Acute Back Pain

Acute back pain is very common and most people will have one or more bouts of back pain at
some time in their life. Most bouts of back pain ease quickly and are not due to serious back
problems. You may have had a similar episode in the past or this may be the first time.
Whichever is the case, prompt management at the outset will reduce the time it takes to recover
and reduce the pain.

Types of back pain:

Simple backache – is the most common. About 19 in 20 backaches are classed as ‘simple
backache’. Typically, the pain is in one area of the lower back but sometimes it spreads to the
buttocks or thighs. The cause is thought to be ‘mechanical’ in most cases such as a sprain or
minor injury to a ligament or muscle. Often, the exact site and cause of the pain is not clear.

Nerve root pain – occurs in less than one in 20 cases of backache. This means that a nerve
coming out of the spinal cord is irritated or compressed (trapped). Irritation may be due to
inflammation from a ligament or muscle sprain. The irritated nerve causes pain to be felt along
the course of the nerve even though the problem is in the back. Therefore, pain is felt down the
leg to the calf or feet and is often worse than the back pain.

Uncommon back conditions – such as bone disorders, arthritis or ankylosing spondylitis
occasionally cause back pain.

Treatment and advice:

Most people recover quickly from an acute episode of mechanical back pain, with 90 per cent of
patients recovering within six weeks.

Exercise and ‘keep going’:
Continue with normal activities as far as possible. This may not be possible at first if pain is
severe but do as many of your normal activities as the pain allows you. As a rule, anything that
causes a lot of pain should be avoided but some discomfort may have to be accepted when
trying to do normal activities. Be aware of the difference between the ache of un-used muscles
and the pain associated with your back problem — accept the first and limit the second.
Setting a new goal each day may be a good thing to try. For example, walking around the house
on one day, a walk to the shops the next, etc.
Finding a position that is comfortable and reduces pain can be very useful to manage the pain
levels. It is important not to stay in one position too long but move regularly.
Positions that are most commonly preferred are;
Lying on stomach,
Lying on your side with a pillow between the knees.

Pain relief:

Painkillers are often helpful. Speak to your doctor to discuss the best medication to
take. It is best to take painkillers regularly. This is better than taking them now and again just
when the pain is very bad. Taking them regularly may prevent pain getting severe and enable
exercise to be taken.
If you have any side effects or queries about the drugs you have been prescribed, or if they are
not adequately controlling the pain, contact your doctor.

Sitting:
For some people with acute/severe back pain, sitting makes their pain worse. When you do sit,
we recommend an upright chair with a cushion for support in your low back to maintain the
natural curve of the low back. Try to avoid low soft chairs/ sofas as they do not support the
spine.

Posture and positions:
If you work in an office, make sure your desk and chair are a suitable height for you and the chair
supports you. We recommend that you get up at regular intervals, and, if possible, go for a
short walk round the office. If you do a lot of driving, adapt the car seat to your needs by using a
rolled towel in the small of your back and adjusting the distance between the seat and the
steering wheel.

Preventing future back pain:
Research has shown that keeping a fit and healthy body and strong muscles are the best
protection your back can have.

Exercise:
The aim is to give strength and suppleness to the supporting back muscles. Swimming, walking,
pilates are good and other regular exercise will also help.

Posture:
Avoid standing or walking in a stooped position. Wherever possible, walk or stand as ‘tall’ as
possible. When sitting at a desk to work, make sure that the chair is at the right height for the
desk and the feet should be able to rest flat on the floor.
Sleeping:
Make sure your mattress is supportive and you regularly check the quality of the mattress. Turn
or flip the mattress as the manufacturer advises.
Lifting:
Avoid bending the back when lifting. Bend at the knees keeping the back straight. Do not lift
with the back in an awkward twisting posture. Be ‘back aware’ – it may not be so much heavy
work that causes recurrences of back pain. More likely it is due to bad posture or bad
lifting techniques at work or home.
Weight:
Being overweight increases the stress on the back which can lead to reoccurrences. Losing
weight will help prevent this and reduce the strain on the spine.

More information:
The Physio Therapy Department Ali Hospital