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10 Things You Need To Know About Your Back

Posted on 4th May 2017 by

The Chartered Society of Physiotherapy (CSP) have today launched a great new campaign, ’10 Things You Need To Know About Your Back’.

Back pain research constantly gives new insights into previously held beliefs. Their new guide reflects these advances to give clear, simple advice on how to manage your pain and prevent future episodes.

Here’s the latest advice from the CSP:

  1. Your back is stronger than you may think Most people worldwide will experience back pain during their lifetime. It can be disabling and worrying but it is very common and rarely dangerous. The spine is a strong, stable structure and not easily damaged so in most instances it is a simple sprain or strain. In these cases – 98 per cent, according to research – people recover reasonably quickly, and many do so without treatment. Some people experience repeat episodes, which can be distressing, but again these are rarely dangerous.
  2. You rarely need a scan and it can do more harm than good
    This is because seeing perfectly normal changes to their spine can cause people to avoid the activities they should be doing to get better, such as exercise and movement in general. In very rare cases, there may be something more serious or underlying that requires medical advice. A scan may help with your diagnosis and symptoms to be aware of are at the bottom of this page. However, these account for just two per cent of cases so if your physio or GP does not send you for one, you should take it as a good sign that there is nothing concerning going on.
  3. Avoid bed rest, stay in work and gradually resume normal activities
    Scientific studies now indicate prolonged rest and avoidance of activity for people with low back pain actually leads to higher levels of pain, greater disability, poorer recovery and longer absence from work. In the first few days of a new episode of low back pain, avoiding aggravating activities may help to relive pain. However, staying as active as possible and returning to all usual activities gradually is actually important in aiding recovery – this includes staying in work where possible. While it is normal to move differently and more slowly in the first few days of having back pain, this altered movement can be unhealthy if continued in the long-term.
  4. You should not fear bending or lifting
    Bending and lifting are often portrayed as causes of back pain and while an injury can occur if something is picked up in an awkward or unaccustomed way, it’s most likely to just be a sprain or strain. The important thing is to practice and get your body used to carrying different loads and weights in a way we find comfortable and efficient. We all run differently, and it’s perfectly normal for us to find our own technique for lifting.
  5. Exercise and activity reduce and prevent back pain
    Exercise is shown to be very helpful for tackling back pain and is also the most effective strategy to prevent future episodes. Start slowly and build up both the amount and intensity of what you do and don’t worry if it’s sore to begin with – you won’t be damaging your back. No one type of exercise is proven to be more effective than others so just pick an exercise you enjoy, that you can afford to maintain in the long-term and that fits in with your daily schedule.
  6. Painkillers will not speed up your recovery
    There is no strong evidence on the benefits of painkillers and they do not speed up recovery. They should only be used in conjunction with other measures, such as exercise, and even then just as a short-term option as they can bring side effects. Exercise, which is safer and cheaper, is considered the preferred option.
  7. Surgery is rarely needed
    There are some uncommon back conditions where there is pressure on the nerves that supply the legs and the patient gets leg symptoms, such as pain, pins and needles or numbness. For these conditions, surgery can help the leg symptoms but it is important to understand that it is not always required. You also need to know that on average, the results for back surgery are no better in the medium and long term than non-surgical interventions, such as exercise. So a non-surgical option, which includes exercise and activity, should always come first.
  8. Get good quality sleep
    The importance of sleep in tackling back pain has become increasingly clear in recent years. This is because it reduces stress and improves your overall feeling of wellbeing, making you less susceptible to the triggers of pain in the first instance and helping you to cope when it does occur. Aim for 7.5-8 hours a night and try to aim for a regular routine, as far as possible. It is also very important to know that there is no best position or type of mattress – whatever feels most comfortable for you is best.
  9. You can have back pain without any damage or injury
    Many physical or psychological factors can cause back pain and often a combination of these are involved. Many factors can cause back pain and often a combination of these are involved. They could be– Physical factors, such as ‘protecting’ the back and avoiding movements, or a simple strain.
    – Psychological factors, including a fear of damage or not getting better, feeling down or being stressed.
    – More general health and lifestyle factors, like being tired and rundown, not getting enough good quality sleep, being overweight or not getting enough physical activity
    – Social triggers, such as difficult relationships at work or home, low job satisfaction or stressful life events, like a family death or illness. Crucially, it’s important to know that all pain is 100 per cent real and never ‘all in your head’, even when factors like stress or mood are involved. Each of the factors can turn up the volume on your pain and gaining a greater understanding of when that can happen puts you in a stronger position to recognise them and learn how to turn down the dial again.
  10. If it doesn’t clear up, seek help but don’t worry Physiotherapists provide expert advice, guidance and treatment for back pain. This is to help reduce your chances of future episodes, while improving your overall health and well-being.

At goPhysio, we offer a range of services to help you manage your back pain. 

Physiotherapy – If you want reassurance and help to become more confident with your back, physiotherapy can help. We can provide expert guidance and treatment for your back pain, tailored to you and your lifestyle. You can book an appointment online or give us a call on 023 8025 3317.

Clinical Pilates – Our specialist Pilates classes are a great way to keep you strong and active. They focus on building strength and flexibility and being able to move well. The classes are small and you will be under the close supervision of one of our Therapists at all times. We run 17 classes a week, including evenings and weekends, at a variety of levels, so it’s easy to find a class to suit you. Have a look at our latest timetable.

Yoga Classes – Our onsite Yoga classes are another great way to get you moving. We offer a range of different styles of yoga, including a gentle and restorative class for beginners to a more challenging Himalayan Hatha class. Bookings are made easily online, you can find out more about booking here.

Active Backs – Our Active Backs classes are supervised exercise classes, specially designed for people who have or have had back pain. The classes will help build your confidence in exercising and are combined with education and advice to empower you. These classes can be booked online.

Symptoms to be aware of:

These symptoms are very rare but you should contact a doctor if you experience any of them:

  • Difficulty passing urine or having the sensation to pass water that is not there
  • Numbness/tingling in your genitals or buttocks area
  • Loss of bladder or bowel control
  • Impaired sexual function, such as loss of sensation during intercourse
  • Loss of power in your legs
  • Feeling unwell with your back pain, such as a fever or significant sweating that wakes you from sleep

Read More:

Low back pain and sciatica, the latest NICE guidelines

Help, I’ve got back pain! What should I do?

Back Pain Myths

 

 


Low Back Pain & Sciatica – The Latest NICE Guidelines

Posted on 20th January 2017 by

The National Institute for Health and Care Excellence (NICE) has recently published new guidelines on best management of low back pain. This includes both people with ‘simple’ back pain (localised to the back) and those with referred pain (sciatica) which can affect the nerves down one leg. These guidelines are based on latest evidence and expert analysis of what is the best course of action for people with low back pain.

Here’s how we’re putting them into practice at goPhysio

Assessment

When you come to see us with back pain we will do a thorough assessment by asking a number of questions to find out more about your pain and to rule out any ‘red flag’ conditions. These red flags can indicate serious pathology such as cancer, infection, trauma, inflammatory conditions or Cauda Equina Syndrome. Thankfully these conditions are rare but if we have any suspicion we will referral you on to the appropriate speciality for further investigations without delay.

We will do a complete back examination to assess how the joints, muscles and nerves are functioning. We know there are a number of factors that can influence your recovery both positively and negatively so our staff are undergoing further training on use of the STarT Back Risk Assessment tool. This will help us identify those who are at risk of poorer outcomes and ensure that we tailor our treatment to address these factors.

Treatment

Self-management education is a vital aspect of treatment for any patient. We help you to understand why you have pain and what steps you can take to reduce it – both during an acute flare up of pain but also long term strategies or simple changes you can make to your lifestyle which will help your back.

Your treatment will vary depending on the nature and cause of your pain, how severe it is and a variety of individual factors. Physiotherapy treatment may include manual therapy such as joint mobilisations or massage, alongside a personal exercise programme and advice on pain relief.

Research has shown that anti-inflammatory medications (NSAID’s) such as Ibruprofen or Naproxen are much better than paracetamol for back pain, however, for people that are unable to take NSAID’s or that find them ineffective, weak opioid medications such as Co-codamol can be recommended for simple back pain.

For acute sciatica your GP may recommend stronger ‘neuropathic’ pain medications which are much better for nerve pain (tingling/burning/shooting pain). Please note all medications have side effects and can interact with other medications you are already on or other conditions that you may have so please check with your GP or a pharmacist before taking any new medication.

What happens if you are not responding to treatment?

For acute sciatica you may be referred on to a spinal consultant, who in more severe cases can consider epidural injections or a spinal decompression surgery. However it is important to remember that this is never a first course of action as most episodes of sciatica resolve within 6-12 weeks. Your physio will help you decide when it is appropriate to be referred on depending on how you respond and recover.

Sometimes there are psychological factors affecting your rehabilitation such as depression, anxiety or other mood disorders. In this case your physio may recommend that you are referred on to a psychologist for cognitive-behavioural therapy. This is because we know that people with negative mood and health beliefs rarely respond well to usual treatment without first addressing these factors.

So if your pain is persistent or not responding to usual treatment it is important to seek professional help.

What about x-rays and scans?

X-rays are no longer routine for lower back pain unless there is the suspicion of a fracture (such as after a severe trauma or in people with osteoporosis). This is because it exposes you to radiation but does not often provide any useful information on how we should best treat your back. Likewise MRI’s are only needed to rule out serious spinal pathology or to help a consultant identify if a nerve in your back is being significantly compressed to warrant injection or surgery. The vast majority of this information your physio will be able to deduct from a thorough assessment.

Once an acute episode of back pain has eased off, we recommend continuing with exercise to help keep any further recurrences at bay. Research indicates that any form of exercise is great for people who’ve had back pain – being active and moving helps! many of our patients go on to our specialist Pilates classes. These are particularly beneficial as they are taken by our Physiotherapists, so they are well equipped to deal with any concerns or issues you may have with your back and can modify and progress the exercises for you individually. The classes are also small, so you aren’t lost in a sea of people struggling – you get individual care and attention. We run 16 classes a week, so there’s plenty of choice to fit in with your weekly commitments.

NICE back pain

If you’re suffering with back pain and want some peace of mind and reassurance that it’s nothing serious and help to get on the road to recovery, come and see one of our Physio’s at goPhysio. We make it easy for you, with appointments available 8am – 8pm and Saturday mornings, we can normally offer you an appointment within 24 hours, if not the same day. Just call one of our friendly Patient Services Team on 023 8025 3317 or book an appointment online.