Lower back pain
Lower back pain is very common and very normal and gets better over a few days or weeks. Find more information on back pain on the Arthritis UK website.
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
- Spondylolisthesis
- Spinal stenosis
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 - where a disc of cartilage in the spine presses on a nearby nerve. Information and guidance from NHS UK about slipped discs.
- Sciatica - irritation of the nerve that runs from the pelvis to the feet. Information and guidance from NHS UK about Sciatica.
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 (swelling of the joints in the spine) - this causes pain and stiffness that’s usually worse in the morning and improves with movement. Information and guidance from NHS UK about Ankylosing spondylitis.
- Spondylolisthesis (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. Information and guidance from NHS UK about Spondylolisthesis.
- Spinal stenosis - narrowing of the nerve passages in the spine. These can be caused by 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.
Cauda equina syndrome is a rare and severe type of spinal stenosis where all of the nerves in the lower back suddenly become severely compressed. Symptoms include:
- Sciatica on both sides
- Weakness or numbness in both legs that is severe or getting worse
- Numbness around or under your genitals, or around your anus
Warning signs:
- Loss of feeling/pins and needles between your inner thighs or genitals
- Numbness in or around your back passage or buttocks
- Altered feeling when using toilet paper to wipe yourself
- Increasing difficulty when you try to urinate
- Increasing difficulty when you try to stop or control your flow of urine
- Loss of sensation when you pass urine
- Leaking urine or recent need to use pads
- Not knowing when your bladder is either full or empty
- Inability to stop a bowel movement or leaking
- Loss of sensation when you pass a bowel motion
- Change in ability to achieve an erection or ejaculate
- Loss of sensation in genitals during sexual intercourse
Cauda Equina information cards - Musculoskeletal Association of Chartered Physiotherapists.