Lower back pain

Lower back pain is very common and is likely to affect the majority of the population at some point in their lives. Pain can spread both up the back and often into the buttock or down a leg. Fortunately, back pain tends from days, to a few weeks, to a couple months and so this short episode is referred to as "acute lower back pain". There are multiple reasons it can arise and multiple things that can be done to help. 

For pain that persists longer than three months; consider looking here.

Back pain is often unspecific meaning there is not necessarily one specific structure that is responsible for your pain. Equally, abnormalities such as "bulging discs" are often found in people without pain and therefore don't always cause an issue. As a result, scanning spines is not routine. Without the clinical presentation and assessment they could be misleading and therefore it is more often used to support a clinical concern.

Warning: If you have new symptoms that refer down both legs, any issues with your bladder/bowels, a loss of power in your legs, or loss of sensation in and around the saddle region you should go to your local Accident & Emergency department. 

Factors contributing to the development and persistence of lower back pain include;

• A change or increase in physical work/exercise
• Quality of sleep
• An increase in stress/anxieties
• Attitudes and beliefs about back pain/back health. 

The National institute for health (NICE) sets guidelines of the best methods/things you can do to help your back pain. This includes;

• Exercise - Your back is not fragile and it is important to keep it moving despite being in pain. You do not need to force yourself through exercises with a "no pain no gain" approach. It should start little and gentle and build gradually over time. For examples of exercises that can be done in this manner, see the video at the bottom of this page. 
• Resuming your normal activity - While it may be difficult, still try to resume your normal daily activities and/or work if possible. 
• Pain medication - Pain medication should not be used as a "fix" but can really help settle some pain down to allow you to exercise and resume your normal daily activities. 
•  "De-stress" - While stress is a normal response in life, it is important to be aware that this will contribute to your sensitivity and level of pain perceived. Techniques such as mindfulness and ensuring good quality sleep can help reduce the impact of stress. Often stress cannot be avoided. However, your response and understanding of stress can be altered which will help.

  Further info can be found here: www.nhs.uk/conditions/stress-anxiety-depression/mindfulness/

• Heat/ice - The use of hot or cold treatment often tends to have pain reducing effects. Try both and see what works for you!
• Manual therapy/"hands on treatment" - Health practitioners often utilise various "hands on techniques" to help reduce pain and give you more confidence in returning to your normal life. Whilst they may help, they should be used as an adjunct to exercise based therapy and not solely relied on. Your back is not fragile and there is no "putting back into place" as commonly believed, though various techniques can help to get you moving more and with more comfort. It is believed that it is this improved movement that helps your back resolve, not the technique itself and it is often not needed.

Additional information about back pain with referred leg pain can be found here: British Association of Spine Surgeons - Nerve Root Pain and Some of the Treatment Options.