Back Pain

Back pain can be caused by many different things, but these things aren’t always obvious. It can also not have a specific cause. Back pain can often get better on its own and it can be categorised into groups depending on the cause.

Mechanical or structural 

Mechanical problems can cause back pain. This can involve the spine, discs, muscles, ligaments, tendons or nerves. Some of these include:

•A sprain – an injury to the ligaments that support the spine

•A strain – an injury to a muscle or tendon

•Degenerative disc disease – ageing can cause the discs between the spine to slowly break down, it’s often associated with arthritis or spinal stenosis

•Herniated discs – an event can compress the discs between the spine and this can irritate nearby nerves 

•Spondylolisthesis – this is when one of the bones in your spine (called a vertebra) slips out of place 

•Spinal stenosis – this is a narrowing of the spinal canal that can put pressure on the nerves and spinal cord

•Fractured vertebrae

•Scoliosis – a congenital condition affecting the spine

Inflammation 
•Ankylosing spondylitis – a type of arthritis of the spine 

•Other types of inflammatory arthritis of the spine

Other medical conditions

•Osteoporosis – a health condition that can weaken the bones 

•Fibromyalgia – a long-term condition that causes muscle pain and fatigue and often affects the whole body

•Kidney stones or infections 

•Endometriosis – a condition where tissue that’s similar to the womb lining starts to grow in other places in the body 

•Infections of the bones of the spine or the discs between the bones

•Pregnancy

•Tumours (in rare cases)

Treatment for back pain depends on the cause. In some cases, treating the cause of the pain can help reduce the discomfort. Some back pain can also improve on its own in a few weeks, but there are things you can do to help with recovery. These include:

• Staying active if possible 

• Trying to continue with your everyday activities if possible 

• Using an ice pack wrapped in a tea towel to help reduce any swelling or pain

• Using a heat pack or a hot water bottle wrapped in a tea towel to help relieve muscle spasms or stiffness in your joints

• Trying to do some exercises and stretches that can help with back pain

• Trying to avoid lying down or sitting down for long periods of time. If you work from home and you find you find that you’re struggling with your posture, take a look at our article for advice

• Consider an anti-inflammatory medicine like ibuprofen if it’s suitable for you. Any type of ibuprofen (tablets, capsules, or liquid) needs to be taken with a snack or meal so that it’s less likely to upset your stomach 

Exercises & stretches

There are exercises and stretches that can help with back pain, but if your pain gets worse doing any of these, make sure to stop and see your GP for advice. Walking, swimming, pilates and yoga may also help with easing back pain. Although back pain can get better on its own, it’s a good idea to speak to your GP if the pain gets worse or becomes severe, doesn’t improve in a few weeks or if you’re worried. 

TENS machines
Transcutaneous electrical nerve stimulation (TENS) is a method of pain relief which uses a mild electrical current. A TENS machine is powered by batteries and is connected to pads called electrodes. The pads are attached directly to your skin and when the machine is turned on, it sends small electrical impulses to the affected area of your body – this might feel tingly.

If you’d like to try TENS, it’s a good idea to speak to your GP. Although TENS machines can be bought, it’s important to have an assessment with your GP to find out if it’s appropriate for you and to learn how to use TENS properly. TENS can only provide temporary pain relief from minor pain. 

TENS isn’t safe for everyone. Don’t use one without speaking to your doctor if:

•You have a pacemaker or another type of electrical or metal implant in your body

•You’re pregnant or there’s a chance you might be pregnant (TENS may not be recommended early in pregnancy )

•You have epilepsy or a heart problem

•You have an overactive bladder

Pain clinics 

If you’re struggling to manage your pain, you can ask your GP to refer you to a specialist pain clinic. Pain clinics aim to support you with a range of treatments and support including developing self-help skills which can help you to control your pain.

Some people who are receiving treatment at a pain clinic may be offered a pain management programme (PMP).

The aim of a pain management programme isn’t to reduce your pain, it’s to help improve your quality of life. The sessions can include:

•Relaxation and mindfulness

•Gentle exercise

•Tips on how to manage any emotions that are linked to your pain

•Group discussion

•Tips on pacing yourself and setting goals  

Leva Specialist Pain Clinic¹ is a private service that can be accessed through Boots Health Hub. The online clinic offers specialist, real-time appointments with experts. The Leva Clinic can also create a pain management plan which is tailored to your needs. 

Leva Pain Management Programme¹ is also a private service designed for people aged 18 years and over who have been experiencing pain for longer than three months which can be accessed through Boots Health Hub. It’s an online self-guided 12-step journey which has been designed by pain experts. It can help with teaching you ways to manage chronic pain. You may also choose to access a Circle Health Group private specialist Orthopaedic Consultant for face-to-face assessment and, if appropriate, treatment¹.

If your back pain isn’t caused by an underlying condition there are some measures you can take that aim to reduce your chance of having back pain.

Lifting correctly
You should avoid lifting heavy objects where possible, however, if you do have to lift things, you should:
•Place your feet shoulder width apart

•Keep your back straight

•Bend your hips and knees (make sure to keep your arms and the object you’re lifting close to your body) 

•Lift the object by straightening your legs 

Standing correctly
Having good posture is important to help prevent back pain. You should be standing upright and tucking in your bottom and abdomen.

Improving your posture
Stooping can affect your posture, so to help prevent back pain, try to avoid stooping. When you’re standing up, your work surface should be level with your hip. You can learn more about improving your posture in our guide to good posture.

Sleeping 
Make sure to sleep on a bed that has a firm base. When getting out of bed, follow these steps:

•Roll onto your side

•Bend your knees

•Swing both of your legs together over the edge of the bed 

•Push up on your elbow 

Sitting correctly 
Sitting with your back straight can help prevent back pain. Your back and thighs should be supported properly.

Doing regular exercise
Continuing to exercise and keeping fit can help to strengthen your back and abdominal muscles. Exercising can also keep your spine from getting stiff. Exercising in water can reduce the strain on your joints,  so if you’re able to exercise, swimming is a good choice.

Relaxing 
Pain can cause tension which can increase pain. When you’re relaxed, you’re more likely to be less tense, which can reduce pain. There are many types of relaxation techniques, from breathing exercises to meditation. 

Sciatica happens when the sciatic nerve becomes irritated or compressed. Your sciatic nerve runs from your lower back to your feet. Sciatica is a common cause of back pain for people in the UK.

Sciatica can get better in four to six weeks, but it can last for longer than this. If you have sciatica, you might have the following symptoms:

•A stabbing, burning, or shooting pain in the back of your leg, foot, toes and bottom

•Tingling like pins and needles in the back of your leg, foot, toes and bottom

•Numbness in the back of your leg, foot, toes and bottom 

•Weakness in the back of your leg, foot, toes and bottom 

These symptoms might feel worse when you’re moving, coughing or sneezing. Some people also have back pain, but this is usually not as bad as the pain in the back of your leg, foot, toes and bottom. If you only have back pain, it’s probably not sciatica. If you think you have sciatica, take a look at our article which delves into treating and preventing sciatica, as well as advice on when to speak to your GP. 

A slipped disc happens when a soft cushion of tissue between the bones in your spine pushes out. You might also hear it being called a bulging disc. This can be painful if it presses on nerves. This pain can get better slowly with gentle exercise, resting and taking pain relief if it’s suitable for you.

Having a slipped disc can cause the following symptoms:

•Lower back pain

•Tingling or feeling numb in your shoulders, back, hands, arms, legs, or feet

•Pain in your neck

•Discomfort when bending or straightening your back

•Muscle weakness

•Pain in your bottom, legs or hip, if the disc presses on the sciatic nerve (this is called sciatica)

Having a slipped disc doesn’t always cause symptoms, so many people won’t know if they have a slipped disc.

Easing the pain from a slipped disc

There are some steps you can take to ease the pain from a slipped disc and help improve your quality of life.

Staying active
If your pain is very bad, you might need to rest at first, but if you’re able to, gentle exercise can help you get better faster. The type of exercise you do isn’t important, what is important is to gently increase your activity level.

Taking pain relief 

Pain relief like ibuprofen and paracetamol (if suitable for you) can help with back pain. Paracetamol on its own isn’t recommended for back pain. Taking pain relief regularly by following the dosage on the packet can help you keep moving in the short term but shouldn’t be taken for longer than a few days without speaking to a GP first.

Speaking to your pharmacist
Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen aren’t suitable for everyone. If you aren’t sure if you can take ibuprofen, have a medical condition, are taking any other medicines, or are pregnant or breastfeeding, speak to your pharmacist for advice.

Your GP will usually know if you have a slipped disc from your description of the symptoms. They may give you a physical examination to confirm if it’s a slipped disc.

Treating a slipped disc
Your GP might prescribe a strong pain relief medicine, steroid injection or muscle relaxant to help ease your pain in the short term. If your symptoms don’t improve, they might suggest further tests like an MRI scan to investigate. 

Your GP might also refer you to a physiotherapist. Physiotherapy can be accessed through the NHS or privately, for example through Boots Health Hub. PhysioFast Online Virtual Physiotherapy¹ is a private service which offers access to online appointments with a physiotherapist skilled in assessing, diagnosing and treatment.

Preventing a slipped disc

To help prevent a slipped disc, you should:

•Stay active and keep doing regular exercise if you can

•Use a safe technique when lifting heavy objects 

•Stop smoking if you do smoke, as nicotine can weaken the disc tissue

Osteoporosis is a health condition that weakens bones. This can make them more fragile and more likely to break. Osteoporosis develops slowly over several years and is often only diagnosed if you have a fall which makes a  bone break.

Common injuries in people with osteoporosis can include:

•Broken spinal bones (vertebrae) – this can cause back pain

•A broken wrist

•A broken hip (hip fracture)

Osteoporosis doesn’t usually cause any pain until a bone breaks, but having a broken bone in your spine can be a common cause of long-term pain. A broken bone is often the first sign of osteoporosis, but some older people develop a bend forward (a stooped posture). This happens if the bones in the spine have broken, which makes it harder to support the weight of the body.

Losing bone density is normal as you grow older, but some people lose bone density at a faster rate. This can lead to osteoporosis and an increased risk of having broken bones. Osteoporosis can affect anyone, but going through menopause can increase the risk of osteoporosis.

Caring for your back with osteoporosis 

Most people who have osteoporosis are unlikely to experience a spinal fracture while they’re exercising. To reduce your risk of having spinal fractures, make sure to keep your back straight and use safe techniques for moving and lifting safely. You can learn more about moving and lifting safely in the “Preventing back pain” section of the page.