Stress factors

The symptoms of simple back pain often occur suddenly and can be triggered by a particular movement, but the causes may have been building for some time.

Some of the most common causes of stress and strain on the spine include:

  • Slouching in chairs
  • Driving in hunched positions
  • Standing badly
  • Lifting incorrectly
  • Sleeping on sagging mattresses
  • Being unfit
  • Generally overdoing it

Inactivity and the wrong sort of movement are usually at the root of simple back pain.

Inactivity makes the muscles go slack and weak so they are unable to support the back properly. This leaves the back more vulnerable to damage when certain movements put too much strain on one area.

Often, the problem is caused by a strain or tear to the muscles, tendons or ligaments around the lower spine. In turn, this can produce painful muscle tension and spasm.

Even a minor problem can cause a lot of pain when you stand, bend or move around. Pain sometimes comes on suddenly, sometimes gradually, but usually it only lasts a few days or up to a week.

Work-related back problems

The spine wasn’t designed for sitting in front of a computer or behind the wheel of a car for long periods. The consequences of such actions are often all too uncomfortable, and painfully, apparent.

Musculoskeletal problems

Awkward movements and bad posture cause musculoskeletal disorders that affects the full length of the spine, from the neck to lower back, as well as the shoulders, arms and fingers.

Spending long periods of time in the same position makes spine and muscle problems more likely. Fortunately, simple steps taken early on can reduce the risk of such problems developing.

Head and neck strain

Tension in the supporting muscles of the neck, caused by physical or emotional stress, makes them tight and uncomfortable. This tension is most often felt in the upper back and back part of the neck.

Lower back pain

Lower back pain is an increasingly common problem. An injury may be responsible, but often it’s the consequence of poor posture or an awkward twisting movement, bending or reaching – or a combination of these, along with inactivity which results in stiffness and poor flexibility. Being overweight, especially if excessive, also adds to the discomfort and pain.

Back pain: when to see your doctor

Many people with back pain never need to see their doctor. But you should be able to call or visit your GP if you’re worried about your back or feel unable to cope with the pain. As a general rule, people with back pain are advised to contact their doctor if the pain is no better after about a week.

You should certainly see your GP as soon as possible if you have any of these symptoms:

  • Difficulty passing urine, or if you are passing blood
  • Numbness around the back passage or genitals
  • Numbness, pins and needles or weakness in the legs or arms
  • Pain running down one or both legs
  • Unsteadiness when standing

These are associated with uncommon conditions, but ones that need treatment immediately.

First aid for backs

The following self-help treatments may help to relieve back pain.

Apply heat and ice

Apply an ice pack to the affected area. If you haven’t got an ice pack, use a bag of frozen vegetables instead. Don’t put the ice directly on your skin, as it might cause a cold burn. Put a wet cloth between the ice and your skin.

If ice doesn’t work, try applying gentle warmth with a hot water bottle. Don’t apply the hot water bottle directly to the skin – cover it so it isn’t too hot. A hot bath or shower might also help.

Some people find alternating heat and cold produces most relief. Try to get professional advice on applying heat
and ice if you can.

Medication

Take painkillers following the instructions on the packet – never take more than the recommended dose.Many people find that paracetamol or ibuprofen helps – your pharmacist can advise you.

Painkillers shouldn’t be used as a long-term solution. If you find you still need them after a week or so, consult your doctor.

Relaxation

Muscle tension is bad for back pain, so try to relax as much as possible. Take a long bath or listen to soothing music. Use a relaxation tape if you have one.

A gentle massage from a partner or friend may help, but make sure they don’t do anything that causes pain. Topical anti-inflammatory gels such as ibuprofen can also be massaged gently onto the skin over the back.

Bed rest versus exercise

Doctors used to recommend long periods of rest for people with backache, but research has shown this is actually bad for backs. Even crawling around on your hands and knees is better than no movement at all.

Some kinds of exercise, such as walking, don’t put too much stress on your back. It’s a good idea to make a start on them even if your back is a bit sore, just to get your joints moving and your heart and lungs working.

Use a firm chair when sitting down, or sit on the floor rather than a sofa that’s too soft. Similarly, make sure your bed is firm enough.

Getting back to normal

In most cases, the back recovers naturally if allowed to do so and the pain should settle in a couple of days. Once this has happened, continue getting back to normal activities and try not to stay in one position or do any one activity for more than 30 minutes.

Avoid lifting, bending or twisting until the pain has gone for a few days. Refrain from returning to the activity that caused the pain for a week or so, even if you feel better, and gradually build up your exercise and activities day by day.

Don’t just listen to your friends and relatives – ask an expert. Talk to your doctor or a properly physiotherapist, osteopath or chiropractor.

Back pain: making adjustments

Making small changes to your lifestyle can reduce your risk of back pain.
Back pain can be caused by many factors. Run through your daily routine and examine the amount of strain you place on your spine.

Stress can also create muscle tension, causing a loss in flexibility that can lead to back pain. To reduce stress, try exercise, yoga, meditation, getting more sleep or listening to music.

If you smoke, stop. It puts you at increased risk for back problems since your blood has trouble delivering oxygen to working tissues, making your back weaker.

Dealing with back pain out and about

When you’re shopping:

  • Don’t shop until you drop – take regular rests or make several short trips
  • Distribute your shopping evenly between both  hands or hold a bag in front of you, or use a  small backpack (not large or over-filled)
  • Wear comfortable shoes

In the car:

  • Adjust your seat properly so your arms have a slight bent at the elbow when your hands are on the steering wheel
  • Support your lower back with a small cushion or rolled up towel
  • Take regular breaks on long journeys and get out of the car for a stroll and a stretch

Dealing with back pain at work – Preventing work-related back problems

If you spend much of your time at work sitting at a desk, there are steps you can take to reduce your risk of back problems.

Seating
A properly adjusted chair reduces the strain on your back.

  • Sit up straight
  • Make sure your knees are level with your hips
  • If your chair doesn’t provide enough back support, use a rolled up towel or cushion
  • Are your feet flat on the floor? If not, use a footrest to relieve pressure on your joints and muscles
  • Avoid crossing your legs or sitting with one (or both) twisted beneath you

Monitor

  • Your computer monitor should be about 30cm to 75cm (12in to 30in) from your eyes – a good guide is to place it at arm’s length
  • The top of the screen should be roughly at eye level
  • Position the monitor so it reflects as little overhead lighting and sunlight as possible

Keyboard

  • Keep your wrists straight, not bent up or down – a wrist rest may help
  • Your elbows should be vertically under your shoulders – position the mouse as close to you as possible to allow this
  • A mouse mat with wrist pad can help keep your wrist straight
  • Learning keyboard short cuts may also help

Other objects

  • Position frequently used objects, such as a telephone or stapler, within easy reach – it’s important to avoid repeatedly stretching or twisting
  • If you spend a lot of time on the phone, consider using a headset – cradling the phone between your ear and shoulder can strain the muscles in your neck

Take a break

  • If your job is computer-based, make sure you take regular breaks – for every hour at your keyboard, have at least five to ten minutes’ rest
  • Get up and move around
  • Rest your eyes regularly – look away from the screen and focus on something in the distance for a few seconds
  • Gentle exercise can help to relax your muscles and clear your mind

Back pain: posture checklist

A good posture can greatly improve and prevent back problems. Follow these simple rules.

How to stand

  • Don’t round your back – imagine you are being lifted by a string fixed to the top of your head
  • Avoid hunching your shoulders and tensing your neck when stressed
  • Wear comfortable, low-heeled shoes – high heels put pressure on the lower back

How to sit

  • Use an upright chair that supports your lower back
  • Support the small of your back with a small cushion or rolled up towel
  • Stand up and stretch every 20 to 30 minutes

How to lift

  • Always look at alternatives to lifting – can you push or pull?
  • Lift only what you can handle and get help if you need it
  • Bend your knees and keep your back straight and your feet apart when lifting
  • Avoid lifting and twisting at the same time
  • Always lift and carry close to your body
  • Bend your knees rather than your back when putting a load down

Can exercise help back pain?

Make sure you’re doing the right kind of activity to help protect your spine.

Keeping fit

Gentle exercise can build strong back and stomach muscles to support your spine and maintain flexibility.Walking and cycling are easy to incorporate into your daily lifestyle. Swimming is particularly good for backs, because it strengthens the muscles while supporting the body with water. However, some strokes may not be suitable, so get professional advice.

Exercise dos and don’ts

When exercising, make sure you do:

  • Choose exercises suitable to your level and work up gradually
  • Take things at your own pace
  • Drink water before, during and after exercise
  • Do gentle warm-up stretches before and after exercising
  • Wear good footwear and appropriate clothing
  • Enjoy yourself

Don’t:

  • Continue with an activity if it hurts your back
  • Eat a large meal before exercising
  • Perform exercises on a stone or concrete floor
  • Exercise if you feel ill
  • Do exercises that put weight or excessive strain on an acutely painful joint or spine

Back pain and keeping trim

Excess weight can pull the spine out of alignment and cause a back injury, so it’s important to keep your weight down. Aerobic exercises such as cycling, walking and running can help you lose the excess pounds. However, keep in mind that some popular sports, such as golf and tennis, can actually injure your back if not done properly.

It’s also important to maintain a healthy diet that’s high in fruits, grains and vegetables. In addition to causing weight gain, a poor diet can also make your back weaker and more susceptible to injury.