Health
My back's killing me! Print E-mail
Written by Mary Turner, 2008   
Why is back pain so prevalent and what treatments are available? Mary Turner's own experience with a 'bad back' led her to investigate.

Anyone who has suffered from acute or chronic back pain would agree that it can make life a misery. It seems that these days more of us than ever experience it - and it has been estimated that 80 per cent of the population will have some level of back pain at least once in their lives.

The rise in the number of people with back problems is largely explained by our increasingly sedentary lifestyles. Long hours spent sitting at a computer, being cooped up in a car or squashed in a commuter train, together with a lack of exercise and increasing obesity levels, are all taking their toll on our backs.

Even schoolchildren are experiencing back pain. Not only are they expected to carry their books around with them all day, but they exercise less than earlier generations and many spend a lot of their leisure time slumped in front of a television or a computer.

Back pain can be caused by a number of conditions including arthritis, osteoporosis, and damage to joints, tendons and muscles. Simple back pain, especially in the lower back, is often the result of muscle strain. Prolapsed discs (slipped discs) are less common and occur when one of the discs in the spine bulges out of its normal position.

In rare cases, however, back pain can be a sign of a more serious illness. So always consult your GP if you suffer from back pain for more than a few days or if you experience other symptoms along with the pain.

Conflicting advice

The treatment of back pain is a controversial topic and one that seems to bring conflicting reports. While it is now generally agreed that the old remedy of bed-rest and lying on hard boards is likely to worsen, rather than cure, back problems, discussion continues about the most effective treatments.

GPs generally suggest resting for a few days, taking painkillers and continuing with the normal daily routine. However, a recent study on the effectiveness of acupuncture came to some surprising conclusions. Researchers found that acupuncture was more effective than drugs in suppressing pain and improving mobility.

Even more surprising was the finding that fake acupuncture (with pins placed incorrectly) was also more effective than drugs. As many physiotherapists and some GPs have trained in acupuncture, it is possible it will become more widespread within the NHS.

Another report has opened a debate about spinal surgery. In 2005 a study led by consultant orthopaedic surgeon, Mr Jeremy Fairbank, found that, in most cases, an intensive rehabilitation programme of daily exercise and cognitive behavioural therapy was as effective as surgery. He suggested patients eligible for surgery should first be offered the rehab programme.

Many people, tired of the 'rest and ibuprofen' approach, have been turning to alternative methods of pain relief. Chiropractors and osteopaths have long been successfully treating back problems by a combination of manipulation, stretching of the spine and massage of the surrounding muscles and tissues.

Attitudes within the medical profession towards alternative therapies are mixed, but GPs are permitted to refer patients to chiropractors and osteopaths, as both groups are statutory regulated professionals; it is a criminal offence to practise without being registered with either the General Chiropractic Council or the General Osteopathic Council.

Some GPs work in partnership with osteopaths or chiropractors and in a few areas these treatments are available on the NHS. Physiotherapy is available on the NHS if your GP refers you for treatment. However, it is also available privately too.

It is advisable to check with your GP before undertaking alternative therapies and always ensure that the practitioner is registered with the appropriate professional body. Be aware that some chiropractors use the title 'Doctor' - but this does not mean they are medically qualified. Always check.

Who does what?

Chiropractors, osteopaths and physiotherapists all treat back pain. In some cases their methods overlap - much will depend on the individual therapist. Details of their beliefs and methods can be found on the websites of their professional bodies.

10 tips for taking care of your back

Most of us take our back for granted until something goes wrong. But being back aware and following these simple steps could prevent problems arising in the first place.

1. Check your posture

Poor posture can lead to back problems because it places a strain on the spine. Standing tall aligns the spine correctly. An added benefit of good posture is that you will appear more confident and approachable. Yoga, Pilates and the Alexander Technique can all help to improve posture.

2. Are you sitting comfortably?

Many people love to relax with their feet curled up under them but this puts pressure on the spine and can cause problems for weak backs later. Sitting on a chair with good support is essential and is equally important whether you are relaxing or at work.

3. Learn how to lift

Lifting incorrectly is one of the main causes of back injury. When lifting you should bend your knees, not your back, and let your leg muscles take the strain. Avoid twisting when lifting and don't lift anything heavy without help.

4. Carry things sensibly

Carrying can put a great strain on your back. Don't carry excess weight and when shopping, try to have a similar load on each side. Consider using a bag on wheels or a rucksack type of bag, which can be correctly positioned on both shoulders.

5. Keep moving

Humans aren't designed to sit or stand for long periods. Make a point of getting up from your desk at regular intervals. Gentle stretching exercises can help avoid back and neck pain.

6. Exercise regularly

Swimming and walking are especially good for strengthening backs. However, as with all sports, seek advice before you start, especially if you already have a back problem. Walkers need suitable shoes to avoid jarring the spine and swimmers should avoid strokes that put a strain on the neck and joints.

7. Relax

Tension and stress put strain on muscles. Avoid stress, learn to relax and do your back a favour.

8. Keep your weight under control

Being overweight puts a great strain on your body, especially your back. It also makes it harder for you to exercise and so is doubly bad for you.

9. Take care when gardening

Many incidences of back pain occur as a result of gardening. You should warm up your muscles before starting work. A booklet offering advice and tips on preventing injury when gardening is available from BackCare, the charity for healthier backs.

10. Check your mattress

A bed mattress that doesn't provide the correct support is often the cause of an uncomfortable and disturbed night's sleep, which can lead to back problems.

When a pain isn't what it seems

Although some medics are dismissive of the theory that problems with the spine can cause problems elsewhere in the body, there have been cases where a reluctance to look beyond the immediate symptoms has led to misdiagnosis.

In my case, I was diagnosed with trigeminal neuralgia and was prescribed an anticonvulsant drug - usually prescribed for epilepsy. Unwilling to take this medication, I consulted an osteopath who had successfully treated me for an earlier back problem. After a single treatment the pain lessened and by the next day it had gone completely. I have had no recurrence of the symptoms since.

In a high-profile case, top golfer Jose Maria Olazabal's career was brought to a halt in the mid-1990s soon after he had won the US Masters. His problems, which had started with a pain in one of his toes, grew steadily worse until he was barely able to walk. When he was diagnosed with foot problems and told he had rheumatoid arthritis, his golfing career appeared to be at an end.

Some time later he went to Germany to be fitted with a special shoe designed to lessen pain when walking. While there, he consulted Dr Hans-Wilhelm Muller-Wohlfahrt, a leading sports physiotherapist, who told him that his problem was in his back not his foot. After treatment, which involved a series of injections and a very painful exercise regime, Olazabal was able to resume his career.

In 1999 he won the US Masters again and at the formal presentation he publicly thanked Dr Muller-Wohlfahrt for making the victory possible.

Further information

Back Care - contact the charity for healthier backs at www.backcare.org.uk or call the Helpline on 0845 130 2704.

The Back Show is an annual event held in London that showcases the different therapies and products designed to alleviate back pain. You will find tips and features at www.backshowexpo.co.uk. The next show will be at Olympia on 4 and 5 October 2008.

To find a registered practitioner near you, contact:
 
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