Back Pain Explained

Back pain affects so many Australians, and it can be as debilitating as it is commonplace. If you have not been affected, it's more than likely you know someone who has.

Yet there is still stigma around having back pain, injuries and treatment. 

Musculoskeletal Australia does a great job of exploring this stigma in their article ‘Shining a Light on Back Pain’, and we want to keep this conversation going because it is such an important issue. 

Back pain, like other musculoskeletal problems, is a medical condition or issue that is invisible to the naked eye. 

Those suffering often cannot explain why the onset of back pain occurred, and often it can come and go for no apparent reason.

Despite so many people worldwide suffering from back pain, it may come as a surprise to you that it's the world's leading cause of disability. 

According to WHO, one in every six Australians suffers from back pain, amounting to approximately 4 million Australians suffering daily. Interestingly, these statistics do not include those who suffer from illnesses such as osteoporosis.

Musculoskeletal Australia conducted a national survey in 2020, showing that these figures of 4 million would be far higher if chronic illness sufferers were included in the statistics. 

How the back works

Back pain and injuries can be highly debilitating and often difficult to understand. It may be easier to understand the pain when you know how the back works.

The spine comprises many bones or vertebrae; together, they form a loose 'S' shape running up the middle of your back. 

The intervertebral discs are between each vertebra, a spongy material that supports each vertebra and aids the back in its movement. These intervertebral discs work as shock absorbers and provide flexibility to your spine. 

Facet joints are tiny joints that connect each vertebra. Ligaments, tendons, and muscles support the spine, aid in movement, and protect the spine from injury.

The spinal cord runs through the centre of the vertebrae, linking your brain to the rest of the body. 

Why do we experience back pain?

It is not always easy for individuals to understand why they suffer from back pain.

Back pain, despite sometimes being quite severe,is generally not due to damage to the spine. It is generally the joints, muscles and ligaments in the back that are responsible for the pain.

Back pain can be caused by a variety of reasons, including:

• The most common cause of back pain is ‘non-specific’, which as the name suggests, means there is no specific reason someone suffers from the pain.
• Arthritis is another major cause of back pain, osteoarthritis and ankylosing spondylitis being the most associated forms.
• Osteoporosis is a common condition that can cause the bones to become brittle and weak. Sufferers with this condition can have spinal disc disease, which causes the vertebrae to be porous and break, causing extreme pain.
• Stress and fatigue can cause the muscles around your spine to tense, causing muscle tightness and discomfort, resulting in back pain.
• Sciatica can cause shooting back pain as it’s the chronic condition of pinching of the sciatic nerve.
• Poor lifestyle choices can also lead to chronic back pain, such as inactivity, obesity, smoking, poor diet and lack of sleep.
• Accidents, such as a fall or moving the wrong way, can cause acute ‘short-term’ or chronic 'long-term' back pain/injury.

Diagnosing back pain

Back pain diagnosis will usually begin with a consultation with your doctor, as back pain can be challenging to diagnose. Your doctor will ask you to identify your back pain and what you believe caused the initial injury. 

Discussing your movements and daily activity can assist in identifying this. The doctor will be interested in knowing how often this back pain occurs and if anything helps you maintain or fix the pain.

Your doctor will then conduct an initial examination of your back to try and identify why and where the pain is occurring.

If your doctor suspects a severe or underlying condition, you may be sent for more testing.

Other testing may include CT scanning, MRI and x-ray; however, these are not required in all back conditions and diagnoses. 

Before undergoing a test, treatment or operation, visit the Choosing Wisely Australia website for the questions to ask your doctor. 

Managing back pain

If your back pain goes away on its own, there might be no need to seek medical advice. However, the following tips may assist in relieving your pain and getting you back on your feet faster.

• Understand your pain - recognise what may have caused your back pain initially. Is there anything that eases the pain, such as light exercise or stretching? Understanding the cause and possible treatment for your pain ensure you can reduce the occurrences of the pain and have informed decisions on treatment.

• Take it easy – Resting in bed for prolonged periods is not helpful for recovery; however, avoiding strenuous activity temporarily while incorporating light movement such as walking can help.

• Accomodation - Return to your daily routine as much as physically possible. If your job is physically demanding, ask for reduced duties while you recover.

• Move - While resting is important, prolonged periods of sitting or lying down can hinder recovery. Never sit, stand or lie down for extended periods. Stretching, going for a walk and a light yoga class with an instructor will assist in recovery. 'Motion is lotion', as the professionals say, and movement will keep your muscles supple, your joints active and will aid in reducing inflammation and discomfort.

• Pain management - You can learn to manage your pain more effectively by learning new techniques. When it comes to dealing with pain, it's critical to understand what works for you. You can seek advice when understanding how to maintain your pain. Some proven natural techniques include applying heat, light massage, an anti-inflammatory gel, ice, stretching, light exercise and non-invasive procedures such as using a 'tens' machine.

• Managing stress - When you are experiencing pain, it is natural to experience irritability, stress and tension. However, stress and anxiety will only cause your pain to increase or prolong it due to tension in the muscles during times of distress. Stress-relieving activities such as meditation, tai chi and yoga incorporate breathing techniques that can assist in relieving stress and anxiety.  While the pain you feel is not imaginary by any means, our perception of pain can influence how it is felt within the body and how we cope with it. Talking to a friend, family member or professional about why you may be feeling these emotions and how to ease them is a positive step in the recovery process.

• Heat and cold treatment - The use of hot and cold treatments on the area of discomfort may provide relief from pain. A cold compress and heat pack applied to the area of pain can provide relief to the area. Ensure you wear appropriate clothing while using this treatment so the skin is not affected. Applying your cold compress or heat pack for a maximum of 10 to 15 minutes at a time with a break in between will provide effective pain management and soothe the area.

• Positive lifestyle choices - Positive lifestyle choices are crucial to wellbeing. It's critical to maintain a healthy weight by following a balanced diet and regularly exercising. Quality sleep is essential to maintaining a healthy back and lifestyle. Ensure you are getting a good amount of regular quality sleep and ensure resting is a priority. If you are a smoker, it's important to seek advice on quitting, and excessive alcohol consumption needs to be reduced.

• Medication - In the short term, if your pain is unmanageable, it's a good idea to speak to a doctor who may be able to prescribe an effective short-term medication to assist you. If you choose to use prescribed or over the counter medicines in the short term, ensure you get informed advice on its benefits and possible side effects.

• Seek advice - If your back pain does not ease, it's important to talk to a professional about an appropriate treatment plan for you.

What about Surgery?

In some extreme cases, surgery may be an option for you. Although back pain can usually be managed by non-invasive treatments, exercise, diet and positive lifestyle changes, in some cases, your doctor may decide surgery is appropriate for you. 

If your doctor recommends surgery, it's important to understand the benefits and risks to make an informed decision. In some cases, seeking a second option or alternative advice may be a good idea. 

Final Words

Millions of Australians and people across the world suffer from chronic back pain, but fortunately there are many treatment options available. It's important to discuss your pain and treatment options with a trusted professional. 

Be sure to make informed decisions about your health and maintain a healthy lifestyle to ensure you maintain the wellbeing and entire movement of your back.

Body Active Myotherapy specialise in treatments for back pain and back injuries. If you would like more information feel free to contact us or book a session for treatment if you are experiencing back pain.

Reference: Musculoskeletal Australia