Back pain: Causes, management tips, and myths

Whether it's due to a winning kick in football or lifting something heavy, back pain affects most people at some point in their lives. Mr James Langdon sees patients with back pain in every clinic he runs. Here, he explains the commonest causes of back pain and shares some top tips for managing acute back pain.

What are the common causes of back pain?

Back pain is very common, affecting 75% of us at some point in our lives. The back is a complex structure comprising bones, muscles, nerves, and joints, making it difficult to pinpoint the exact cause of pain. Back pain can be severe and alarming, often leading patients to worry about serious underlying issues. However, most back pain is due to minor soft tissue sprains or strains rather than serious damage or disease. It can be triggered by everyday activities, develop over time, or occur suddenly without an apparent reason. When there's no clear cause, it's termed non-specific or mechanical back pain. This accounts for 85% of acute cases of back pain.

Occasionally, back pain can be a sign that there is something more serious going on. If your back pain does not start to settle after 10 days or if it is getting progressively worse then you should consult a doctor. Whilst we may not always be able to tell you the cause of your back pain, doctors are skilled at ruling out serious conditions. Certain signs, known as "Red Flags," may indicate a more serious problem:

• History of previous cancer
• Unexplained weight loss
• Feeling unwell
• Changes in bladder or bowel function
• Pain that wakes you at night
• Pain radiating into arms or legs

Do I need an MRI scan?

MRI scans can identify issues and provide reassurance, but they often don't pinpoint the source of back pain. Without proper interpretation, MRI reports can be confusing and alarming. Many findings on MRI scans are age-related degenerative changes that are normal as we age. However, anyone with red flag symptoms should have an MRI scan.

What should I do if I have back pain?

Staying mobile and avoiding prolonged bed rest is crucial. Regular anti-inflammatories and painkillers can help to keep you mobile, resulting in a quicker recovery. Many people find it beneficial to see a physiotherapist, osteopath, or chiropractor.

Mr Langdon’s top 5 tips for managing acute episodes of back pain

1. Stay mobile and avoid prolonged bed rest.
2. Take painkillers regularly. 
3. Avoid remaining in one position for extended periods; take frequent movement breaks.
4. Continue normal activities but reduce their intensity.
5. Set up your computer screen at head height to encourage proper posture.

Dispelling common myths about back pain 

Myth 1: Bed rest helps alleviate back pain. Not true. Your back will respond much better to movement than inactivity

Myth 2: Pain equates to harm. No. Staying mobile is important even if it causes some discomfort. Regular pain relief can help you remain active.

Myth 3: I need an MRI scan if I have back pain. Not necessarily. Most back pain is due to soft tissue issues, and MRI scans aren't usually helpful in assessing these. If pain persists despite physical therapy or if there are red flag signs, consult a doctor as you may require a scan.

Mr James Langdon is an esteemed orthopaedic spinal surgeon. You can schedule an appointment with Mr Langdon on his Top Doctors profile.