Back pain is a prevalent issue that can be caused by various factors, ranging from simple muscle strain to more serious underlying conditions. Here are some common causes and treatments for back pain:

Causes:

1. Muscle Strain: One of the most common causes of back pain is muscle strain or sprain, often due to improper lifting, sudden movements, or poor posture over time.

2. Poor Posture: Sitting or standing for prolonged periods with improper posture can put strain on the muscles and ligaments in the back, leading to discomfort and pain.

3. Herniated Disc: A herniated or slipped disc occurs when the soft inner core of a spinal disc protrudes through the tougher outer layer, putting pressure on nearby nerves and causing pain.

4. Degenerative Disc Disease: With age, the discs between the vertebrae in the spine can wear down, leading to pain, stiffness, and reduced mobility.

5. Spinal Stenosis: This condition involves the narrowing of the spinal canal, which can put pressure on the spinal cord and nerves, resulting in back pain and leg pain, especially when walking or standing.

6. Lesions or Tumours: Spinal tumours can occur anywhere on or in the spinal column. They are a mass of abnormal cells and can be cancerous or non-cancerous.

Treatments:

1. Rest and Activity Modification: Resting the back and avoiding activities that worsen the pain can help alleviate symptoms initially. However, it's important to gradually return to normal activities and incorporate gentle exercises to improve flexibility and strength.

2. Physical Therapy: A physical therapist can provide tailored exercises and techniques to strengthen the muscles supporting the spine, improve posture, and alleviate pain.

3. Osteopaths/Chiropractors: Osteopathy and Chiropractic care offer similar treatments. Osteopathy involves care for muscles and manipulation, while chiropractors carry out manipulation or ‘adjustments only’. These treatments can be effective for patients.

4. Acupuncture: Acupuncture may be carried out by physiotherapists or osteopaths as a stand-alone treatment or part of a wider set of treatments. Clinical studies have shown that patients receiving acupuncture have less pain than those not receiving the treatment.

5. TENS: Transcutaneous electrical nerve stimulation (TENS) is a method of pain relief involving the use of a mild electrical current. The current stimulates nerves and treatment has become become more accessible. Machines are compact and can be purchased for as little as £15 from Amazon or a pharmacy.

6. Medications: Over-the-counter pain relievers like ibuprofen or acetaminophen can help reduce pain and inflammation. In some cases, muscle relaxants or prescription pain medications may be necessary.

7. Heat and Cold Therapy: Applying heat or cold packs to the affected area can help reduce inflammation and relieve pain. Alternate between hot and cold therapy for maximum benefit.

8. Injections: Epidural steroid injections or nerve blocks may be recommended to reduce inflammation and relieve more severe or persistent pain.

9. Surgery: In cases where conservative treatments fail to provide relief or when there's an underlying structural issue like a herniated disc, surgery may be necessary to alleviate pressure on the nerves and restore function.

10. Cancer Treatment: For cancerous tumours treatment may include surgery, radiotherapy, chemotherapy or other cancer treatments.

The NHS tends to take a relatively hands-off approach to generalised back pain, even when the symptoms prevent normal daily activity. Treatment tends to involve referral for physio therapy. Historically, this involved face-to-face appointments where a therapist would be hands-on; these days, appointments are usually shorter and involve being given exercises. Other countries tend to move towards surgical treatments much earlier on. Surgical options include decompression, disc replacement and fusion, where vertebrae are linked together with metal plates and screws.

One exception to this is a condition called Cauda Equina, which is when compression on the spinal cord is so severe that it causes symptoms such as loss of sensation, pain and loss of motor function in both legs; loss of bladder or bowel control. Cauda Equina is a medical emergency and emergency decompression is required in order to prevent permanent paralysis. Imaging usually by MRI (Magnetic Resonance Imaging) is usually the preferred option to confirm the cause. If you suspect Cauda Equina, you should contact the emergency department immediately.

It's essential to consult with a healthcare professional for an accurate diagnosis and personalised treatment plan tailored to your specific condition and needs. Additionally, maintaining a healthy weight, practising good posture, and engaging in regular exercise can help prevent back pain and promote overall spinal health. If you have health insurance, you contact your insurer to be referred to an orthopaedic consultant who will arrange an MRI for diagnosis. In most cases, to see a consultant, you must have a referral from a GP. If your insurance offers online GP consultations, as many do, they will be able to refer you directly to a specialist.

One other option for diagnosis is self-referral for MRI. Vista Health allows patients to refer themselves. You book the scan and will then receive a radiographers report, which you can share with a doctor.

Prevention:

There are things you can do to help prevent back pain, this is especially important if your job involves lots of heavy lifting.

• Have massages when your muscles get tight

• Carry out stretching routines or attend yoga or pilates

• Strengthen your core with stability exercises

• Maintain a healthy lifestyle and avoid being overweight

• Use correct manual handling techniques and avoid lifting heavy items if you can

• Avoid lifting extreme weights, particularly if carrying out deadlifts or squats in the gym

• If you start to get back pain, listen to your body rest up, but do not spend too much time in bed. Evidence shows that too much bed rest can hinder recovery

• Work on good posture and avoid slouching