Advice and information for patients
Low back pain is soreness or stiffness in the back, between the bottom of the rib cage and the top of the legs. Most people's low back pain is described as 'non-specific'. That means the pain is unlikely to be caused by an infection, a fracture or a disease like cancer. Some people also get back symptoms radiating down one or both legs (radicular symptoms/sciatica).
Radicular symptoms are caused, when the nerves from the back, are irritated causing pain, numbness or tingling down the leg. This pain, may vary from mild to severe, may be related to or triggered by a particular movement or action or it may be spontaneous. Most people will tend to suffer from back pain at some point in their lives and indeed it may recur.
Low back pain
Most back pain usually improves enough within few days to few weeks, to be able to return to normal activities. For such pain, it is best to continue with normal activities as much as possible, although you may need to return to them in stages, as the back pain steadily recovers. Getting back to work helps your recovery and employers will often arrange lighter duties to get you back sooner. Continuing with normal life as much as you can helps to take your mind off the pain and avoid you getting stiff and weak.
Complete or prolonged bed rest is not advised at all as it is associated with delayed recovery. If needed, simple analgesics (pain killers) help people with back pain or radicular pain keep active. Many of these are available over the counter.
How can I help myself to get better?
The most important thing is movement. Your back is designed to move – the joints, ligaments, tendons, muscles and nerves are all designed to move, and they don’t like it too much if they don’t move. Indeed, studies show that longer periods of rest and avoiding activity actually leads to more pain, longer recovery times and longer time off from work.
Contrary to many people’s beliefs, it is good to stay active when you have pain in your soft tissues or joints. In the first few days, it may well be that you have to modify how active you are. However, staying as active as possible and gradually building up to your previous activity levels is actually very important for your recovery. It is perfectly safe to exercise with back pain. Do not be afraid to bend and twist and stretch. That’s what your back is designed to do and by doing it you’ll make your back stronger, more flexible and healthier in the long run. Muscles that might be in spasm, due to the pain, relax when they are gently stretched and moved. Back pain should not stop you enjoying exercise or regular activities. Again, the research shows that continuing with your regular activities can help you get better sooner.
Most types of exercise are of some benefit to people with LBP, with no particular type of exercise being better than another. So walking, running, swimming, cycling, yoga and pilates, for example, are all good. The most important consideration regarding exercise is to pick something you enjoy. When you are in pain, starting exercise can feel hard, especially if your back isn’t used to it. Feeling stiff and sore after exercise isn’t a sign you’ve damaged yourself though – it’s simply a sign that your body is not used to that activity and that stiffness and soreness will ease as you strengthen up from doing that activity.
- Some basic exercises can be useful in easing your low back pain and to help it move better. These simple back exercises from ARC UK may be a useful starting point.
- Pain relief through medication may be useful – however it is essential that prior to using pain-relieving medication that you check with either your GP or pharmacist that you are OK to use them - even if they are “over-the-counter” type medications such as paracetamol, ibuprofen or creams that you can buy at the chemist.
When should I see my doctor or physiotherapist?
Many episodes of low back pain get better or improve on their own, or with the self-management approaches as discussed above.
However you should seek medical advice for the following:
- the low back pain does not respond to the measures described above, gets worse and certainly if it does not improve after six weeks
- you are on steroid medication
- experience unsteadiness when you walk
You should seek urgent help if you experience any of the following, then you need to attend A&E as soon as possible:
- difficulty passing or controlling urine, urinary incontinence
- numbness/ loss of sensation around your back passage or genitals
- numbness/loss of sensation, pins and needles, or weakness in both legs
The Healthy Living Teams in St Helens/Knowsley provide tailored support and guidance to local people who would like to be more physically active. To find out more about the programmes available, please click on the link below for your Borough: