Back pain Dr Trisha Macnair Back pain is extremely common yet, in most cases, no exact diagnosis is made and there's no simple treatment.

In this article

What causes it? What are the symptoms?

Who's affected? What's the treatment?

Can it be prevented?

Back pain is the largest single cause of sickness absence from work and, for many people, can be a chronic problem. At least half of people with back pain have recurring problems.

In most cases, the pain is caused by minor damage to the ligaments and muscles in the back. This may occur from sitting or standing in the wrong position, straining the muscles when lifting or twisting, or from being overweight.

Sometimes back pain is caused by a slipped disc or disease in the spine itself, such as arthritis. There are plenty of other medical causes of low back pain, from muscle tears to abnormal curvature of the spine, known as scoliosis.

It's worth seeing your doctor the first time you develop back pain to rule out treatable medical causes, especially if you're very young. In many cases, a doctor won't be able to offer a precise reason for your pain.

The main things to think about are:

• Could your posture or habits be putting your back at risk?
• Could you have done something to damage your back?
• Could you have a medical problem that's affecting your back?

A sharp pain may appear in a localised area or, more commonly, be felt as a generalised ache in the lower back and buttocks. There may be back stiffness and difficulty bending.

When a disc prolapses and puts pressure on the nerves, causing sciatica, pain may radiate down the back of the leg to the foot and be accompanied by numbness or tingling.

Back pain associated with weight loss, or difficulty controlling bowel or bladder function, may be caused by a serious disorder, so it's important to get immediate medical advice.

Everyone can be affected by back pain, but it's more common in those who are overweight or who sit slouching for long periods of time.

Back pain can occur at any age, but the peak time is between the ages of 45 and 59. Men and women tend to be affected equally.

The road to recovery is individual and you'll have to work out (with some medical help) what suits you. However, there are a few general points.

• Seek specialist help as early as possible, when treatment is most effective, and before acute problems become chronic.
• In the acute stages, some treatments help most people. Regular and effective pain relief is essential.
• For the first two to three days after a sudden injury, take painkillers at fixed intervals as directed on the label - don't wait for the pain to kick in before taking the next dose. If this isn't enough to control the pain, get advice from your pharmacist or doctor.
• Applying alternate hot and cold compresses to the affected area may also help relieve pain.
• It's recommended you remain as active as possible rather than lying flat on your back for days on end, unless specifically advised otherwise by your doctor.

Early research suggests a combination of spinal manipulation, general exercise and active management, or specific treatments while you return to normal activities, may produce most benefits.

Surgery is a last resort. Although it can be a welcome end to pain for some, it has disappointing results for others.

It's possible to prevent low back pain, or reduce the chance of it recurring.

As a general rule, being fitter and having a strong back and good posture will help to reduce the risk. Two good types of exercise for backs, especially while recovering from an injury, are cycling and swimming. However, if you arch your back to keep your head above water it can put strain on the spine. Some sports, such as golf and racket sports, put extra strain on the back.

Practise back exercises or learn the Alexander technique or yoga to improve posture.

Learn how to lift safely - whether it's children or suitcases, ensure you know how to pick something up without putting unnecessary strain on your back.

This article was last medically reviewed by Dr Rob Hicks in November 2007