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Managing a new episode of low back pain
Key things to know:
• Most people get better
• Your spine is strong and it is designed to move
• There are lots of self-help treatments that you can use. Further investigations are rarely needed
• There is additional help available, if you need it.
Episodes of Low Back Pain are surprisingly common. Most occurrences are usually short lived and will pass in 4-12 weeks. The best approach is to stay as active as possible. Here is our short guide to managing things in the early stages.
Why have I got Low Back Pain?
Low back pain is a very common symptom in people. It is thought that 80% of people will experience an episode in their lifetime and that at any given time about 15% of people are experiencing low back pain symptoms. There is no specific cause of low back pain. Some people will describe doing something to cause their symptoms but for most people the symptoms will come on out of the blue.
What is causing the pain?
The pain is usually related to irritation of soft tissues in your low back. There are over 100 distinct soft tissues in your low back so establishing which one is causing the problem is usually not possible or beneficial to recovery. Soft tissues follow a fairly uniform process of recovering from irritation (which usually takes 4-12 weeks) so most episodes will clear themselves up over this time.
What can I do?
The best advice is to stay active.
The Chartered Society of Physiotherapy (CSP) have put together a short video about the best advice for managing back pain:
Performing normal day to day activities as well as light cardiovascular activity such as walking are usually fine in the early stages and people often feel better after the activity.
Staying at work is good for you (in the long run). If your job involves long periods in one position or heavy lifting, you may want to speak to your employer about modified duties for a few weeks. If you are an employer and want to know more about why offering modified duties is a good idea click here.
Simple exercises can be helpful to keep your back moving and prevent stiffening up. Arthritis Research UK provide an online guide to simple exercises for low back pain that can be accessed here.
These simple movement exercises may also be useful.
Pain killers can be helpful at managing the acute pain symptoms which can allow you to remain active. Simple analgesics such as Paracetamol and Ibuprofen can be obtained over the counter at any pharmacy. We would advise speaking to the pharmacist before starting any medication to ensure that they are suitable for you.
For more severe cases, the NICE Guidelines for back pain recommend the use of Naproxin to help manage your pain. This is available on prescription from your GP.
Will it go away?
For the majority of people the symptoms will go away on their own. Physiotherapy can be helpful if symptoms aren't showing any signs of improvement after 4 weeks. You can arrange to see one of our physiotherapy team by speaking to your GP or referring yourself here.
It is thought 30% of people may experience some persisting or reoccurring symptoms. Again physiotherapy can be helpful should this be the case.
There are some lifestyle factors that have been linked to the presence of long term or recurrent low back pain. These include smoking, being over-weight, and inactivity. For more information about lifestyle and musculoskeletal health please click here.
Do I need to see a doctor?
For most episodes of new low back pain you don't need to see a doctor. However, there are some specific circumstances where medical review is indicated:
- Problems with bladder or bowel function or loss of sensation between the buttocks/around the genitals. These symptoms can indicate something called Cauda Equina Syndrome. This is pressure on the nerves in your spine that control these areas. If you have these symptoms you should attend your local emergency department for assessment.
- Weakness in the legs or feet. This can be an indication of pressure on a nerve that controls the affected area. You should arrange to see you GP for assessment on the day you notice these symptoms.
- If you have other symptoms alongside your low back pain such as weight loss, night sweats or a history of cancer you should arrange to see your GP.