Back pain is common.
Back discomfort is common and is usually not associated with a serious disease or problem.
Very few people with backache have a “slipped disc” or “pinched nerve”. Even if this is the cause of your pain, 90% of people experience spontaneous relief of their symptoms within six to twelve weeks.
Eighty percent of the population will experience a significant episode of back pain at some time in their life.
Most back pain settles quickly, at least enough to enable you to get on with your normal life and activities.
About half of those who suffer back pain will have it again within a couple of years but this still does not mean there is a serious cause of these symptoms.
If discomfort is significant you may need to reduce or modify the way you go about some of your activities.
Resting for more than a day or two will not reduce your period of incapacity, and may in fact delay the onset of relief and restoration of function.
People who cope best, are those who stay active and get on with their life despite their discomfort. This will however often require you to modify the way certain activities are preformed.
Most of the changes evident on x-ray are normal, age related or degenerative changes and may not be related to the cause of an acute episode of pain.
In a lot of cases, the exact cause of an episode of pain will not be identified, which you may find frustrating, but be reassured that it is extremely rare for there to be a serious cause of these symptoms.
Most back pain comes from irritation or minor damage to muscles, ligaments and joints in your back. Pain may also develop because the muscles in and around your back are out of condition. The aim of initial treatment is to get your back working properly again.
People who are physically fit generally suffer less back pain, and recover from episodes of pain more rapidly.
In the past rest was considered the best way to treat an acute back injury, however we now know that bed rest for more than one or two days, actually delays recovery and retards progress.
Bed rest results in the loss of condition of your bones and muscles. You also lose joint mobility and your physical fitness deteriorates quite rapidly. You may also become depressed as a result of your inactivity which makes it harder for you to become motivated to resume activity.
Exercise is good for you!
You should however obtain advice about the type of exercise that is appropriate. A description of several simple exercises that can form a part of your rehabilitation program, are contained in “Essential Exercises” .
Walking, swimming and using an exercise bike are also useful ways to improve your fitness. You should however seek advice about the use of such activities in your particular case from your physiotherapist or local doctor.
When you start to exercise you will need to build up your activities gradually over several days or weeks. Different exercises suit different people. If what you are doing aggravates your symptoms try alternative activities but develop a routine of exercise which you perform every day for at least 10 to 15 minutes.
Athletes know they will experience muscle aches when they start training, perform activities or take part in sports they have not done for some time. This is normal and does not mean you are doing damage.
Pain experienced during an exercise may indicate you are performing the exercise incorrectly or that the exercise is not suited to you. In this case seek advice from your physiotherapist or local doctor.
Discomfort experienced after activity does not indicate harm but may indicate you need to back off slightly and build up activity a little more slowly.
Do not cease activity if you have this sort of discomfort but continue your routine of activity at a reduced level of intensity.
Nobody believes exercising is easy and we accept that maintaining this routine of exercise will be difficult at times, but it is the effort you invest in these activities that will determine your outcome and the speed of your recovery.
When you have pain there are many treatments you can try to help relieve your symptoms and enable resumption of your normal activities. These treatments may not remove your pain completely but should control it enough to help you get active.
Treatments of this type help you control your pain but do not “cure” your back. That is up to you, and is dependant on the effort you invest in your exercise and rehabilitation activities.
Pain killers such as Paracetamol or soluble Aspirin are the simplest and safest pain killers. These types of analgesics are also often the most effective in relieving symptoms.
You should usually take two tablets every 4-6 hours and should do so regularly in the first instance to control your pain. You should not wait until your pain is out of control to use this type of medication.
It is better to take this type of analgesia and remain active than to go without and be unable to resume your normal activities.
The use of anti-inflammatory medication may also help you control your symptoms.
With an acute injury (i.e. within 12 hours of the onset of pain) the use of a cold pack may help relieve symptoms. This helps reduce initial inflammation. Beyond this the use of heat, ultrasound or interferential may help the healing process but is unlikely to result in further benefit if there has been no response or improvement within a week. The use of these modalities for more chronic symptoms (i.e. more than six to eight weeks) is unlikely to alter the natural history of your problem.
People who have chronic (long term) pain may benefit from short courses of this type of treatment to help them get over acute exacerbations of pain, but if there is no sustained benefit evident after four to six weeks, it is unlikely to help to any significant degree beyond this period.
When returning to activity the basic idea is not to stay in one position, or do any one thing for more than 20 to 30 minutes at a time without a break. Then try to do a little more, move faster and further every day.