracture, an infection of the spine or cancer. Your GP will look for symptoms and signs associated with these conditions.
Most cases of back pain are exacerbated by lifestyle factors including:
Your doctor will discuss your back pain with you and will:
Your doctor may also refer you for some tests, especially if they think there may be a more serious cause for your back pain.
However in most cases of back pain, imaging (e.g. x-rays, CT or MRI scans) isn’t useful and isn’t recommended.
Unnecessary tests can be expensive, and some scans involve exposure to radiation that should be avoided if the results won’t help with your treatment.
A thorough examination by your doctor will decide whether more investigations are appropriate or helpful in developing a treatment plan that’s right for you.
It‘s also important to know that many investigations show ‘changes’ to your spine that are likely to represent the normal passage of time, not damage to your spine.
For more information about questions to ask your doctor before you get any test, treatment or procedure visit the Choosing Wisely Australia website.
The key to preventing back pain is keeping your back flexible and strong. In most cases back pain can be prevented by making a few lifestyle changes:
In many cases of back pain, the first and most important treatment is to keep active and resume normal activities – work, sport and recreation – as soon as possible. The majority of back injuries will improve by themselves.
However there are times when it’s important to see your doctor to check there are no medical problems that may be contributing to your pain.
See your doctor if you have back pain and any warning signs such as:
Most cases of back pain will get better on its own and you won’t need to see a doctor. If your back pain is recent, the following may help relieve your symptoms and speed up your recovery.
Learn more about your back pain – what makes it better, what makes it worse? Knowing as much as possible about your condition means that you can make informed decisions about your healthcare and play an active role in the management of your condition.
Rest your back (temporarily) – avoid strenuous activity but where possible continue light activity (e.g. walking). If severe pain means you need a break from standing or sitting, then limit the time you spend lying down to just a few hours at a time. Bed rest for more than a day or two isn’t helpful and will actually make your back pain worse.
Get back to your normal activities – try to be as active as possible and get on with your day to day life, including work and exercise. If you’re returning to heavy manual jobs this may take longer.
Use medication as prescribed – pain-relieving and muscle relaxant medication may be prescribed temporarily by your doctor.
Learn ways to manage pain – there are many strategies you can use to deal with pain. Knowing about these different strategies and what works best for you is an important part of living with back pain. Check out the How we can help section below for links to great videos on managing pain using your brain.
Apply heat and cold therapy – hot and cold packs applied to the area of pain may be helpful in relieving pain temporarily. Make sure you take measures to protect your skin from heat and cold (e.g. wrap your ice pack in a tea towel).
Try an anti-inflammatory or analgesic cream or gel – There are many different kinds that may provide some temporary pain relief. Talk with your doctor or pharmacist for more information.
Back pain can be an ongoing problem for many people. About half of the people who get back pain will experience it again. It’s important to strengthen and condition your back, and be aware of your posture, even after the pain has subsided.
Talk to your physiotherapist or exercise physiologist about exercises you can do on an ongoing basis to maintain the health of your back and for your general wellbeing.
Call our MSK Help Line and speak to our nurses. Phone 1800 263 265 or email helpline@msk.org.au.
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