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YOUR PHYSIO

Long term conditions

Persisting Low Back Pain with and without sciatica

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If you are experiencing an episode of low back pain, you are not alone. It is estimated that 80 percent of people will experience back pain at some point in their lives. If your back problem is new (you've had it for less than 3 months and it isn't a recurrent problem) we would recommend using our acute back pain information page.

If your back problem has persisted for more than 3 months, again your not alone. Back pain persists in about 20 percent of cases.

It's important if you have a persistent back problem to know what to do about. The thinking about how we decide which treatment will help an individual has changed rapidly in the last few years. New national guidelines recommend that the first thing you do is complete a simple online questionairre called the STARTBACK Tool.

The point of the STARTBACK Tool is to determine how likely your back pain is to persist and what support you are likely to need to help improve your symptoms.

Before proceeding complete the tool here.

 Once you've completed the questionairre you'll be given a risk score and a recommended action.

LOW RISK- your in the right place! The information on this page has been designed to help you manage your back pain more effectively.

MEDIUM RISK- Speak to your GP about a referral to see a Physiotherapist. In the mean time use the resources on this page to understand how you can manage your own back problem most effectively.

HIGH RISK- Speak to your GP about a referral to a see a pain specialist Physiotherapist. In the mean time use the resources on this page to get a better understanding of how to manage your back problem most effectively.

What is non specific low back pain with or without sciatica?

 This short video explains the basics about chronic non specific low back pain with or without sciatica.

Low back pain refers to pain in the area of your low back, while sciatica refers to pain that may travel down your leg.

Chronic means that the pain has been going on for more than three months.

Are there any risk factors for chronic low back pain?

 

In terms of Risk factors for low back pain the main factors we are able to influence are around lifestyle. the key areas to focus on are eating healthly and maintainig a healthy weight, taking regular exercise, and if you are a smoker to get help quitting.

Our lifestyle section is filled with help and advice on these three areas and can be accessed here.

The other key area where risk's related to low back pain should be considered and managed is the workplace.

 

What treatment options are availalbe?

 

Medications

 The most recent recommendations around medications and back pain are that non-steroidal anti inflammatories (NSAIDs) should be used as the first line treatment for pain providing that you are able to take these. The common versions of this type of drug are ibuprofen and diclofenac. You should check with your GP that you are able to take these. Sometimes they will prescribe a stomach protector to take alongside them or suggest you use the gel versions of the drug. 

 

Regular exercise

Getting regular exercise is really important in managing the symptoms of your low back pain. Regular exercise can:

  • Decreased pain (usually an improvement of 2-3 points on a 0-10 scale of pain)
  • Enhance performance of work and recreational activities (strong improvement)
  • Decreased fatigue
  • Decreased number of tender points (joint and muscle pain)
  • Improve physical fitness

Current guidelines suggest that the type of exercise doesn't really matter, but that it can include:

  • Aerobic fitness
  • Biomechanical exercise (i.e. pilates)
  • Mind/Body exercise (i.e. yoga)

If you are new to exercise you might want to read our guide to exercising with persisting pain before you get going. This guide tells you what to expect when you first start exercising and how to keep flairing up your symptoms to a minimum.

To get you started here are some ideas.

Pilates

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NHS Studio: Pilates for Back Pain (Beginners)

 Yoga

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NHS Studio: Introduction to Pilates

Aerobics

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NHS Studio: Aerobics for beginners

 

Physiotherapy

Physiotherapy can also be useful in persisting Low back pain with or without sciatica. The core treatments offered in Physiotherapy are: Information session about persisting low back pain, help with activity pacing and getting more active, exercise classes for persisting low back pain.

If you would like to see a Physiotherapist, speak to your GP about a referral.

Quick links

Arthritis research UK back pain booklet

A comprehensive guide to back pain.

Arthritis research UK back exercises PDF

A simple exercise guide for low back pain.

Chartered Society of Physiotherapy Myth busters

Some common back pain myths busted.