Back Pain Treatments
Back pain is rather like that old saying about death and taxes: it affects most people at some point during their lives. According to the National Institute for Health and Care Excellence (NICE), up to 60 per cent of the adult population can expect to have low back pain at some point or other (i). A survey also suggests that every year, 49 percent of adults in the UK report lower back pain that lasts for at least 24 hours (ii), while another claims it’s the second-most popular reason for long-term sickness in most parts of the country (iii).
Indeed, non-specific lower back pain is believed to be the most common type of back pain, causing soreness, stiffness and tension in people of all ages. The pain may also become more intense during the night or after you’ve been sitting in the same position for a long time (after a long drive, for example).
While it may be very common, the good news is back pain isn't usually caused by anything serious and most people get better within a few weeks or months (acute back pain lasts for less than six weeks, while sub-acute back pain lasts between six and 12 weeks and chronic back pain lasts for 12 weeks or longer).
One of the main problems with back pain, however, is that it’s often difficult to pinpoint exactly what causes it, as most cases aren't a result of serious damage or disease but by muscle or ligament sprains, strains, minor injuries and pinched or irritated nerves. These may be caused by a number of things, usually over a period of time, including lifting, carrying, pushing or pulling incorrectly, slouching, twisting, over-stretching and overusing your muscles. Years of poor posture can also contribute to back pain, but it can also happen for no reason whatsoever.
Some people may be more likely to suffer from back pain, including those who are overweight, smokers, pregnant women, people taking certain long-term medications and those who are under stress. One study even suggests that emotional factors such as anxiety and depression may contribute towards back pain (iv).
Some cases of back pain can be caused by damage to parts of your spine, including a fracture, a slipped disc (or herniated disc), degenerative disc disease, osteoarthritis, rheumatoid arthritis or osteoporosis.
Types of back pain
Lower back pain may be the most common type of back pain, but there are also several other types, including neck pain, frozen shoulder, upper or middle back pain, sciatica, whiplash and ankylosing spondylitis.
According to Patient his is one of the most common musculoskeletal complaints, with about two thirds of the UK population experiencing neck pain at some point in their lives (v).
Frozen shoulder can cause pain and stiffness in your shoulder for months, and according to the NHS sometimes for years (vi). It’s thought to affect about 3 per cent of adults – including more women than men – at some stage in their lives, most commonly those who are between the ages of 50 and 65 (vii).
Nobody really knows why this happens, but it’s thought that a shoulder injury or shoulder surgery could increase your risk of developing a frozen shoulder. Other risk factors include having diabetes, though it’s unclear why this is the case.
If you’ve suffered a neck injury where your head was suddenly forced forwards, backwards or sideways, the result can be a condition called whiplash. Often associated with road accidents, whiplash describes damaged tendons and ligaments in the neck, causing pain, tenderness, stiffness and limited mobility in the neck, as well as headaches.
In most cases, whiplash improves over time without causing any permanent damage. According to the NHS it often gets better within a few weeks or months, but for some it can last longer (viii).
Thoracic back pain
Also known as upper back or the middle back pain, thoracic back pain affects the area from the base of your neck to the bottom of your rib cage (an area also known as the thoracic spine). Often causing a dull, burning or sharp pain, it’s less common than lower back pain, but a medical review suggests up to 19.5 percent of people may suffer from it at some point during their lifetime (ix).
The sciatic nerve runs from the back of your pelvis right down to your feet (it’s the longest nerve in the body). When this nerve is irritated or compressed – causing mild to severe pain, tingling or loss of feeling from the lower back down the leg and even to your feet – the result is called sciatica.
More commonly affecting the buttocks and legs than the lower back, sciatica can be caused by a slipped disc (also known as a herniated disk, which is when one of the discs between two bones in the spine, or vertebrae, becomes damaged). If you think this may be the cause of your back pain, our guide to managing sciatica may help.
A type of arthritis that affects the spine, ankylosing spondylitis (AS) usually starts to develop in people aged 20-30 and is three times more common in men than in women (x). According to Patient, about one in 1,000 people in the UK develop AS (xi), which is the result of parts of the spine and other joints becoming inflamed. Experts don’t really know what causes it, but it may be genetic, as some believe AS is linked to a gene called HLA-B27 (xi). Discover more about how ankylosing spondylitis could be causing your back pain.
How to keep your back healthy
Having a strong, supple back is one of the best ways to prevent back pain. Here are some tips that may help:
Regular exercise and being active on a daily basis will help keep your back healthy and strong. Try walking or swimming to strengthen your back muscles, as well as yoga or Pilates to improve flexibility.
Make sure your mattress is firm enough to support your back and keep your spine straight. Try putting a stiff board under an unsupportive mattress to see if that works before splashing out on a new one. Also avoid using too many pillows, which may put unnecessary pressure on your neck.
Too much body weight can put a strain on your lower back, so make a decision to lose weight if you need to – your back will thank you for it. Doing regular exercise will help you to achieve a healthy weight, as will eating a healthy, balanced diet.
Incorrect posture can put a strain on your back and, in the long term, lead to back pain. So always stand upright with your back straight, your weight balanced evenly on both feet. Sit upright too, and keep your knees and hips level, your feet flat on the floor. A small cushion or other support in the small of your back may help keep your posture correct.
Be even more careful about your posture if your job entails sitting for long periods of time. If you do lots of driving, position your side mirrors so that you don’t have to twist your torso, shoulders or neck to see them, and adjust your seat so that you can access the foot controls and keep your lower back well supported. Also don’t forget to take regular breaks if you regularly drive long distances.
Also be careful when it comes to lifting heavy objects, especially if you’ve had a back problem in the past or if you have to do a lot of lifting in your job. According to the charity Backcare , the correct lifting technique is to bend your knees and keep the weight as close to your body as possible.
Finally, a survey published on Statista.com suggests adults in the US believe stress is the number cause of their back pain (xii). So if you’re feeling under a lot of pressure, take steps to manage your stress levels as effectively as possible. For instance, you could try a relaxation technique such as meditation or learn some simple breathing techniques..
Pain relief for backache
Health experts recommend that most cases of short-term back pain can be treated with widely available painkillers:
NSAIDs – or non-steroidal anti-inflammatory drugs – are a suitable type of relief for back pain, such as ibuprofen tablets and gels or diclofenac tablets and gels (depending on your age, you may need to speak to your GP before taking NSAIDs as these medicines should be used with caution in older people because of an increased risk of side effects). Ibuprofen is available over the counter at pharmacies, while other NSAIDs such as diclofenac and naproxen need a prescription.
A stronger painkiller such as codeine may provide relief if you can’t take NSAIDs or if they don’t work well for you. Try co-codamol, which is codeine combined with paracetamol (this is available without a prescription). However, codeine can cause constipation, which may make back pain worse.
According to Patient, if you need painkillers for back pain, it’s best to take them regularly rather than just now and then when the pain is bad (xiii). Meanwhile, drug-free treatments may also be beneficial. These include hot or cold treatments such as heat pads and patches and ice packs and sprays. Alternatively, try a hot bath or apply a hot water bottle to the affected area, or a handful of ice cubes or frozen vegetables wrapped in a tea towel (don’t allow ice or frozen vegetables come into direct contact with your skin as they can cause a cold burn). Many people also find that alternating hot and cold treatments can be effective
Should you see your GP?
Experts at the NHS advise that you should visit your GP if you have back pain that doesn't start to improve within a few weeks, if it’s very severe or gets worse over time, if it stops you doing your day-to-day activities or if you’re worried about it or are struggling to cope (xiv).
Meanwhile, get immediate medical help if your back pain is accompanied by one or more of the following:
Unexplained weight loss
Swelling in the back
Pain in other parts of your body
Loss of bladder or bowel control
Tingling and/or numbness in the legs
Natural Remedies for Back Pain
Conventional painkillers may be recommended as a treatment for short-term back pain, but if you prefer a more natural solution, the following may help:
A plant that originates from South Africa, devil’s claw is a traditional herbal medicine used for the relief of backache, as well as other types of joint aches and pains. Most of the scientific evidence for devil's claw comes from arthritis studies, but one small-scale trial suggests it is effective as a treatment for muscular tension or pain in the back, shoulder and neck (xv). A review of 14 randomised controlled trials also found that devil’s claw seems to reduce pain more than placebo (xvi).
It may be best known as a curry spice, but turmeric – or rather, a substance in turmeric called curcumin – is also thought to have anti-inflammatory properties and there is some evidence to suggest it may treat pain effectively without the side effects of NSAIDs (xvii). Indeed, in Ayurvedic medicine – a traditional system of Indian herbal medicine – turmeric is sometimes used to treat the symptoms of arthritis.
Many people may take fish oil supplements to boost their cardiovascular health. But the omega-3 fatty acids EPA and DHA found in fish oil are also used to relieve inflammation, which can be present in some types of back pain. That’s because omega-3 fatty acids are thought to affect the body’s production of prostaglandins, substances that play a key role in the production of inflammation.
One study, for instance, suggests that long-term use of omega-3 fatty acids may lower your risk of developing rheumatoid arthritis, a disease that causes inflammation of the joints (xviii). Another study suggests fish oils may be a safer alternative to NSAIDs when used to treat nonsurgical back or neck pain (xix).
If you’re a vegetarian or vegan you can still benefit from an omega-3 supplement, thanks to the availability of products that contain the natural triglyceride (TG) form of omega-3, which is sourced from plant organisms called microalgae rather than fish oils.
A simple molecule derived from glucose, glucosamine is a key building block for making joint cartilage, including the tissue that supports the discs in the spine. It is widely accepted as a natural treatment for osteoarthritis. One small-scale study also suggests that glucosamine may help relieve low back pain as well as improve quality of life in back pain sufferers (xx).
Meanwhile, several therapies may offer relief from back pain, including physiotherapy, acupuncture, chiropractic, osteopathy, t’ai chi and yoga.
Also known as palmitoylethanolamide, PEA is a type of fatty acid made naturally by the body and found in all cells, tissues and fluids including the brain (it’s also found in foods such as soya beans, peanuts, eggs, flaxseed and milk). Described as an endocannbinoid-like chemical that belongs to a family of fatty acid compounds called amides (xxi), PEA is an alternative to CBD, since both substances are thought to have similar properties including the ability to reduce pain and inflammation. However researchers suggest PEA is safer than CBD, since it has been studied more extensively and has a more robust safety profile (xxii) with no known side effects (xxi).
Your body naturally increases its production of PEA when your cells are damaged or threatened. But in certain situations – such as when your body is experiencing chronic (long-term) inflammation – the level of PEA in your cells drops (xxii). When this happens, PEA supplements may be helpful. In fact one study suggests PEA supplements may help with chronic lower back pain management when used alongside a conventional type of painkiller, claiming that it may even allow those affected to reduce their painkiller dosage over time (xxiii).
To discover more information on a number of joint conditions visit our health library, where you’ll find a whole range of helpful articles.
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Disclaimer: The information presented by Nature's Best is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.
Christine Morgan has been a freelance health and wellbeing journalist for almost 20 years, having written for numerous publications including the Daily Mirror, S Magazine, Top Sante, Healthy, Woman & Home, Zest, Allergy, Healthy Times and Pregnancy & Birth; she has also edited several titles such as Women’ Health, Shine’s Real Health & Beauty and All About Health.