Guide to back pain

When health professionals talk about back pain, they generally talk about lower back pain and upper back pain. In fact, back pain can run from your neck, through your middle back, right down to the base of your spine.

Back pain can make you feel miserable, as most of us know. How? Because four out of five of us are likely to get back pain at some point in our lives, and men and women are equally affected.

How bad can back pain be?

Back pain can be significant and debilitating. It’s hard to play sport, carry shopping, drive a car, or lift children when you have acute or chronic back pain. At its worst, back pain can stop you working and interfere with the simplest of daily tasks.

CBHS Exercise Scientist Tyler Schreurs speaks from experience when he talks about back pain.

“I was born with one leg longer than the other,” Tyler reveals. “My hips aren’t level, which means my pelvis is uneven. If I get lazy and sit for too long, I get a very sore back.”

What’s more, a sporting injury when Tyler was 15 left him bedridden with debilitating sciatica for weeks.

“Back then, I was prescribed bed rest,” says Tyler. “Now we know there are far more effective ways to treat back pain.”

What are the symptoms of back pain?

Back pain may be common, but the symptoms can vary because we all experience pain differently. Symptoms may include:

• spasms
• aching
• sharp pain
• stiffness
• difficulty bending
• pain radiating down one or both legs
• numbness.

Back pain can also impact your mental health, making you irritable and bad-tempered.

Lower back pain

Lower back pain generally happens in the part of your spine known as the lumbar region. This area is where your spine connects to your pelvis, below the bottom of your ribcage. Your lower back muscles are attached to your spine by soft tissue tendons.

Lower back pain is more common than upper back pain.

Upper back pain

Upper back pain can occur anywhere from the base of your neck to the bottom of your ribcage. The 12 bones that make up your spine in this region (known as your thoracic spine) end just below your ribcage.

Acute back pain

This is pain that last less than three months. Most episodes of acute back pain settle down within a week to ten days.

Chronic back pain

The term chronic back pain is used to describe pain that lasts three months or longer. It might come and go, offering occasional relief before flaring up again.

What causes back pain?

Most back pain tends to be the result of straining muscles, ligaments, or joints.

Sometimes a simple movement, like picking up a child or reaching for an article of clothing in the wardrobe, can be enough to ‘tweak’ your back.

Back pain becomes more common as we age and the discs in our spine (which act as shock-absorbing cushions between our bones) gradually wear out. Sometimes, a disc can protrude and compress the sciatic nerve, causing pain, tingling or numbness that radiates down the leg. 

Back pain can be caused by:

• falls, accidents or injuries
• poor posture
• lack of movement
• sitting still for too long
• underusing muscles
• overusing muscles
• incorrectly using muscles
• underlying illness
• carrying too much weight.

In more than 90% of cases, back pain is not caused by a single condition or injury.

Less than one in 100 cases of back pain are related to a serious medical condition, such as cancer, infection, fractures, or ankylosing spondylitis.

How can you treat back pain?

Before we look at treatment options, if your back pain is the result of a fall or an accident, it’s important to see your GP or local hospital emergency department to rule out any broken bones. Equally, if you experience symptoms of sciatica, see your GP for further investigation.

See a suitably qualified healthcare professional, such as a physiotherapist, for assessment before starting any treatment regime.

Exercises for lower back pain

It may sound counterintuitive, but the best thing you can do for back pain is to keep moving.

“If you stop moving completely your muscles get stiff and weak, your mental state can worsen, and you’ll end up with less energy,” says Tyler.

If the initial pain is intense you may need to rest for a while but try not to lie in bed for more than a couple of hours at time.

Hydrotherapy

Muscles respond better when they’re warm, so a gentle activity like walking through the warmth of a hydrotherapy pool is ideal. Warm muscles aren’t as painful as cold muscles, and the buoyancy of the water takes the weight away from your joints.

Physiotherapy

A physiotherapist can help with acute back pain caused by muscle strain.

“A physio can identify the muscles or joints that might be involved and suggest a regime of exercise to help you recover,” says Tyler.

Benefits for physiotherapy are included on all levels of CBHS Extras cover.

Stretches for lower back pain

“Gentle movements like ‘cat camel’ can help with mild back pain,” advises Tyler. “This simple exercise engages the thoracic and cervical spine and can help increase mobility.”

Avoid these exercises if you have back pain:

• running
• jumping
• heavy lifting
• weighted squats
• aerobics classes.

Should you use ice or heat to treat back pain?

The jury’s out on this one.

“Inflammation causes pain, and ice can stop the pain and inflammation that often accompany a back injury,” explain Tyler. “But when your body wants to promote healing, its natural response is to heat up.”

One suggestion from Harvard Health is to use an ice pack in the first couple of days to reduce any inflammation, then use heat after 48 hours to help increase blood flow and soothe aching muscles.

Is cycling good for back pain?

The answer is maybe.

Cycling doesn’t jar the spine like other forms of aerobic exercise, especially if you’re on a static exercise bike. The forward-leaning position might even feel more comfortable for some people with lower back pain. A reclining bike is another option that allows you to exercise without putting undue stress on your spine.

However, cycling for prolonged periods in a forward crouch position, with the forearms on the handlebars, can round your lower and upper back and has the potential to cause neck strain.

If you cycle a lot, try to adopt a more upright posture and adjusting your position periodically.

Back pain in pregnancy

It’s common to get back pain during pregnancy as your body weight shifts and your lower back muscles carry a heavier burden. This can also strain the joints in your lower back and pelvis, leading to back pain.

Good posture is important, and regular physical exercise can help to keep your back strong. Prenatal yoga or aqua-natal classes may also help relieve back pain during pregnancy.

Read more: The health benefits of exercise during pregnancy

Seek urgent medical assistance if:

• you have back pain in your second or third trimester that suddenly becomes severe, lasts for several weeks, worsens over time, and/or is not relieved by rest
• your back pain is accompanied by vaginal bleeding, fever or burning when urinating
• you also lose feeling in one or both of your legs, buttocks, or genitals.
  
  

Treatment for chronic or persistent back pain

If back pain persists for longer than three months, the nervous system and brain can become highly sensitive, triggering an over-protective response. Persistent back pain can lead to depression and a sense of hopelessness, requiring a wider range of treatments:

• physical therapy
• exercise therapy
• lifestyle changes
• mindfulness and meditation
• changes to diet
• psychological intervention.

Staying active and exercising are more effective treatments for chronic pain than medication, injections or spinal fusion surgery. 

How can you prevent back pain?

Exercises to improve posture

Tyler’s ‘Posture Masterclass’ video is a great place to start if you need to improve your posture.

And the Australian Chiropractors Association has a Straighten Up app on Google play or the App Store, which also demonstrates what good and poor posture looks like in different settings.

Mobility and stability are both key to preventing back pain.

Sit less, walk more

On average, adults sit for nine hours a day, and that’s bad for your body in so many ways. Not only does it increase the risk of heart disease and type 2 diabetes, sitting can also aggravate back pain.

Walking, on the other hand, increases circulation, boosts blood supply, and helps nourish and enrich the muscles and soft tissues surrounding your spine.

Walking can also help:

• rehydrate spinal discs
• improve posture
• improve flexibility and mobility.

Check your sleep

Sleeping on your side or your back is better for your posture than sleeping on your front. It’s best to find a position which maintains the natural curve in your back. You could try sleeping on your back with a lumbar roll under your lower back, or a pillow under your knees, or on your side with your knees together.

These tips on how to get a good night’s sleep may help.

Keep moving

Sitting for too long, or standing for too long, is not a good idea, especially if you maintain a single position. Tyler counsels you to keep moving, keep changing position and keep coming back to neutral. If you always cross your legs one way, cross them the opposite way. The more you move, the better your posture is likely to be.

“Your next posture is your best posture,” says Tyler.

Stretching to improve posture

Stretching is a great, low impact way to improve your posture and mobility. Try these simple stretches that can all be done at home.

This ten-minute static stretching routine, if performed at least three times a week over four weeks, should begin to increase the range of motion in your joints and improve your flexibility. Several of these routines focus on the lower back.

Check your home office set-up

Many of us spend our working lives sitting at a desk, staring at a screen. If that describes your day, make sure your desk and office are set up to improve your posture, and help prevent slouching.

Read more: Five ways to improve your home office set-up.

Use your CBHS health cover

None of us can avoid the occasional muscle sprain, but staying active, improving your posture, and achieving a healthy weight can all help make back pain less likely.

Your CBHS Extras cover can pay benefits towards things like gym membership or personal training to improve your fitness, as well physiotherapy or chiropractor sessions, massage therapies and, on some policies, exercise physiology, osteopathy and antenatal or postnatal physiotherapy.

Depending on your policy, CBHS Hospital cover can also help pay for pain management and Better Living programs to support lifestyle changes.

If you’d like to check what’s included on your cover, call our Member Care team on 1300 654 123.

All information contained in this article is intended for general information purposes only. The information provided should not be relied upon as medical advice and does not supersede or replace a consultation with a suitably qualified healthcare professional.

Five ways to improve your home office set-up (cbhs.com.au)

Do-It-Yourself Tips (mybackpain.org.au)

lower back muscles - Bing

Upper back pain: 9 causes (medicalnewstoday.com)

Acute Low Back Pain | Emergency Care Institute (nsw.gov.au)

Back pain | healthdirect

Back pain in pregnancy - NHS (www.nhs.uk)