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Lower back pain
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Low back pain is very common and very normal and gets better over a few days or weeks. Your spine is one of the strongest parts of your body and is surprisingly difficult to damage. Although the pain may last longer than a few weeks, or may come and go, this does not mean your back problem is serious. Back pain is rarely due to serious disease or damage. The amount of pain felt is not related to the amount of damage - think of a paper cut. With the right information, support and treatment, most people can manage their own back pain.
Scans of the spine correlate poorly with symptoms. Most people without low back pain have changes on scans and x-rays which do not cause any pain at all. Exercise is the best treatment.
There are lots of different factors that contribute to low back pain that can involve physical aspects, lifestyle aspects and mental aspects. For example, if we are a bit stressed, a bit run down, not sleeping well and not exercising enough but spending long periods sitting or bending and lifting then we can develop back pain.
Some common causes of back pain are:
- Non-specific back pain
- A slipped disc
- Sciatica
- Ankylosing Spondylitis
- Spondylolithesis
- Spinal stenosis
You may find this video helpful in understanding the common causes of low back pain:
It is often not possible to identify the cause of back pain. Doctors call this non-specific back pain. Sometimes the pain may be from an injury such as a sprain or strain, but often it happens for no apparent reason. It is very rarely caused by anything serious.
Occasionally back pain can be caused by:
- A slipped (prolapsed) disc (Slipped disc - NHS (www.nhs.uk)) - where a disc of cartilage in the spine presses on a nearby nerve
- Sciatica (Sciatica - NHS (www.nhs.uk)) - irritation of the nerve that runs from the pelvis to the feet.
These conditions tend to cause additional symptoms, such as numbness, weakness or a tingling sensation, and they're treated differently from non-specific back pain.
- Ankylosing spondylitis (Ankylosing spondylitis - NHS (www.nhs.uk)) (swelling of the joints in the spine) - this causes pain and stiffness that’s usually worse in the morning and improves with movement.
- Spondylolisthesis (Spondylolisthesis - NHS (www.nhs.uk)) (a bone in the spine slipping out of position) - this can cause lower back pain and stiffness, as well as numbness and a tingling sensation
These conditions are treated differently to non-specific back pain. Click the links to find out more.
Spinal stenosis - narrowing of the nerve passages in the spine. These can caused with degenerative changes and disc pathology.
Very rarely, back pain can be a sign of a serious problem such as:
- a broken bone in the spine
- an infection
- cauda equina syndrome (where the nerves in the lower back become severely compressed)
- cancer
If you see your GP or Physiotherapist with back pain, they will look for signs of these.
The main treatments for back pain are described below. You can also read (Back pain - Treatment - NHS (www.nhs.uk)) to compare the options.
We have collated some useful resources below.
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If you require this information in another language please use the following links:
https://www.macpweb.org/learning-resources/cauda-equina-information-cards.aspx
https://www.eoemskservice.nhs.uk/advice-and-leaflets/lower-back/cauda-equina