Back Pain
Most of us have had back pain at some stage and know that it can be pretty uncomfortable. It can vary from a grumbly ache in the low back to fairly severe pain that can track into the buttock and legs. Even though back pain is common the good news is that backs respond well to straightforward treatments and only a very small percentage of people end up having surgery. Doing the right things can make big improvements in decreasing the pain and more importantly get your back right for the future to avoid it coming back. See what best describes your back pain and what you can do about it..
Low Back Pain
Where are the symptoms and what does it feel like?
This is the most common type of back pain. You can get pain in the in the middle of the low back or more on one side. It can be sharp or a dull ache or a mix of both. Your pain might travel into your buttock or legs. Sometimes you might get other symptoms like pins and needles or weakness in the legs - this usually means one of the nerves that come out of the spine are irritated. Its usually the discs and/or the small joints in the back (facet joints) that cause the pain, but sprains and strains of the muscles and ligaments can also cause symptoms. Generally speaking pain from discs gets worse with sitting and better with standing, walking or lying down. With facet pain it’s the opposite - its sore to stand, walk and lie down on your back but better to sit. Sometimes you can have a mix of both!
How does it happen?
Sometimes we’re just unlikely – we get a blow in the back in sport or fall and hurt our backs. Other times wear and tear in the discs and joints of the low back as we get older can cause pain and annoy the nerves that come out of the back into the legs. Bad posture can put pressure on the structures of the back and cause pain. Sometimes we’re not as strong as we think and we lift a heavy weight (including weights in the gym that we may not be prepared for or have the right technique) and we can injure our back. Sometimes it can be something really unexpected like taking a bag out of the boot at a funny angle and feeling a sharp twinge.
What is it stopping you from doing?
Even simple day to day things can be affected with back pain – sitting at a desk in work, lifting the shopping (or the kids!), going to the gym, playing sport, sleeping. It can be annoying at the very least and very debilitating at worst.
How can we get you better?
In a lot of cases back pain is straightforward to treat. Most people are stiff or their back is weak. Often, its both. First of all, we’ll look to relieve your pain so that you can get moving again. Then we’ll look at what might have caused the pain in the first place. We’ll test your movement and your core strength. We’ll do nerve tests. We’ll guide you through what you need to do to get your back more flexible and strong for the future. We’ll show you how to sit properly and get the desk set up right. We’ll also give you advice on getting back to work and to your gym/sports.
Upper Back Pain
Where are the symptoms and what does it feel like?
Pain higher up in the back is less common than lower back pain. The pain tends to be higher up the trunk and can be a dull ache or a sharp pain on a sudden movement like turning. Sometimes the symptoms can track into the front of your chest and you might get a sharp pain on coughing or deep breathing. You might also get pain in your arm or shoulder blade area.
How does it happen?
This type of back pain usually comes from muscle strain or tension from poor posture or looking down for long periods of time (sound familiar?). It can also come from osteoporosis (thinning of the bones in middle to older age, particularly in women). Disc pain is less common higher up the back compared to the low back. The small rib joints can also cause pain if you have been coughing a lot or rotate your spine suddenly.
What is it stopping you from doing?
Usually sitting is sore so it can affect working on a laptop involving long periods of focused work. Often it feels better if you get up out of the chair and move around. You can also get pain on coughing, laughing or sneezing.
How can we get you better?
This type of pain responds well to postural correction, good desk/chair management, strengthening weak muscles and stretching tight muscle. We can advise you on how to change your posture, the right desk set up and what you need to do to keep your back able to cope with long periods of sitting. If your pain is related to osteoporosis/osteopenia we can show you show you how to manage the pain and how to stretch and strengthen up your back safely.
Scoliosis
Where are the symptoms and what does it feel like?
Scoliosis is a condition where the spine curves. You might notice that your spine is leaning to one side and your shoulder, hips or ribs may be sticking out on one side. It can affect any age but usually affects early teens particularly as they are growing. An Xray and a visit to your GP/spinal consultant will confirm if there is scoliosis and whether medical treatment is needed. Treatment for scoliosis depends on your age, how bad the curve is and whether it is likely to get worse with time. With mild to moderate curves you may have no symptoms or you may get pain in your back, neck or shoulder blades. You may feel stiff on certain movements or waking up in the morning.
How does it happen?
In most cases it is not clear what causes scoliosis (idiopathic scoliosis). In other cases it can be due to underlying conditions. It mainly affects children/teens but it can also affect older adults.
What is it stopping you from doing?
If the curve is mild it often does not stop you doing anything and you can continue to do normal activities and sports. When the curve is bigger it can cause pain in the low back, neck or shoulder blade on day to day activities or sports.
How can we get you better?
You usually see a consultant if you have scoliosis. We then work with your consultant and GP to improve your pain and function. Some people end up wearing a brace and some people have corrective surgery. Some people are simply monitored and they need no other medical intervention. We can help with relieving some of the soreness, showing you how to loosen and strengthen your spine, show you some specific movements to help with the curvature of the spine and help with post op rehab if you have scoliosis correction surgery.
Recovering from Back surgery
Where are the symptoms and what does it feel like?
Two common spinal surgeries are spinal fusions and discectomies. After surgery the original back pain or leg pain is usually much better but you can still get some milder back and leg pain. You might feel weak or you can be nervous moving after surgery.
How does it happen?
People usually get spinal surgery as the symptoms has not responded to medication or other treatments and is continuing to cause significant pain and/or weakness.
What is it stopping you from doing?
There will be a period of restricted activity following spinal surgery where you may not be able to do certain activities. This will depend on what surgery you have had and what guidelines your surgeon wishes you to adhere to.
How can we get you better?
After your surgery we will help you to gradually get your movement and strength back working with your consultant’s guidelines so that we can get you safely back to your activities and sports.