BACK PAIN: THE ESSENTIAL STEPS TO RECOVERY

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1 BACK PAIN: THE ESSENTIAL STEPS TO RECOVERY Information Leaflet Your Health. Our Priority.

2 Page 2 of 7 Introduction This booklet is based upon the latest research into back pain and contains the most up-to-date information. It aims to help you understand your back pain and help you manage it in the best possible way. The treatment and management of back pain has changed a lot in recent years, so read on to find out the best way to help you keep your back in action Back Pain Many people suffer from back pain at some point in their lives but most of the time it is not serious, even though it may re-occur. Unfortunately, there are no 'quick fixes' - but there is a lot you can do to help yourself - you are the best person to deal with your back pain, it is important that you don't let it take over your life. Having back pain does not mean you will become an invalid. A therapist can help during an acute attack with pain relieving techniques but most acute symptoms do settle with time as long as you stay active and follow a few simple rules. A therapist can give you advice on this and on how to manage your back pain to reduce the likelihood of future episodes. MOST BACK PAIN IS NOT SERIOUS The Spine

3 Page 3 of 7 Due to its' design, it is surprisingly difficult to seriously damage your spine. The strong ligaments and muscles that surround and support the spine add to this strength and flexibility. The majority of back pain comes from muscles, ligaments or the small joints (facet joints) of the spine -because they are not moving as they should and have become stiff. This is called 'mechanical' back pain. Poor posture, repeated or prolonged postures or a poor lifting technique are common causes. The 'slipped disc' is a relatively rare occurrence and is usually associated with severe leg pain. Your therapist/gp will advise you on appropriate treatment. MOST BACK PAIN IS CAUSED BY STIFFNESS AND LACK OF MOVEMENT; NOT A SLIPPED DISC'. Will an X-ray help? An x-ray shows bones, and their relationship to one another. Since most back pain is due to soft tissue problems (e.g. muscle, disc), an x-ray is neither useful nor necessary in determining the course of treatment. How will I know if I need to seek medical attention? Most episodes of mechanical back pain can be self-managed, but if: You have developed difficulty passing urine. You have numbness in your 'saddle' area (your back passage/genitals). You have numbness/pins and needles into both feet and have noticed unsteadiness/loss of co-ordination whilst on your feet. You have a loss of bowel control have been incontinent and feel generally unwell. In the event of any of the above, you should see your GP urgently or attend your local accident and emergency department.

4 Page 4 of 7 What can I do to help myself? Keep yourself active - you may need to rest/modify your activities for a day or two during an acute episode; but the sooner you get back to normal activities the better. Studies have shown bed rest for more than two days is likely to make you worse. Change position regularly. Remember: KEEP ACTIVE! INACTIVITY» WEAK MUSCLES» DECREASED FITNESS» STIFFNESS» INCREASED PAIN Try gradually introducing an exercise to do each day e.g. a brisk walk, swimming, cycling. It is normal for this to cause twinges and aches and may initially increase your pain since you are moving stiff joints and muscles, but if you persevere and gradually increase your activity levels it will get easier, make you feel better and more able to cope. Be patient with yourself and stick at it! Exercises and normal daily activities will not damage your back - exercise actually stimulates release of the body's own natural painkillers and helps decrease stress. Your back is designed to move - try to find an exercise that you enjoy - it will prevent stiffness, decrease stress levels help you stay fit, active and positive and may help you sleep better. You may need to take painkillers or anti-inflammatory medication during an acute attack, or perhaps try some heat a warm/hot water bottle or some people even find ice helpful. Stress can cause increased muscle tension and therefore increased pain; try a new relaxation technique. PROLONGED BED REST IS LIKELY TO MAKE YOU WORSE! Activities of daily living Sitting Don't slouch when sitting - this is a common cause of low back and neck pain since it puts a prolonged strain on your spine. Avoid sitting with your legs crossed or with your feet up. Try a rolledup towel or a lumbar support in the curve of the lower part of your back. Stand up and stretch every 20 mins.

5 Page 5 of 7 Lifting Use your legs when lifting -maintaining that slight hollow in your lower back. Do not twist - hold loads close to your body and reduce the load and distance wherever possible. E.g. when emptying shopping bags - do not empty them from the floor, put them on the work surfaces. Sleeping Your mattress should be supportive but not necessarily hard. As a general rule when lying on your back, you should just be able to slide your hand underneath the small of your lower back. Washing yourself Where possible, try to shower rather than bathe. In the bath you tend to curl up into a poor position. Resting Instead of sitting on the sofa -try relaxing by resting on your tummy for short periods -this is a better position for your lower spine. Exercises Along with your daily exercises you could try adding the following: Arching Backwards: Stand with your feet apart. Support your back with your hands while bending your back as far backwards as possible. Keep your knees straight during the exercise. Lie face down with both your hands at shoulder height. Straighten your elbows and lift your upper trunk as far up as you can. Keep your buttocks and legs relaxed.

6 Page 6 of 7 Summary FALSE TRUE Pain is always a sign of serious damage. Bed rest is best until the pain settles. Most back pain is due to 'slipped discs, crumbling joints or trapped nerves'. X-rays are needed to diagnose the problem. A back operation may be needed to sort out the problem. The amount you feel is directly related to the amount of damage you have. Pain can continue even when any damage has healed. It is because you have become stiff. Keeping active is better than resting. Bed rest for more than 2 days will slow down your recovery. Very few people have these kinds of problems. Most back pain is not due to damage to the spine. X-rays subject you to a large amount of radiation. X-rays often do not show the problem. An experienced clinician has been shown to be more effective in reaching a Diagnosis. Only a small number of people ever have surgery for a back problem and it doesn't always make them pain-free. Most people can be helped with simple measures. A positive attitude, learning to relax and continuing with normal activities has a positive physical effect and can help decrease your perception of the pain. Remember: Stay positive. Try and decrease stress by doing an activity you enjoy each day. Don't worry; pain with movement does not mean harm. Continue with as many activities of daily living as possible. It s your back stay in control and make positive steps to help yourself. Contact us Sarah Thompson

7 Page 7 of 7 If you would like this leaflet in a different format, for example, in large print, or on audiotape, or for people with learning disabilities, please contact: Patient and Customer Services, Poplar Suite, Stepping Hill Hospital. Tel: PCS@stockport.nhs.uk. Our smoke free policy Smoking is not allowed anywhere on our sites. Please read our leaflet 'Policy on Smoke Free NHS Premises' to find out more. Leaflet number TO05 Publication date January 2016 Review date January 2017 Department Trauma and Orthopaedics Location Stepping Hill Hospital