BACK PAIN

The treatment of back pain has been radically revised recently and extensive periods of bedrest are thought to be inappropriate in almost every case. The emphasis now is on the muscles and keeping them in a good state of tone. If they become weakened then the recovery from back pain is likely be delayed and we know from other parts of the body disuse weakens the muscles and prolongs the disablity. In most cases it's very true that if you don't use it you'll lose it!

In the absence of pre-existing disease such as cancer or of any symptoms other than  low back pain made worse on movement and if your age is between 20 and 50 it is most unlikely that there is anything serious going on. Outside this age range (if this is backpain arising for the first time), if there are additional symptoms (fever, pain in the leg, numbness, urinary symptoms, incontinence etc.) or if you are worried that you don't seem to be improving then you will need checking. Only very severe pain or difficulty controlling bowels or waterworks or if you are generally unwell with a high fever does it really warrant a call out of hours. In all other cases we would expect you to come to surgery unless poor mobility necessitates a routine visit.

If you need to see the doctor you please take the advice you are given otherwise we endorse the following advice from the local Darlington guidelines:

• Keep moving.
  • Do as many of your normal daily activities as possible.
  • Getting in and out of a chair:
    • Brace tummy muscles.
    • Do not sit for longer than 20 mins.. Then get up and walk around.
    • Try to do a little more each day.
  • For relief from pain when standing you could try rocking from one foot to the other.
  • Getting in and out of bed. Roll on to side first and keep your back straight.
  • Getting out of bed - some people find it easier to roll on to their tummy first.
• Using towels pillows and cushions.
  • Placed between your legs/knees when lying on your side in bed. Support your head with enough pillows to prevent your neck bending.
  • Underneath your knees whilst lying. Put a pillow under your knees. Add another pillow if that is more comfortable.
  • Can be used to support your arms whilst sitting and to sit on if your chair is too low or too soft. Good arm support encourages you to straighten your back. It may be helpful to roll up a towel and place at the back of your waist.
• Pain relief.
  • You may be taking something to relieve the pain. In addition, for extra comfort, you may like to try cold or heat.
    • Cold. Place a cold pack on your back for 10-20 mins. at a time. If you do not have a proper cold pack you can use a bag of frozen peas or crushed ice cubes in a bag. (Always remember when using cold or heat to wrap the source in a towel to protect your skin and the tissues underneath).
    • Heat. You may prefer heat in the form of a hot water bottle or hot pack wrapped in a towel.
    • Taking a bath or shower. A shower is better if available as it avoids the difficulties of getting into and out of the bath and baths are not usually designed to give good support to the back.

Remember - back pain is extremely common. If you've had it it is important to:

• Listen to medcal advice.
• Always think about your back and the position that you are in.
• Try to avoid repetitive movements.
• Remember to walk as straight as you can.
• When bending remember to keep your back straight and bend your knees.
• Avoid lifting heavy weights.
• You may feel discomfort but try to keep moving unless the doctor has specifically advised you against this.

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