What do I need to know about back pain?


Back pain is very common and will affect most of us at one time or another in our lives.

It is usually not a serious problem and can be caused by a strain on a muscle, ligament, or muscle.

It's best to carry on with your regular activities as quickly as possible and to keep moving.

Even if your back hurts, being active and doing exercise won't make it worse. You will feel better if you stay active. This can be achieved by taking painkillers.


The spine (also known as the backbone of the spinal column) is one of our strongest parts and allows us to have a lot of flexibility and strength.

It is made up of 24 bones (vertebrae), each one on top of another. These bones are supported by discs between them and strong ligaments and muscles. The bones at the bottom of your back are the tailbone, which is fused and has no discs.

Many small joints, known as the facet joints, can be found on either side of the spine. They run from top to bottom.

The vertebrae protect the spinal cord by allowing it to pass inside them.

The spinal cord connects to the brain via the base of the skull. Nerves that run through spaces between bones of the spine pass through these spaces to reach the rest of the body also connect to the brain. These nerves are also called nerve roots.

As you age, your spine structures, including the joints, discs, and ligaments, change. While the structures are strong, it is normal for your back to become stiffer with age.


Sometimes back pain is not due to one cause. It could be caused by one or more of these:

Poor posture

Lack of exercise can lead to stiffening of the spine and weakening of muscles

Muscle strains and sprains.

There are a few other conditions that can cause pain in the back, along with the ones mentioned above. Remember that severe pain does not necessarily indicate a serious condition. Below are some common conditions.


As we age, our bones, discs, and ligaments can become weaker. All of us will experience this as part of aging, but it doesn’t have to cause pain.

As we age, the discs in our spines become smaller and the space between the vertebrae becomes narrower. Osteophytes are small pieces of bone that may develop at the edges and facet joints of the vertebrae.

This medical term is called spondylosis. It is similar to the changes that osteoarthritis causes in other joints.

Spondylosis can be reduced by keeping the spine flexible and strengthening the muscles surrounding the spine and pelvis.


Sometimes back pain can be linked to pain in the legs. There may also be numbness and tingling sensations. Sciatica is the name for this condition.

This happens when a nerve in your spine is squeezed or pressed. Sciatica can cause leg pain, which is the most severe. However, some people may experience little to no back pain.

Sciatica is most often caused by a bulging disk pressing on the nerve. The discs are designed to bulge to allow us to move our spines around easily. However, sometimes a bulge can catch a nerve root and cause pain down the leg or foot.

Although most people can recover quickly, some cases may take several months.

Start the gentle exercise as soon you can to reduce sciatica. A physiotherapist is also a good idea.


Sometimes, back pain can be linked to pain in the legs. This happens after you walk for a while and then it tends to improve quickly when you sit down. This condition is called spinal stenosis.

This can occur at birth, or as we age.

Problems can be caused by something pressing on the tiny space between the spine and the nerves. This is the nerve root canal or spinal canal. It can be compressed by bone or ligament.

Both legs can feel the effects, although one leg may be more severe than the other. It is common for the pain to get worse if you rest and sit down. Some people also find that they feel less pain when they are stooped. The main problem is usually leg pain, which is similar to sciatica.

Most cases of sciatica and spinal stenosis are not serious. If you are experiencing severe pain or discomfort, you should consult your doctor to get further advice.


Other causes of back pain are rarer:

A fracture is a condition that can lead to bone problems. This condition is called osteoporosis.

An infection

A tumor

Inflammation, such as in the condition of Ankylosing Spondylitis.


It's not uncommon for back pain to be common. However, most cases can be treated without seeing a doctor.


  • It is bad
  • It lasts a long time
  • Stops you from doing what you love or working.
  • Your daily activities are affected
  • It gets worse.

If you experience changes in your sexual function (e.g., inability to erection), it is a good idea to see your doctor.

Your doctor will assess you if the pain is causing significant discomfort and preventing you from going about your normal work and personal life.

These questions will help you predict the likelihood of further treatment for your back pain. Your doctor may refer you to physiotherapy if you feel you need more support. This will allow you to get treatment quickly to reduce pain and help you return to your normal activities.

It is natural to want to find out what caused your back pain. Even after carefully assessing your back, experts may not be able to tell you what caused it.

Talking openly with your healthcare professional about your back pain is a good idea. It may be helpful to reduce your fear and speed up your recovery.


Rarely is back pain or pain down the legs a sign that there is a more serious problem.

You should immediately seek medical attention if you experience any of these symptoms:

  • Trouble controlling or passing urine
  • Loss of control over your bowels
  • Numbness in your back or around your genitals
  • A serious weakness in your legs makes it difficult to stand.
  • Chronic, severe back pain that persists for several weeks.

These symptoms could be a sign of a serious, rare condition that requires immediate medical attention.


According to national guidelines, doctors should adopt a common-sense "wait and see" approach to diagnosing back pain. This is because most back pain cases resolve themselves. This approach can be frustrating for patients, but it may prove to be a good idea.

Your GP can assess your back pain and discuss your symptoms to determine if you require further treatment. A simple exam will diagnose most problems. It's unlikely that you will need to undergo any additional tests.



  • You've suffered a back injury, such as from a fall.
  • Your doctor may suspect that there is an underlying cause of your pain
  • The pain lasted an unusually long period.

This may lead to the need for a magnetic resonance imaging scan (MRI) or computerized tomography (CT), respectively.

X-rays are less common because back pain can often be caused by soft tissue problems, such as muscles and ligaments, that cannot be seen on X-rays.

On x-rays, spondylosis may show up as changes to the spine. These are common changes that affect us all and can be seen on x-rays. X-rays can't be used to diagnose this condition.

Sometimes, even after an extensive investigation, it may not be possible to determine what is causing the back pain.


To treat back pain, it is important to continue moving and to live a healthy life.

People worry that lifting heavy objects, twisting and turning, or other activities, could make back pain worse. Remember that your spine and back are strong and designed to move.

Too much rest can make back pain worse.

Keeping active and participating in daily activities will help speed up your recovery.

Evidence also suggests that emotional responses to back pain can have a significant impact on how fast you heal. Your back will heal faster if you're positive and active.

Do not suffer in silence if you are ever experiencing difficulties. Talk to a healthcare professional.

  • Keep moving
  • Painkillers
  • Heat/ice packs
  • Posture
  • Complementary medicine
  • Correct lifting
  • Nutrition and diet
  • Pain management programmes


If you suffer from back pain, it is important to stay active.

The muscles surrounding the spine should be strong to provide support for the bones and joints. Your back will retain its natural range of motion if you move more.

You can cause back pain by not moving for long enough. Your back can become more stiff and painful if you stop moving.

Regular exercise can reduce back pain by making it less frequent and shorter. Endorphins are also released, which are the body's natural painkillers. These chemicals reduce pain and make you happier.

Although it may feel uncomfortable at first, exercise doesn't do any harm. Start slowly and increase your exercise. You can start slowly with small, regular exercises. Then each day you will increase your exercise.

You can also take painkillers before you go. Your back will become stronger and more flexible over time. This should help reduce your pain.


You'll be more likely to do the exercise you love. People with back pain can benefit from many types of exercise. Examples include:

  • Swimming
  • Walking
  • Yoga
  • Pilates
  • Going to the gym.

A 12-week program of yoga designed specifically for low back pain has been shown to help patients live more active lives and manage their condition better. The study found that many participants could recognize signs and prevent future episodes of back pain.

If you are interested in learning yoga, many places offer them. Before you begin, make sure to speak with the instructor about your back pain.

On the back page, you will find examples of exercises that can help reduce pain.


When you exercise, you may feel discomfort or pain. It is normal to feel some discomfort and sometimes pain after exercising. This should resolve within a few minutes. This is not an indication that you are hurting yourself. You can reduce your pain by exercising and helping manage your back pain.

You can push yourself to do hard exercise but not overdo it. You should consult a doctor if you experience pain during or after exercise. Start slowly and gradually increase your activity.

Many people quit exercising after their back pain is gone. If you stop exercising, all of the gains you have made in your back health will be lost. You must keep exercising even if you feel better.

For tailored advice on exercise, it's a good idea for anyone who is having trouble exercising to visit a GP. Personal trainers may be available at your gym if you need expert advice. Tell them everything about you.


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People with back pain can benefit from taking painkillers, being active, and doing specific exercises. Some people may need additional medical attention.

  • Therapies
  • Drugs
  • Surgery



Physiotherapy can help you increase your flexibility and strength. The best treatment for back pain is exercise. A physiotherapist will be able to oversee your exercise program and suggest exercises that can be helpful.

Manual therapies, also known as 'hands-on' treatments, include manipulation and mobilization, of the spinal joints. They can be combined with exercises to relieve back pain. Manual therapy is usually performed by osteopaths and chiropractors.

These therapies may not be appropriate for everyone. If you are considering trying these therapies, talk to your doctor. Also, tell the therapist about any medical conditions you may have.


Occupational therapy may be helpful if your back pain is making it difficult to do everyday activities like dressing, washing, and driving. You may be offered alternative ways to relieve the strain, or they might recommend gadgets or aids that can help. You shouldn't rely on gadgets or aids to help you get back to your normal activities.

Learn more about Occupational Therapy.


People can feel depressed if they have back pain that lasts for a while. Talking to someone, such as a friend, relative, or doctor, can help you feel better. Talking therapies are helpful.

Cognitive behavior therapy (CBT), for example, can be used to treat back pain. It helps people deal with their problems in a more positive manner by breaking them down into smaller pieces. You might be referred by your doctor for CBT. Or you may want to go private.

It is important to stay active socially and physically to help with anxiety and low mood. You might find it helpful to join a local leisure club, sports club, walking or gardening group, or simply go out with friends for coffee every now and again.


Most people suffering from back pain will find it helpful to return to work sooner than expected.

You will be able to reduce your back pain by staying active and moving your back muscles. You'll feel happier about yourself, as it will make you feel better.

People used to be advised to stay in bed. However, we now know that this is a mistake. It's better to move, even if it means taking some painkillers.

Most people return to work within 2 days. However, some people can take longer depending on their job.

It doesn't mean that you have to wait for your back problem to resolve completely. You will find that the longer you stay off work, the more likely your back problems are.


Keep in touch with your employer to discuss how you can return to work. You may be required to work fewer hours if your job involves lifting heavy objects or other physically demanding tasks.

An occupational health advisor can help you stay on track and help you cope with your job by advising you what work you're able to do.


The Government's Access To Work scheme may be able to assist you if you have difficulty getting to work or need equipment.

Talk to your doctor and your employer if you are unable to return to work after two weeks' absence due to back pain.

Further assistance can be obtained through your local Employment Centre Plus or the Government's Fit For Work guidance.


Our research has contributed to improving the management of lower back pain. STarT Back Tool was developed by researchers at Keele's primary care center. This tool is used to assist clinicians in deciding the best treatment for lower back pain patients.

This focused approach to treatment has been proven to reduce patient-reported disability, fewer days off work, and significantly lower costs for the NHS as well as the wider society. Organizations such as the Royal College of General Practitioners (NICE) recommend the STarT back Tool for low back pain. It has been used by many services in the UK and around the world.

We support research to determine why people with spondylosis of the lower spine experience a lot of pain while others feel little or no pain. The study will compare the movement and function of people with low back pain and those without it. The results will allow physiotherapists and other healthcare professionals to better serve patients.

We are also studying the role of genes in causing back pain. Our researchers are examining bony lumps that can be caused by spondylosis, also known as osteophytes. They will examine the nerve pressure they can cause. To study the causes of spinal osteoarthritis in zebrafish, we use them as models. Because of the surprising similarities between their anatomy and that of the human spine, zebrafish make excellent models.

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