Back pain is one of the most common complaints I come across in the clinic. In Physiotherapy and among health professionals back pain is frequently either mechanical or nerve and normally resolves with advice, education, simple exercise and manual therapy if indicated. In this post, we advise the best ways to get back pain relief by identifying the type of pain and best course of action. A full assessment would be required to recommend the best Physiotherapy exercises for back pain.
What type of back pain are you experiencing?
Mechanical pain is when your back is a little stiff and the muscles are tight around it. Patients generally describe their pain as an ache that is worse when sedentary, improves with movement and does not refer into their legs or buttocks.
Pain like this commonly happens due to inactivity and lack of stretching and exercise, which can easily build up over time from sedentary jobs, for example sitting at a desk, and can be worsened by remaining sedentary again out of working hours. Mechanical pain can also occur in individuals who make repetitive movements such as twisting, bending and lifting for long periods with minimal rest.
Mechanical pain can also cause the back to go into spasm whereby the muscles in your back tighten involuntarily often whilst performing minor movements such as turning in bed, bending down to pick up a newspaper or stepping off a footpath. The muscles constrict and refuse to elongate (lengthen) which can commonly affect posture and result in leaning off to one side. When this occurs it can be quite painful to move even the slightest little bit, however, it is important to keep moving, as will be explained later.
Nerve pain can appear anywhere in the body, not just in the back. If nerve pain occurs in the lower back, symptoms may appear in the buttocks and travel down into the leg even as far as the foot; this is usually on one side only. This can be accompanied by a feeling of “pins and needles”, tingling and numbness and/or sharp shooting pain. The pain is normally intermittent, worse when sitting or when sedentary, as this is a position that puts the most pressure on the lower back. This type of pain can be commonly referred to as sciatica by the general population. These symptoms are nothing to be worried about don’t indicate anything serious or sinister. Again, the key is to move, keep active and remain positive.
How to treat back pain
Whether back pain is mechanical, spasm or neural the best course of action to resolve pain is always movement. Gentle back exercises that have been prescribed by a Chartered Physiotherapist will help relieve back pain and start you on the road to recovery. A Physiotherapist is best placed to assess back pain thoroughly and will be able to provide reassurance, putting the mind at rest and advising how to move the back if it’s safe to do so. This level of reassurance is often the best first step in a recovery plan to ensure the patient does not have a fear of moving and understands that movement is required and avoiding this will make the back pain worse and pro-long the symptoms. As the brain is reassured it will send fewer signals to the ‘painful area’ in the back and pain will begin to reduce.
Top tips for back pain relief
- Avoid sitting any longer than 20 minutes at a time. Get up and move, stand, walk about, change position regularly throughout the day
- Try positions of comfort such as lying on your back with your knees bent up or lying on your front with a pillow under your stomach. Again move every 20 minutes and change position
- Take pain relief, provided it’s safe to do so (always check with your pharmacist or GP). This can help reduce the pain and will make it easier for you to move more
- Keep active. If you can tolerate it, go for a short walk, even if it’s only a few minutes, this could be done a couple of times a day and gradually built up over time
- Don’t avoid moving your back. Move in your own pain-free range. A little movement is better than no movement at all
- Use heat on the area for 10-15 minutes. The temperature should be comfortable not hot. Some prefer ice which is also an effective method of pain relief
- If symptoms have not improved after a couple of days, booking in with a Chartered Physiotherapist for further treatment and a full assessment would be advisable (book your appointment with Next Level Physiotherapy here).
Warning signs to look out for with back pain
If you experience any of the below signs or symptoms whilst suffering back pain, it is best to make an appointment with a health professional as soon as possible:
- Pins and needles and numbness radiating down both legs
- Bladder retention or lack of control over your bowel movements
- Pins and needles and numbness in and around the groin and buttocks region on both sides in the distribution of a saddle
- An increase in pain when you lie on your back
- Lack of control over legs and feet tripping and stumbling
- Unexplained weight loss of more than 1 stone over a three to six month period
Back pain can be complex, but all the evidence points towards exercise and movement as being the gold standard for back pain treatment and pain relief. Movement is good and should be encouraged but start small and gradually build up. As I always tell my patients, there is no magic fix and it is generally a combination of advice, education, keeping active, exercises and manual therapy to get back on the road to recovery and back to a normal routine. For more information and further tips on back pain visit the ISCP website. For an assessment and further advice, make an appointment now through our contact form or call 087 184 9464.