Self Help
Back and Neck Problems
What Do You Do if You’ve Got a Bad Back
A summary of the medical evidence
Backache is so common that everybody can expect to have an episode some time in their lives. Fortunately most people get better within two to three weeks. Although your back can be intensely painful at the time, bed rest has been shown to have a bad overall effect. Those people who cope best usually stay active despite the pain. In fact the back is designed for movement and often people seize up if they stay in any position for any length of time.
Usually the pain is not due to a serious problem and investigations such as X—rays only show changes associated with age. These changes occur in everyone even if they have no back pain.
Resting a back will tend to make your back weaker and stiffer. You will also become less co—ordinated and unfit. In the long term resting in bed can often make you depressed and make it harder to get going again.
In contrast exercise will tend to make you stronger and more co—ordinated, as well as keeping you supple and fit. It can also make you feel good and will release chemicals which might reduce the pain.
If your back is sore you can make a start by doing activities that don’t put too much stress on your back. For instance, you could try walking, swimming or you could go to the gym starting with an easy programme designed by a qualified gym instructor and then work up to more normal activities under their supervision.
If you have acute backache it is reasonable to control the pain with painkillers (Aspirin, Paracetamol or Ibuprofen). You should avoid taking Aspirin or Ibuprofen if you have indigestion or an ulcer problem. If you feel the need for stronger medication or muscle relaxants you should see your doctor.
Although most people improve with no specific treatment some get relief more quickly by using manipulation (Osteopath, Physiotherapist or Chiropractor). Other treatments may help pain relief. These might include acupuncture or massage. It is up to you to find out what works best for you and your backache.
Stress may make backache worse. If it does, this needs to be recognised early, as there are techniques which can be learnt that have a calming effect. These techniques may also help muscle relaxation.
Clearly you should discuss your backache with your doctor if pain control is a problem or if the backache worsens. It may also be worth discussing your backache with your doctor if you have a lot of night pain. It is particularly important to see your doctor if you have leg pain (sciatica) especially if it is associated with difficulty in controlling your bowels or bladder or if you have some numbness around your back passage or genitals. Usually sciatica is in one leg, however it can appear in both legs and this may be worth discussing with your doctor especially if it is associated with numbness and weakness or unsteadiness. Fortunately these problems happen infrequently and you should not worry about them too much as most backache is not due to any serious cause.
As your backache improves you should increase your activity, although you may have to be a little cautious at first. It is a good idea not to stay in one position or do any one thing for more than twenty to thirty minutes without a break (especially sitting and stooping). People who take regular exercise tend to have fewer problems than those that do not. Going back to work early is usually not a problem especially if it is discussed with your employer first as they may be able to temporarily change your working patterns.
Remember if you avoid doing certain things in the long term to “protect” your back you are likely to create a weakness that will re—occur. People who have a positive attitude and stay active tend to get better more quickly and have less trouble later.
Above all think positively and stay active.
Source The Back Book
HMSO £1.25
This article and the Back Book are based on the Royal College of General Practitioners Clinical Guidelines for the Management of Acute Low Back Pain.