Types Of Back Pain

Neck Pain

Neck pain refers to any pain experienced in the area from the base of the skull to the shoulders and can spread to your upper back or arms.

This can include feelings of stiffness or tightness, as well as sharp pain and, in severe cases, can reduce the movement of the neck and head. Neck pain can also cause tension headaches.

Most muscles in the body will relax completely when they are not being used, but the muscles in the neck are permanently tensed in order to support the head. Although most common in people over 50, neck pain can develop at any age as the result of excess strain on the neck. This could include slouching, sleeping in an awkward position or working at a computer for long periods of time without a break.

Neck pain can also develop as the result of an accident. Perhaps the best known is whiplash; an injury sustained as a result of the head being thrown forward and back in a car accident.

Neck pain is rarely the result of a serious injury and will often lessen after a few days. If you are suffering from neck pain, try to keep moving and maintain your normal routine as best you can. Over-the-counter painkillers may also help.


Upper And Middle Back Pain

The upper and middle back refers to the section of vertebrae, known as the thoracic vertebrae, which runs from the base of the neck to the bottom of your ribcage. This type of back pain is less common than neck or lower back pain as the bones in this area are not required to move and flex as much.

Like many other types of back pain, upper and middle back pain can range from aching and stiffness to a sharp or burning sensation. Pain in this area is often the result of pinched nerves in the spine by the ribs.

One cause of back pain in this area is poor posture. Try to keep your back as straight as possible and balance your weight evenly on both feet. When sitting, keep your shoulders rolled back and be sure to adopt suitable positions when driving, sitting or using computers.

For more advice on ways you can protect your back, see the 'preventing back pain' section of this guide.

Lower Back Pain

This is the commonest type of back pain with around 8 out of 10 people affected at some time in their lives. The lower back is defined as the area between the bottom of the ribcage and the top of the legs. Symptoms range from tension and stiffness to pain and soreness.

Most people's back pain is described as non-specific, meaning it is caused by structures in the back as opposed to rare conditions such as cancer or a fracture.

The back is a delicate area of muscles, nerves, bones and joints and is continuously working hard to support the weight of the upper body. Lower back pain is often triggered by everyday activities such as bending awkwardly, lifting incorrectly, standing for long periods of time, slouching when sitting and driving for long periods without taking breaks.

The 'preventing back pain' section of this guide has advice on guarding against these common causes of back pain and includes tips on lifting correctly, sitting properly, using computers and avoiding back pain caused by driving.

Buttocks And Legs (Sciatica)

Sciatica is pain caused by irritation or compression of the sciatic nerve. The sciatic nerve is the longest nerve in your body and runs from the back of your pelvis, through your buttocks, and all the way down both legs, ending at your feet.

When something compresses or irritates the sciatic nerve, it can cause a pain that radiates out from your lower back and travels down your leg to your calf. This can be mild to very painful.

The most common cause of sciatica is a slipped disc. This occurs when one of the discs that sit between and cushion the vertebrae is ruptured. Most cases of sciatica will pass without the need for treatment. A combination of the self-help measures described in this guide such as over-the-counter painkillers, exercise and hot or cold packs can usually relieve the symptoms.

For persistent sciatica, you may be advised to try a structured exercise programme under the supervision of a physiotherapist. In rare cases, surgery may be needed to control the symptoms.

Urgent (Red Flag Symptoms)

Most cases of back pain will usually get better without medical help. However, there are a number of warning signs, known as 'red flags', which may indicate that your back pain is serious.

These red flag signs include:

·         A high temperature (fever) of 38C (100F) or above
·         Unexplained weight loss
·         Constant back pain that does not ease after lying down or resting
·         Pain that travels to your chest or that is high up in your back
·         Pain down your legs and below the knees
·         A recent trauma or injury to your back
·         Loss of bladder control
·         Inability to pass urine
·         Loss of bowel control
·         Numbness around your genitals, buttocks or back passage

If you have any of the signs or symptoms listed above, contact your GP immediately. If this is not possible, you can telephone NHS Direct on 0845 4647.

You should also seek medical advice if you are having back pain and:

·         You are under 20 or over 55 years old
·         You have taken steroids for a few months
·         You misuse drugs
·         You have or have had cancer
·         You have a weakened immune system as a result of chemotherapy treatment or a medical condition such as HIV or AIDS

Also contact your GP if your symptoms fail to improve within three days or you have persistent pain that lasts longer than six weeks.

Preventing Back Pain

To avoid back pain, you must reduce excess stresses and strains on your back and ensure that your back is strong and supple.
If you have recurring bouts of back pain, the following advice may be useful:


Lose Any Excess Weight

You can use the body mass index (BMI) healthy weight calculator to find out whether you are a healthy weight for your height.
Wear flat shoes with cushioned soles, as these can reduce the stress on your back.
Avoid sudden movements or muscle strain.
Try to reduce any stress, anxiety and tension.

Posture

How you sit, stand and lie down can have an important effect on your back. The following tips should help you maintain a good posture.

Standing

Stand upright, with your head facing forward and your back straight. Balance your weight evenly on both feet and keep your legs straight.

Sitting

You should be able sit upright with support in the small of your back. Your knees and hips should be level and your feet should be flat on the floor (use a footstool if necessary). Some people find it useful to use a small cushion or rolled-up towel to support the small of the back.

If you use a keyboard, make sure that your forearms are horizontal and your elbows are at right angles.

Driving

Make sure that your lower back is properly supported. Correctly positioning your wing mirrors will prevent you from having to twist around. Foot controls should be squarely in front of your feet. If driving long distances, take regular breaks so that you can stretch your legs.

Sleeping

Your mattress should be firm enough to support your body while supporting the weight of your shoulders and buttocks, keeping your spine straight. If your mattress is too soft, place a firm board – ideally 2cm thick – on top of the base of your bed and under the mattress. Support your head with a pillow, but make sure that your neck is not forced up at a steep angle.

Exercise

Exercise is both an excellent way of preventing back pain and reducing any back pain you might have. However, if you have chronic back pain (back pain that has lasted more than three months), consult your GP before starting any exercise programme.
Exercises, such as walking or swimming, strengthen the muscles that support your back without putting any strain on it or subjecting it to a sudden jolt.
Activities such as yoga or pilates can improve the flexibility and the strength of your back muscles. It is important that you carry out these activities under the guidance of a properly qualified instructor.
There are also a number of simple exercises you can do in your own home to help prevent or relieve back pain.

Wall Slides: stand with your back against a wall with your feet shoulder-width apart. Slide down into a crouch so that your knees are bent to about 90 degrees. Count to five, then slide back up the wall. Repeat five times.

Leg Raises: lie flat on your back on the floor. Lift each heel in turn just off the floor while keeping your legs straight. Repeat five times.

Bottom Lifts: lie flat on your back on the floor. Bend your knees so that your feet are flat on the floor. Then lift your bottom in the air by tightening your stomach muscles while keeping your back straight. Repeat five times.

At first, do these exercises once or twice a day, then gradually increase to six times a day, as your back allows.
These exercises are also useful for 'warming up' your back. Many people injure their back when doing everyday chores at home or work, such as lifting, gardening or using a vacuum cleaner. 'Warming up' your back before you start these chores can help to prevent injury.

Read Here for more information and advice about Exercises for back pain.


Lifting And Handling

One of the biggest causes of back injury, especially at work, is lifting or handling objects incorrectly. Learning and following the correct method for lifting and handling objects can help to prevent back pain.
Think before you lift: can you manage the lift? Are there any handling aids you can use? Where is the load going?

Start In A Good Position: your feet should be apart, with one leg slightly forward to maintain balance. When lifting, let your legs take the strain – bend your back, knees and hips slightly, but do not stoop or squat.
Tighten your stomach muscles to pull your pelvis in.
Do not straighten your legs before lifting as you may strain your back on the way up.

Keep the load close to your waist: keep the load as close to your body for as long as possible with the heaviest end nearest to you.

Avoid twisting your back or leaning sideways, especially when your back is bent. Your shoulders should be level and facing in the same direction as your hips. Turning by moving your feet is better than lifting and twisting at the same time.

Keep Your Head Up: once you have the load secure, look ahead, not down at the load.
Know your limits: there is a big difference between what you can lift and what you can safely lift. If in doubt, get help.

Push Rather Than Pull: if you have to move a heavy object across the floor, it is better to push it rather than pull it.

Distribute The Weight Evenly: if you are carrying shopping bags or luggage, try to distribute the weight evenly on both sides of your body.