Managing back pain – Dr Jo Kosterich

Simple treatments for lower back pain

What can you do at home? You can put a hot pack on your back, maybe rub in a little bit of some liniment type rub, maybe get somebody to give you a little bit of a massage, and it will probably all be gone by tomorrow morning. Sometimes it relates to more major injuries, and that can be either again from work that you’ve done, or sometimes obviously from trauma. Now, this leads to the really important point, that if you do experience some pain in the back, there are simple things that you can do first at home, and we’ve just touched on a couple of those.




Seeking professional help

So then people will quite reasonably say, “Well, when should I seek help about back pain”? I suppose the answer to that is if it is not settling down with fairly simple measures, such as your hot packs, perhaps some stretching, maybe a bit of a rub, and if need be, some simple pain killers. Now some people may head off to a physiotherapist but chose an experienced one.  If your pain is not settling down, or if there are other problems with the back, for example, getting tingling, or pins and needles in the legs, or if the pain is spreading out, that would certainly be a time to go and see your doctor and get it checked. Now, that may not necessarily, but it may indicate some pressure on some of the nerves and again treatment may need to be directed towards that.

Scans and x-rays for lower back pain

When do we need to do some scans and investigate back pain? Now, a lot of scans and a lot of x-rays are done on the back, and a lot of the bigger research meta-analyses sort of have concluded that a lot of scanning and x-raying doesn’t help as much as we think it does. It is always done more to rule out problems rather than to find them. Now, people often get frustrated when they say “I’ve got pain in my back, and I’ve been to the doctor, I’ve had all these scans, and nothing shows up”. That means there is nothing structurally wrong with your back, and this is an important point. On scans we’ll see if there is a structural problem, but a little bit like with having a headache, you can scan the head, but you may not see anything. It doesn’t mean that it doesn’t hurt; it just means you can’t see anything. So, a normal scan is a good thing, it means there is nothing out of place, there is nothing broken, you’re not going to need any surgery. That’s a good thing. It brings us back to by far and away, the most common cause of back pain, which is muscle and soft tissue problems.

Additional treatments and prevention

So again, what sort of treatments do we look at for lower back pain? We’ve spoken about the simpler ones, the next step may be the use of anti-inflammatory tablets, or stronger pain killers prescribed by your doctor, and, certainly, courses of physical therapy, such as physiotherapy, may be useful. For some people, it may be looking at their work environment, and perhaps a change in their chair, or their work station, or different work practices. For example, making sure you bend from your hips when you’re lifting, rather than bending from your back. It sounds obvious, but it makes a difference. Exercise for the back is important, so, strengthening the muscles. Swimming is good for the back, and there are specific back exercises to do which can help strengthen the back muscles, and that is something that doesn’t improve overnight, but if you can stick with that for a number of months, you’ll make your back more resilient.

To sum up, back pain is very, very common. For most people it is not going to be serious, and you can pretty much manage it yourself with the simple measures that we’ve spoken about. If it isn’t settling down, or there are other symptoms of concern, that is when it is time to seek help. Strengthening your back through regular exercise, and caring for your back are the most important things for keeping your back pain free.

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