How to relieve lower back pain

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Experiencing lower back pain?

Lower back pain can be very troublesome and extremely waring. It can interfere with your day-to-day activities and affect your quality of sleep. In fact, it’s estimated that 8 out of 10 people will experience lower back pain at some point in their lives.

It can feel tricky knowing what to do for the best sometimes and knowing how to relieve lower back pain so hopefully, we can help you out with some simple evidence-based tips:

Firstly, it’s important to know that in most cases, lower back pain isn’t usually anything to worry about and often resolves itself in 6-8 weeks, providing we follow good advice. Hopefully, that gives you some peace of mind.

Demystifying a few terms often used in relation to back pain.

· ‘acute back pain’ simply refers to pain which has a duration of fewer than 3 months

· ‘chronic back pain’ refers to a duration of 3 months or more (with the potential for fluctuating intensity during this period).

· ‘sciatica’ is a term used to describe pain caused by the sciatic nerve in the leg(s) but it is important to understand that not all leg pain is caused by the sciatic nerve. We have other nerves besides and sometimes it is not nerve pain at all. A thorough assessment can help work out the cause of your leg symptoms.

· ‘radiculopathy’ or ‘radicular pain’ refers to pain caused by a compressed and/or inflamed nerve. We have lots of nerves throughout our body so clinicians will ask you about your symptoms and work out which nerve is being affected and why.

How to relieve back pain.

The most important advice we could give is to stay active. This might mean modifying some of your activities for a time (for example, shorter more regular walks or less time spent sitting) but it’s essential you don’t ‘take to your bed’ and rest for weeks on end. Pace your activities and remember the motto ‘variety is the spice of life’. Too much of any one thing tends not to be helpful. For instance, if sitting appears to be exacerbating your symptoms after 30 minutes, get up at 20 minutes and move around. It can be helpful to adopt a change of position such as standing too. Lots of people who have office-based roles have started to use sit-stand desk frames. This is a great way of keeping more active in an otherwise sedentary job.

If pain and discomfort are limiting you, it is helpful to consider taking analgesia to help you remain more active. Anti-inflammatory medication can be a good starting point (with or without paracetamol) but it’s important to check that you can safely take it, particularly if you have any health conditions or take other medications, and that you take the lowest effective dose for the shortest possible time. Sometimes people need medication to help prevent tummy upsets alongside medications such as these too so check with your GP or pharmacist if you’re unsure.

Using heat or ice packs (or a combination of both) can help alleviate muscle spasm and provide short term pain relief. It’s important you know how to safely administer these so if you’re unsure, seek advice on this.

Specific exercises can be beneficial too and this can be where a physiotherapy appointment proves invaluable. We have a range of information and videos on the useful tips and information page of our website and our Plus Health YouTube channel which you might like to check out.

Manual therapy and massage can also be helpful in releasing joint and muscular/fascial restrictions too and sometimes you can learn helpful self-treatment techniques too.

It is also important any worrying thoughts or feelings about your pain are addressed as well, which can be why seeing an experienced healthcare professional can be advantageous. Write down any questions you might have and take them along with you to your appointment.

Further steps.

Sometimes people feel they ought to have an x-ray or scan but it’s important to know that these aren’t always clinically required and can sometimes be misleading. To explain, our bodies naturally change over time and this is reflected in x-rays and scans. It doesn’t necessarily mean that what is seen on a scan or x-ray is causing your current pain and discomfort. Your experienced healthcare professional should be able to make sense of your symptoms from what you cover in your assessment. Having said that, there are times when scans and x-rays are indicated. Usually, a clinician working in the musculoskeletal clinic or a spinal consultant will be best placed to determine whether this is necessary or not.

Occasionally, clinicians may suggest treatments such as traction, ultrasound, interferential therapy, TNS machines etc to help improve your back pain but these are rather outdated approaches and none of which are recommended as effective treatment options according to NICE guidelines for back pain and sciatica in over 16’s. Nor is using back braces/supports, orthotics or rocker soled shoes. Interestingly, NICE also suggest acupuncture should not be recommended either but in practice, we have found this a useful treatment tool for some clients who present with acute muscle spasm and are unable to tolerate other physiotherapeutic treatments.

In a small number of cases, people may require onwards referral for further investigation, spinal injections or surgery. It’s important to feel fully informed about more invasive treatment options and that you feel confident in the clinician/consultant who is discussing these with you. If you’re uncertain, seek out a second opinion and make sure you’re well-researched. Knowledge is power in our opinion.

Ref: NICE Guidelines for Low back pain and sciatica in over 16’s: assessment and treatment. 2016. Updated Dec 2020.

Kneeling exercises to promote mobility, stability and control.

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