About back pain

Your back consists of numerous bones (vertebrae), muscles, tendons, nerves, ligaments and discs (the 'shock absorbers' between the vertebrae). These together from a very strong, flexible and complex structure and any of its components can be responsible for back pain. For example an overstretched muscle, a ruptured ligament or a pinched nerve can cause your back pain. It is often very difficult to pinpoint exactly where the pain comes from and in the vast majority of cases X-rays, MRI scans or other medical imaging tests do not provide any real insights into the origin of the pain. This is why healthcare professionals will only refer people with back pain for X-rays and MRI scans in exceptional cases. However, irrespective of the origin of the pain, we do know what to do to promote recovery from back pain.

Back pain is most commonly felt in the lower back, but can also radiate to the upper legs. Similarly when the pain is higher up in the back, sometimes people feel pain radiating into the arms. This radiating pain can be caused when a nerve that supplies your legs or arms is trapped in the back, for example by a bulging disc. In very rare cases people experience weakness in their legs, reduced feeling in their legs and genital area or bladder and bowel problems. If this is the case, you should seek medical advice immediately. 

Most people with back pain find that their pain decreases within a few days or weeks and most recover without specialist medical treatment. To speed up your recovery and prevent the pain from returning there are a number of things you can do.

There is a long list of factors that can cause or contribute to back pain. Lack of physical activity, obesity, heavy lifting and inappropriate posture are probably the most important, but there are many more (see figure). Often it is a combination of factors that leads to back pain. This means that when you want to prevent back pain, you should consider all the factors that are relevant to you. Some risk factors you can change yourself but for others you may need assistance from your line manager or colleagues.

The Factors that can cause or contribute to back pain:

• posture
• stress
• heavy lifting
• genetic factors
• smoking
• prolonged periods of sitting
• repetitive physical work 
• vibration
• being overweight obese
• psychological factors
• individual pain threshold
• physical inactivity