Back pain

“My spinal support enables me to make more controlled movements when I’m working. It stabilises me considerably” Susanne, 32, a florist, who wears the Lumbo Direxa back support.

According to a recent study described on the NHS Choices website, back pain causes 'more disability than any other condition'. The study, which looked at how much disability is caused by lower back pain globally, was carried out in 2010 by researchers from a number of academic institutions in Australia, the University of Washington in the US and the Royal Cornwall Hospital in the UK. Some 1 in 10 of us suffer with it, with incidence increasing with age. Globally, it is most prevalent in Western Europe.

Your back will soon let you know when it has been strained or damaged by means of localised or sharp pain, tensed or strained muscles. There could be a variety of causes from a sudden movement to picking up a heavy parcel incorrectly, or spending too long in one position, but it could also be the result of a more serious problem.

Back pain is one of the most common causes of sick days in the UK. According to a study by the Health and Safety Executive (HSE) in 2013/14, 2.8 million working days were lost as a result, with the average person taking just over 12 days off.

There are a number of ways you can look after your back and combat the causes of your pain. Sometimes just avoiding certain movements or being a bit more aware of how you do them can help and strengthen your back. Spinal bracing can also help and here you will find a comprehensive source of information on back pain. It’s important that you also consult your GP, physiotherapist or orthotist as required, as they will be able to advise what’s best in your individual case.


The spinal cord

The spinal cord consists of 24 vertebrae: 7 cervical, 12 thoracic and 5 lumbar which are connected to 5 sacral and 5 coccygeal vertebrae.

They are held in place by ligaments supported by muscles and tendons. The biggest strain on the spinal cord is the lumbar area and for this reason, this area is particularly susceptible to back problems and pain.

Many lumbar spine conditions are interrelated. For example, joint instability can lead to disc degeneration, which in turn can put pressure on the nerve roots, etc.

What you need to know about back pain

Understanding the causes

Specific and non-specific

The spine supports both the head and the trunk and is therefore a fundamental part of our bodies. It provides us with mobility and an upright gait and protects the spinal cord.

The majority of those with back problems experience non-specific back pain. It may be triggered by bad posture while sitting or standing, bending awkwardly, or incorrectly lifting heavy loads. Over time, these movements can lead to muscle strain, irritation and wear and tear on the spinal cord.

The impact of this is that the muscles that aren’t stretched enough shorten, while those that have been overstretched tense up and become strained. This muscular imbalance can affect your intervetebral discs, nerves and joints - and frequently causes pain. If, as a result, you become overly protective in your movements, the imbalance further increases.

Specific back pain is as a result of a disorder of the spinal cord, which could include osteoporosis, fractures and congenital deformities. Specific back pain typically worsens with age.

Frequent causes

Frequent causes of back pain are slipped discs (spinal disc herniation), sacroiliac joint disfunction and lumbar sciatica.

1) Spinal disc herniation

The spine has 23 intervertebral discs, which sit between the vertebrae. A disc consists of a fibrous ring or annulus which surrounds a gelatinous nucleus. The nucleus acts as a shock-absorber for the spine. Over the course of a day, its water content reduces and overnight it reabsorbs this water like a sponge - the ability to do so decreases with age. If the fibrous ring tears, the nucleus can leak out and this causes a slipped disc (disc herniation). There is a danger that a nerve can become trapped, which can cause pain and symptoms of paralysis.

2) Sacroiliac joint pain

The sacroiliac joint is located at the base of the spinal canal and connects the sacrum and the ilium (pelvis). The upper part of the sacrum connects with the last lumbar vertebra and its lower part with the coccyx (tailbone). Joint obstructions caused by overexertion or arthritis are often the cause of pain in this area. Pain is usually one-sided and radiates into the buttocks and thighs.

3) Sciatica

Sciatica describes a sharp, burning pain that can radiate down through the entire leg. The cause is often a slipped or herniated disc.

Steps you can take

Steps you can take yourself

For a strong back

Even small adjustments in your daily life can strengthen and relieve the strain on your back. Here are some tips and advice, though make sure you speak to your doctor or healthcare professional in the first instance, particularly if your pain continues.

Walking: back-friendly footwear

For walking and running, make sure you wear shoes with soft soles and low heels, so as to relieve your joints and the lumbar spine.

Creating awareness when sitting, lifting, carrying

Try to sit upright without bending your spine. If you are able to vary your sitting position, that’s even better, as this will relieve your vertebral discs. Trying making telephone calls while standing instead of sitting.

Bend your knees, rather than bending over, before you lift anything. Keep your feet hip distance apart and your back straight. Hold the object close to your body and stand up with a straight back. A bent back overloads your vertebral discs.

While carrying anything it’s important to distribute its weight evenly. Try to carry two smaller shopping bags rather than one large one.

Exercises you can do at home: strengthening your muscles, avoiding poor posture

Targeted back exercises strengthen your back and stabilise you so as to avoid poor posture. We’ve put together a number of exercises, which can easily be done at home.

Exercise improves health and wellbeing and can help you avoid back problems. Cycling, hiking and swimming (especially back-stroke) are particularly good, as they support the spine. Read the next tab for more information...

Exercises you can do at home

Your doctor knows how to treat your particular case of back pain. In consultation with him or her, you can further strengthen your back by doing the following exercises at home.

Make sure that you breathe evenly while doing each exercise. Don’t hold your breath and stop doing an exercise if it causes you pain. Some of the exercises also strengthen the stomach muscles, otherwise a physical imbalance is created: a strengthened back also requires a strong set of stomach muscles. If only the back is exercised, this leads to a weakening of the stomach muscles and vice versa. Just 5-10 minutes daily can have a positive impact. We hope you enjoy doing them and soon notice that your back is stronger.

Exercise 1: relaxing and becoming aware of your back

Lie on your back and place your feet against a wall, so that your thighs and calves make a 90° angle. Press your feet lightly against the wall. Slowly create tension by simultaneously pressing your spine against the floor. Hold this tension for 10 seconds, then release. Repeat 3 times.

Exercise 2: muscle strengthening

Lie on your back and with knees bent, place your feet at hip distance apart on the floor. Now slowly raise your hips so that your back comes off the ground. Tense your abdominal muscles and buttocks, such that your back is straight. Maintain this position for 15 seconds. Repeat this exercise 3 times.

Exercise 3: strengthening your abdominal muscles

Lie on your back as above, bending your knees and placing your feet on the floor at hip distance apart. Gently raise your head and shoulders. Press your hands against your thighs and maintain this position for 15 seconds. While you are doing so, try pressing your belly button into the floor. Repeat this exercise 3 times.

Exercise 4: strengthening your oblique abdominal muscles

Lie on your back, again with knees bent and your feet flat on the floor at hip distance apart. Raise your head and shoulders. With your left hand, reach across and touch your right knee. Maintain this position for 10 seconds. Release and now reach across and touch your left knee with your right hand and again, maintain this for 10 seconds. Repeat this exercise 3 times.

Exercise 5: strengthening your back muscles and stretching your pectoral muscles

Lie on your stomach and place your arms in a U-shape beside your head. Make sure your head is straight, an extension of your spine. Raise your arms, head and chest and pull your shoulder blades in towards your spinal cord. Tense your buttocks and maintain this position for 15 seconds. Repeat this exercise 3 times.

Exercise 6: strengthening back and buttock muscles

On all fours, raise your left leg and stretch it out horizontally behind you, keeping your toes raised, not pointed. Now, raise your right arm at the same time and stretch it out horizontally in front of you. Keep your back straight. Maintain this position for 10 seconds, before repeating with the opposite arm and leg. Repeat this exercise 3 times.

Exercise 7: strengthening abdominal and shoulder muscles

Stand in front of a wall, at a distance of about 50cm. Place your hands on the wall at shoulder height, and lean diagonally towards the wall with a straight back. Then stretch and bend your arms as if doing a press-up, 10 to 15 times. Repeat this exercise 3 times, taking short breaks in between.

Exercise 8: strengthening your back

For this exercise you will need 2 water bottles of either 500ml or 1 litre. Sitting on a chair, and leaning forward slightly, hold a bottle in each hand and raise your arms up level with your ears. With short, rapid movements, raise and lower each arm in turn for 30 seconds, making sure you keep your back straight. Repeat this exercise 3 times.

Exercise 9: building up your shoulder and pectoral muscles

With the same water bottles you used above, sitting on a chair, with a bottle in each hand, raise your arms up into a U shape, with your elbows level with your ears. Now bring your arms forward so that your elbows almost meet in front of you. Repeat this exercise 10 times.

Exercise 10: mobilising your spinal cord and stretching your back muscles

In an all fours position, bring your head inwards to rest your chin on your chest, at the same time arching your back into a cat stretch. Maintain this position for 5-10 seconds. Straighten your head and extend your spine, now stretching and hollowing your back in the opposite direction. Again, hold this position for 5-10 seconds. Repeat this exercise 10 times.