Go to bed and take painkillers?

If you go to bed for more than two days, you can make your back pain worse.

What are the choices?

That depends on how bad your back is - here are some simple guidelines:
If your pain is a mild, low backache:
Keep moving around and stretch your back, being careful not to put your head down and bend - as this is the most likely cause of the problem in the first place.

If the pain is more than this then:

Go and see your GP and ask for a referral to a Physiotherapist or make an appointment with the Physiotherapist direct if...

1. The pain is very sharp and stabbing, which gets worse, especially if you cough or sneeze.
2. The pain goes down the leg.
3. Your back seems to be twisted and you can't stand up straight.

What Causes Back Pain?

Most back pain is caused through a mechanical problem in the spine. This can be a problem with a disc, or with the small joints on either side of the spine. [The facet joints].

In either case the result can be pressure on the spinal cord, or on the nerves that come out on either side between the facet joints. The sciatic nerve is the biggest of these nerves and pressure on it can cause pain down the leg. Sciatica is a symptom and not the cause of the pressure. Muscles go into spasm in the back to protect the joints of the spine from further damage. Pain most often comes from the spine itself - and not from sprained muscles!

There are though, many other causes of back pain and a detailed examination is needed to identify exactly which structures of the body are involved before deciding the best way to actively treat them.

Should you have an X-ray?

No. Not necessarily. Back X-rays have been shown to be of value in only 1% of cases because most of the causes of back pain involve structures that you can't see on X-ray. One X-ray of the back is equivalent in radiation exposure terms to 120 chest X-rays!
A detailed, specialist clinical examination involving testing of all the structures that may be causing trouble is by far the best approach.
It will include a detailed history and will show whether other medical tests are necessary.

What Treatment Should I get?"

There are a number of ways to treat the problem. Every person and every back condition is different.
There is no universal way of treating every back. So you need a qualified practicioner who can "tailor make" the treatment best suited to you and your particular back condition.
You may need manipulation, mobilisation, electrotherapy, specialised stretching and exercise techniques - or a combination of all of these.

You will certainly need sound advice about backcare, a good understanding of the cause of your pain and some ideas about how to stop it happening again. You may also require advice about you bed. The correct mattress can play an important role in both the recovery from and the prevention of, back pain.

Text compiled by PhysioFirst, 'The Organisation of Chartered Physiotherapists in Private Practice'in association with:



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