Back Pain

Mr Cass has a special interest in back pain and its management, but he here gives some helpful advice to reassure most people:

"Back pain, particularly lower back or lumbar pain, is very common. Most people will have at least one episode of back pain in their lives, sufficient to lay them up for a day or so. The majority of these episodes are likely to be self-limiting and a one-off.

You can reduce the risk of having back problems by, amongst others, ceasing smoking (there is a clear correlation with smoking and damage to the intervertebral discs), keeping generally fit, avoiding overloading your back with dangerous lifting & twisting, and keeping well hydrated. 

Back pain can be defined as acute (meaning lasting for a short time only) or chronic (where the pain has gone on for several weeks or longer). Furthermore back pain can be ‘mechanical’ in nature meaning pain arising from the many actual structures which make up the spine, or ‘neurogenic’ meaning arising from irritation of a nerve within the spine.

Mechanical pain often is felt as localised pain & spasm in the area of the spine affected, whilst neurogenic (sometimes called radicular pain) pain is often felt along the line of the nerve (hence the oft used term 'sciatica' for some nerve pain). The two types of pain can occur together.

It is not unusual for back pain to be accompanied by other symptoms, such as numbness and tingling sensations, stiffness, achiness, and weakness. Certain activities may increase or aggravate back pain. Walking, standing, bending over, and twisting at the waist are a few of the movements that can make back pain worse, but it can be different with every patient.  Rather, it depends on what level of the spine is affected and the diagnosis, or cause.

A simple injury, such as a back sprain/strain from lifting and twisting simultaneously, can cause immediate and severe pain that is typically self-limiting. Sometimes though back pain can arise without any clear injury. It can be caused by wear & tear changes, problems with the way your spine was formed before birth or in your teenage years, or more rarely linked to other diseases.

A key question in many peoples minds is “When should I seek professional advice about this?” Most people who experience  back pain - even down into one or both legs - intuitively know when it’s time to seek professional help."

A few important things to consider are whether you have any of the following symptoms:

  • You cannot stand upright
  • Fever accompanies pain
  • Loss of bladder or bowel function or control
  • Weakness in your arms or legs
  • Pain is relentless (occurs even at night or at rest) or worsens

If you have any of these you should seek medical advice promptly.

Many patients with back pain  report feeling afraid and anxious, which is normal, but Its very important not to panic or 'think the worst'. 

The key thing Mr Cass will be trying to determine is the source of your pain (often called the ‘pain generator’) and to rule out more serious causes. To enable him to do this he will usually get from you a description of how the pain started and how it is now; what treatments you have tried before seeing him. Usually a physical examination and imaging of the relevant area will be needed.This will commonly be an MRI scan, but also may include X-rays, CT scans or bone scans.

Mr Cass will tailor any treatments to your specific condition. There will usually be options available to you, which you can expect Mr Cass to explain, in order to enable you to make your own decision on your further management.

If you are concerned and feel the need for an expert opinion, then feel free to contact Mr Cass’s Office to book an appointment. We can be contacted on 01273 828098.

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