Back Pain - Self-Care

What you should know

Back pain is a very common problem and will affect many of us at some point during our lives. The good news is that in most cases it isn’t a serious problem will usually get better over time.

As far as possible, it’s best to continue with your normal everyday activities as soon as you can and to keep moving. Being active and exercising won’t make your back pain worse, even if you have a bit of pain/ discomfort at first. Staying active will help you get better.  But sometimes the pain can last a long time or keep coming back. Even if some aches last for a bit longer, it doesn’t mean that anything serious is wrong. You can still be active even if there is some pain.
 
Flare ups of pain are common but again it does not mean that there is anything seriously wrong.  Between flare ups stay active and you’ll be back to normal soon.
 
The back needs to move to remain healthy. The sooner you get moving the sooner you will feel better. The people who cope the best with back pain are those whose stay active and get on with life.
 

What to do

There are many ways in which you can help reduce lower back pain. Although it may not remove the pain completely, it should reduce it.
 

Keep moving


Staying active is the most important way you can help yourself if you have back pain.  The more you move, the more the back will keep its natural range of movement. If you stop being active for a long time, the muscles in your back become weaker and you lose fitness, and this can make your back pain worse.
 
Regular exercise leads to shorter and less frequent episodes of back pain. It also releases chemicals called endorphins, which are the body’s natural painkillers. These improve pain and make you feel happier. Exercise might make your back feel a bit sore at first but it doesn’t cause any harm – so don’t let it put you off.
 
If you're getting back to exercise, start off gently and gradually increase the amount of exercise you do so you are pacing your activity. Regular and small episodes of exercise are a good way to start and then each day try to do a little bit more.
All types of exercise can be worthwhile choose something you enjoy as you are more likely to stick at it.
 
It’s important that you continue to exercise regularly and don’t stop when the pain is gone and you’re feeling better, for your long-term general health.
 

Pain medication

 

It may surprise you, but simple over the counter painkillers such as paracetamol and ibuprofen are the most effective pain medication. If you feel you need them – use them, following advice of a pharmacist. You should only take the recommended daily dose but do not wait until your pain is out of control to take them.

Consult with your GP or Pharmacist if you have any concerns and do not take ibuprofen or aspirin if you are pregnant or have asthma, an ulcer or indigestion.

Hot/cold


An ice or cold pack in the first 0-72 hours can be used to help reduce back pain, make sure to only use for 10-15 minutes on protected skin.
 
After this period, heat such as a hot water bottle, a bath or a shower can be an excellent effective way to reduce pain. Again use for 10-15 minutes.
 
For both hot and cold you should make sure there is something between your skin and the source of heat/cold such as a paper towel or tea-towel.

Sleep


Sleep is really important when it comes to managing pain. Studies suggest that getting a good night sleep can reduce pain levels by as much as 25%.

Tips to improve your sleep include:

  • Sleeping in a dark, quiet and cool room
  • Try taking pain relief an hour before you go to bed
  • Do not consume caffeine within six hours of sleeping
  • Try to avoid eating within two hours of sleeping
  • Try not to be in front of bright screens such as TVs, laptops or phones for one hour before bed
  • Keep your bedroom as a place to sleep - do not use it for work or as an office
  • If you do wake in the night and cannot get back to sleep - get up, go to another room and do something until you are tired enough to sleep

Diet and nutrition

 

There are no special diets that have been shown to either help or prevent back pain. However, if you’re overweight you should consider changing your diet and doing some regular exercise to help you lose weight, as this is very likely to decrease your pain.

What’s recommend for us all is a well-balanced and healthy diet, which is low in saturated fats, sugar and salt. It’s also a very good idea to eat plenty of fresh fruit and vegetables, and to drink plenty of water.

If you need to lose weight, the key is to regularly burn off more energy than you consume on a daily basis.

Relaxation
 

Stress can make pain worse. One way of reducing the effects of stress is to learn how to relax.

There are many relaxation, meditation or mindfulness tapes, CDs and MP3 downloads available – your doctor or physiotherapist may be able to offer you some, or they’re available online or from high-street shops. A good example is Headspace which is available online or as an application for your smart phone or tablet.

Exercises


If an exercise is painful to undertake or causes a moderate to high level of pain during or afterwards then reduce the difficulty level or stop that specific exercise.
 

  • Knees to chest: lie on your back with your knees bent. Bring one knee up and pull it gently into your chest for 5 seconds. Repeat up to 5 times on each side.
  • Back stretch: lie on your back with your hands above your head. Bend your knees and roll them slowly to one side, keeping your feet on the floor. Hold for 5 seconds. Repeat 5 times on each side.
  • Pelvic tilt: lie down with your knees bent. Tighten your stomach muscles flattening your back against the floor. Hold for 5 seconds. Repeat 5 times.


When to see your GP or Physiotherapist

  • If your back pain is no better after at least two weeks or you develop other symptoms
  • ​If you start having back pain for the first time after age 55, or if you have a history of cancer, osteoporosis, steroid use, or excessive drug or alcohol use

When to attend A&E

There are some rare conditions however, which do need emergency medical care such as Cauda Equina syndrome. This is a rare but serious back condition, which can cause permanent damage and will need the attention of an emergency spinal specialist team.

The warning signs include:
  • Loss of feeling/pins and needles between your inner thighs or genitals
  • Numbness in or around your back passage or buttocks
  • Altered feeling when using toilet paper to wipe your self
  • Increasing difficulty when you try to urinate
  • Increasing difficulty when you try to stop or control your flow of urine
  • Loss of sensation when you pass urine
  • Leaking urine or recent need to use pads
  • Not knowing when your bladder is full or empty
  • Inability to stop a bowel movement or leaking
  • Loss of sensation when you pass a bowel motion
  • Change in ability to achieve an erection or ejaculate
  • Loss of sensation in genitals during sexual intercourse
There are some other rare cases in which back pain can signal a serious medical problem. Seek immediate care if your back pain:
  • Is accompanied by a fever
  • Follows a fall, blow to your back or other injury
  • You have a pulsating feeling in the abdomen
We must also be aware if your back pain:
  • Is severe, unremitting and doesn’t improve with rest
  • Causes weakness, numbness or tingling in one or both legs
  • Is accompanied by unexplained weight loss

Further Resources


Authors: Cianán O’Sullivan, Beth Keddie, Catrin Astbury, Jemima Cope and Jane Leah
Review Date: July 2022