Low Back Pain - advice

Your back has contains a number of different structures, including bones, joints, muscles, ligaments and tendons. Its main support structure is the spine, which is made up of 24 separate bones called vertebrae, plus the bones of the sacrum and coccyx. Between the vertebrae are discs that act as shock absorbers and allow your spine to bend. Your spinal cord threads down through the central canal of each vertebra, carrying nerves from your brain to the rest of your body.Symptoms of back pain

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If you have low back pain, you may have tension, soreness or stiffness in your lower back area. This pain is often referred to as 'non-specific' back pain and usually improves on its own within a few days.

Back pain may be called either 'acute' or 'chronic' depending on how long your symptoms last. You may have:

• acute back pain - lasting less than six weeks
• sub-acute back pain - lasting six weeks to three months
• chronic back pain - lasting longer than three months

You should see your GP as soon as possible if, as well as back pain, you have:

• a fever (high temperature)
• redness or swelling on your back
• pain down your legs and below your knees
• numbness or weakness in one or both legs or around your buttocks
• loss of bladder or bowel control (incontinence)
• constant pain, particularly at night
• pain that is getting much worse and is spreading up your spine

These symptoms are known as red flags. It's important to seek medical help for these symptoms to ensure you don't have a more serious, underlying cause for your back pain.

Causes of back pain

For most people with back pain, there isn't any specific, underlying problem or condition that can be identified as the cause of the pain. However, there are a number of factors that can increase your risk of developing back pain, or aggravate it once you have it. These include:

• standing, sitting or bending down for long periods
• lifting, carrying, pushing or pulling loads that are too heavy, or going about these tasks in the wrong way
• having a trip or a fall
• being stressed or anxious
• being overweight
• having poor posture

There may be other, more serious underlying causes of your low back pain, but these are rare. They include:

• fracture - a crack or break in one of the bones in your back
• osteoporosis - a condition where bones lose density causing them to become weak, brittle and more likely to break
• a slipped disc - this is when a disc bulges so far out that it puts pressure on your spinal nerves
• spinal stenosis - a condition in which the spaces in your spine narrow
• spondylolisthesis - when one of your back bones slips forward and out of position
• degenerative disc disease - when the discs in your spinal cord gradually become worn down
• osteoarthritis - a wear-and-tear disease that can particularly affect the joints of your spine
• rheumatoid arthritis - an inflammatory condition in which your immune system causes inflammation of the lining of your joints and surrounding structures

Low back pain may also be caused by an infection or cancer, but these two causes are very rare.

Diagnosis of back pain

Your GP or Physiotherapist will usually be able to diagnose low back pain from your symptoms and there is usually no need for further tests. If, however, your symptoms don't improve after a few weeks, or you have some red flag symptoms, he or she may advise further investigations. These could be an x-ray, CT scan or MRI scan. They will help to find out whether you have a more specific, underlying cause for your back pain.