Back problems

Most back problems start for no obvious reason, which can be very frustrating. The spine is strong and back problems are rarely due to any serious disease or damage.

Back problems can cause a range of symptoms, including:

• stiffness
• muscle spasms
• hot, burning, shooting or stabbing pains in your back and sometimes into one or both of your legs
• pins and needles due to nerve irritation

In many cases, new or flare-up of long-standing back problems should begin to settle within 6 weeks without the need to see a healthcare professional.

For most back pain problems, you'll not normally need an X-ray or MRI scan.

When to seek help

Speak to a healthcare professional as soon as possible if you:

• feel generally unwell
• have back pain that starts when you're ill with other problems - such as rheumatoid arthritis or cancer
• feel unsteady when you walk

Cauda equina syndrome

Cauda equina syndrome is a rare but serious back condition which can lead to permanent damage or disability. If you develop this condition you'll need to be seen by an emergency specialist spinal team.

Phone 111 or attend your local A&E as soon as possible if you have:

• difficulty passing or controlling urine
• numbness or altered feeling around your back passage or genitals - for example when wiping after toileting
• pins and needles around your back passage or genitals - for example when wiping after toileting
• sudden or newly worsening leg pain which extends below the knee in both legs
• new-onset difficulty controlling bowel incontinence

What causes back problems?

Although most back problems start for no obvious reason, back pain can be caused by:

• staying in one position too long
• lifting something awkwardly
• a flare-up of an existing problem

Can this cause problems anywhere else?

Your back problem may cause hot, burning, shooting, or stabbing pains into one or both of your legs. You may also get pins and needles - this can be due to nerve irritation.

Self-help

Keeping active is an essential part of your treatment and recovery and is the single best thing you can do for your health. Exercising can really help your back and reduce the pain you feel.

Being physically active can:

• maintain your current levels of fitness – even if you have to modify what you normally do, any activity is better than none
• keep your other muscles and joints strong and flexible
• prevent a recurrence of the problem
• help you aim for a healthy body weight

Try not to:

• brace or hold yourself still - your back is designed to be mobile
• sit down or rest for too long - resting in bed doesn't help back pain, and often makes it harder to get going again

If you have to sit or rest, try to change positions regularly and find one that reduces any pain in your back or legs.

Exercises to help with back pain

Pain treatments

The following can help to reduce the pain:

• Pain medication - this can help you move more comfortably, which can help your recovery
• Heat or ice packs
• TENS machine - this is a small battery-operated machine that stimulates the skin to help reduce the level of pain you feel

You can buy a TENS machine online or from a local pharmacy.

Speak to your community pharmacist or other healthcare professional about taking medication. It's important to take medication regularly.

More about taking painkillers

Stay positive

It’s easy to start worrying about all the possible things that could be wrong, but research has shown that most back pain settles with time.

Keeping as active as possible helps you to cope better and recover more quickly.

Consider your posture

Although your posture doesn’t need to be perfect, resting in poor positions can affect your back problem. Try and move often so you don't get stuck in a poor position for long.

Work

It's recommended you stay at or return to work as quickly as possible during your recovery. You don't need to be pain and symptom-free to return to work.

Help and support

If, after following our advice, your back problem hasn't improved within 6 weeks a referral to a physiotherapist may be of benefit.

If available in your health board area, the Musculoskeletal (MSK) Helpline can refer you to a healthcare professional if you need it.