What is back pain?
Physiotherapy can help with most types of back pain, including lower back pain, ranging from severe, acute pain to low grade intermittent aching. It is usually due to the spine moving incorrectly, causing stimulation of pain-sensitive structures. We can help with back pain at our South Gosforth physiotherapy clinic.
The lumbar spine comprises five single bones (vertebrae). The bones are surrounded and supported by a complex system of muscles, ligaments, discs and nerves. Each segment of the spine is able to produce movement through gliding of the joints at the side of the vertebrae (facet joints) and centrally (intra-vertebral joints). The intra-vertebral discs sit between each bone and provide shock absorbency, dispersing load. The spinal-cord is housed in a central canal and peripheral nerves exit from the canal at the sides of each vertebral body. These nerves join together to form larger nerves, which include the sciatic nerve and femoral nerve. These nerves travel down the limbs and supply the joints, muscles, and skin.
Any of these structures can become damaged, irritated, inflamed, overstretched or strained by everyday life including:
- Sustained postures
- Heavy or repetitive movements
- Degenerative changes
Why does it happen?
Back pain can be caused by a sudden incident or injury, repetitive activities or sustained poor posture. It sometimes occurs for no apparent reason.
Who is usually affected?
60-80% of us will have back pain at some time in our life. It is the most common reason for people consulting their GP and taking time off work. Anyone can get back pain because there are many different causes.
Pain, ache, stiffness or tightness in the middle to lower back. Pain can be sharp or may be dull, diffuse and aching. It may be aggravated by movement or by rest. Sometimes pain may radiate down the leg and this may be due to irritation of the nerve. When the pain travels down the back of the leg this is often referred to as ‘sciatica’.
Physiotherapy is very effective for the treatment of back pain. Thorough assessment will help determine the structures causing the pain.
Treatment will be tailored individually and may include:
- ‘Hands- on’ specific joint movements / mobilisations
- Massage and stretching of muscles and ligaments.
- Electro-therapy - e.g. ultrasound, interferential, laser.
Simple exercises and advice on posture and activity will be given to help you return to your normal lifestyle and minimize recurrence.
What you can do yourself
- Stay active if you can. ‘Hurt’ does not necessarily mean ‘harm’.
- Take simple painkillers to help manage the pain. You may wish to consult a pharmacist or doctor on this matter.
- Stay positive. 95% of all back pain gets better.
- Use a hot or cold pack wrapped in a towel to reduce the pain and help reduce muscle tension.
It is very rare that back pain indicates a serious problem but consult your GP immediately if you have any of the following:
- Problems passing or controlling urine.
- Numbness between your legs (saddle area).
- Pins and needles, numbness or weakness in both legs
- Unsteadiness on your feet
Back Pain and Everyday Life
Back pain can occur at any time but usually responds very well to physiotherapy treatment. Repetitive or sustained activities are commonly associated with back pain. There are simple steps to minimise the risk, manage the pain and prevent recurrence.
Back Pain and Driving
Driving regularly and for prolonged periods can result in pain of the lower back, neck, legs and shoulders. Sitting places the intervertebral discs in the spine under increased pressure, especially in poorly supported sitting positions. The long nerves (eg. Sciatic nerve) can be put under strain by sustained overstretching in longer drives. It is important to try to improve posture to give support to your body and reduce back pain from driving .
There are several things you can do to minimize risk and reduce pain. Primarily, it is important to ensure you adjust your seat position to improve your driving posture and manage pain.
Here are some guidelines:
- Adjust your seat height up and forward to ensure maximum view of the road whilst allowing you to fully depress the clutch, accelerator and brake pedals.
- Adjust the seat tilt to allow the thigh to be fully supported without putting pressure behind the knee.
- Adjust the back-rest to provide continuous support along the length of the spine.
- Adjust the steering wheel for maximum comfort of reach.
- Adjust the lumbar support for continuous support with no pressure points or gaps.
- Adjust the head-rest to a comfortable position, i.e. approx. 1" away from your head.
Breaks - The Highway Code recommends a 15 minute break every 2hrs. Try to get out of the car and have a short walk.
Avoid any one posture for too long.
Physiotherapy can help with the pain of driving.
At Balmoral Physiotherapy we are able to treat the symptoms associated with back pain from sustained driving and offer expert advice on posture and exercises to minimise the risk of developing pain.
Also see our page on Trapped nerves
This information was compiled in conjunction with guidelines from the Chartered society of Physiotherapy.
Back Pain from Working on a Computer / Monitor
Sitting for long periods of time can cause pain in the lower back, upper back and neck. Sitting places the vertebral discs under pressure and sustained postures can cause joints of the spine to stiffen, which can result in back pain and neck pain. Pain may be localised, or can radiate into the leg or arm. This may be due to irritation of the nerve. (For more information on trapped nerves see our page on Trapped nerves)
What you can do:
- Take regular breaks - even if it is just to stand and have a gentle stretch.
- Ensure that your chair is positioned to offer continuous support of the spine and thigh, without pressure digging into the back of your knees.
- Ensure you can place your feet flat on the floor.
- Ensure that your keyboard and monitor are directly in front of you, not off to one side
- There should be enough room to manoeuvre your mouse without overstretching your arm
- Ensure you have the correct spectacles for reading your monitor; you may need to speak to your optician about this.
- Avoid glare on your screen, where possible
- Monitor your own posture. Regularly checking - chin in, shoulders back, tummy tight
Some workplaces will offer a workplace/ergonomic assessment to help you improve your work station.
What we can do
Our experienced Physiotherapists at Balmoral will carry out a thorough physical assessment of your spine and general posture to determine the cause of your back pain or other symptoms.
Treatment options will be discussed with you and may include: hands-on mobilisation of joints and soft tissues; electrotherapy to help the pain/spasm, massage; acupuncture; taping.
We can also advise on seating supports, posture and gentle exercises you can incorporate into your day.
Back Pain from Sport
Back pain during physical activity for sport and leisure is very common. Some activities will affect the spine more than others, but by making simple changes, it is often possible to avoid or minimise low back pain.
When running your lumbar spine will extend on the side of your forward leg. This repetitive extension of the facet joints in the lumbar spine can result in irritation of those joints, causing pain – especially if the joints are already stiff. There is also a degree of impact in running. This will be absorbed by the vertebral discs in your spine, to some extent, but this will depend upon the state of the disc. Repetitive impact will have some effect on both the discs and the joints of your lumbar spine.
Many sports require a degree of extension of the lumbar spine and therefore will have similar effects on the facet joints of the spine.
- Cricket bowling
- Jumping sports including netball / basketball/ long jump / high jump
Simple changes and Physiotherapy can help you manage your back pain from sport and leisure activity (see below).Cycling
Often, the cycling position is one of a forward (flexed) posture for the lumbar spine especially with low-slung handlebars. This can put pressure on vertebral discs as well as muscles in the lower back and legs. This position can put the muscles in a less favourable position to work efficiently, resulting in strain or muscle imbalance. Other similar effects can occur in rowing.
What you can do :
- Ensure you maintain good core stability
- Warm up/cool down
- Allow sufficient recovery time between training sessions/events
- Check that your footwear / equipment is adequate and changed regularly.
See also our page on sports injuries.
What your Physiotherapist can do about back pain during Sport
Most pain felt during sporting or leisure activities (such as tennis, football, golf, running and cycling), can be improved with Physiotherapy.
Our team of Physiotherapists and massage therapists at Balmoral Physiotherapy have vast experience of with both elite and non-elite athletes as well as general leisure activities.
Discovering the cause and nature of your back pain symptoms is the key to a successful outcome and that is where our experience counts.
Physiotherapy treatment for back pain includes many options, such as:
- Hands on treatment of stiff joints, tight muscles, and spasm.
- Massage including deep tissue massage, sports massage, cupping.
- Gentle gliding movements of the nerve structures will ensure that the nerves are mobile.
- Electrotherapy including: interferential therapy, therapeutic ultrasound and laser
- Strapping including K tape and zinc oxide.
- Advice on posture, training regime, warm up , pacing and general training programme will help you manage your training regime, whether it be for leisure or for a lead up to an event.
- We are also able to refer you on to other health professionals if this is required, including podiatry and consultant.
- Direct private MRI referral is available where required.
Degenerative Low Back Pain
Doctors often mention 'degeneration' or 'degenerative changes'. This may sound frightening but it does not mean arthritis or damage, it is just the normal changes associated with the ageing process. Degenerative changes in the spine can affect any of the structure of the spine including joint surfaces, ligaments and discs. This is general 'wear and tear' of structures which may include roughening of the joint surfaces, dehydration of the discs and decreased elasticity of ligaments. This is normal!
What you can do
- The spine is meant to move and therefore it is important to continue gently moving as much as possible.
- Try to continue as normally as possible, taking regular breaks and changing the types of activities to avoid repetition.
- AVOID resting too long – keep a balance between movement and rest.
- Take simple painkillers when necessary and,
- Use a heat pack to relieve pain and muscle tension.
What your Physiotherapist can do
At Balmoral Physiotherapy we are experts in helping you manage your back pain. Physiotherapy can relieve the symptoms of pain, inflammation, spasm and stiffness. Our therapists will assess your spine to determine the nature of the pain and will then offer treatment options to suit your needs specifically. Our Physiotherapists can help you improve your back pain and fitness, and give advice on small, simple lifestyle changes to help reduce the risk of recurrence.
Remember, back pain is rarely due to any serious disease.
Contact Balmoral Physiotherapy for help with back pain
Call: 0191 284 0087 to book an appointment with one of our experienced physiotherapists to treat your back pain at our Gosforth physiotherapy clinic.
It is important to remember that most symptoms will respond very well to Physiotherapy and that often you will be able to continue your activity at some level whilst undergoing Physiotherapy for back pain.