Back problems are very common and can be caused by staying in one position too long or lifting something awkwardly. Most back problems start for no obvious reason, which can be very frustrating. Your back problem may cause hot, burning, shooting, or stabbing pains in your back and sometimes into one or both of your legs. You may also get pins and needles. These can be due to nerve pain. The spine is strong and back problems are rarely due to any serious disease or damage. Back problems should settle within 6 weeks of following the advice provided here. You will not normally need an X-ray or an MRI scan.spine2

Rest or Move

Should I be resting or moving?

  • Keep moving, even if you move slowly at first.
  • Do whatever you normally would and stay at, or return to work. This is important and is the best way to get better.
  • Change positions regularly wherever you are.
  • Do not sit down for too long.
  • Resting in bed does not help back pain.
  • Try to find a position that reduces any pains you may have in your back and/or leg(s)
  • Try to stay active, but remember not to carry out activities which aggravate any pain you may have in your back and/or leg(s).
  • Exercise really helps your back and can relieve pain.

Painkillers

Should I take painkillers?

  • Painkillers can help you keep moving. However, it is important that if you are already taking medication for something else or have other health problems you check with the pharmacist at your local chemist before taking painkillers for your back problem.
  • You can use simple, over-the-counter painkillers (such as paracetamol) or anti-inflammatory medicines (such as ibuprofen) to help your pain. You can take both these medicines together.
  • Always follow the instructions on the packet.
  • You can only take two 500mg paracetamol every four to six hours, and no more than eight 500mg paracetamol in 24 hours. You should not take any more than this amount.
  • You can only take three 400mg ibuprofen a day. You should not take ibuprofen if you have stomach problems such as ulcers, have had a previous allergic reaction to ibuprofen or had an injury in the last 48 hours. Always take ibuprofen with or just after food. Don't take ipuprofen if you are pregnant.
  • If you have asthma, ibuprofen may make it worse, but if you have taken it before with no problems then you can safely take it again. If you are not sure, speak to your pharmacist.
  • Take them regularly, not just when you are sore, for the next three to four days only.
  • If you feel you still need pain relief after four days then speak to your pharmacist for advice.

Should I use ice or a heat pad?

  • If you have had an injury or flare-up of an old problem in the last two days, wrap crushed ice in a damp towel and hold it for five to ten minutes against the part of your back that hurts. You can do this every two to three hours. Make sure you use a damp towel between the ice and the skin to avoid an ice burn.
  • Alternatively, you could try sports sprays and gel packs, which do a similar job.
  • After two days, you may find that heat is more relaxing. You could use a heat pad or a hot water bottle with an insulated cover on it. Make sure this is not too hot and not directly touching your skin. You should do this for 10 to 15 minutes, three to four times a day.

Work

You will recover faster and everybody will benefit if you can stay at or get back to work as early as possible. Don’t worry if your back still hurts, as you may only have to do light work at first. Try to stay active and remember to keep moving. Speak to your manager about any concerns you may have.

Sports

You should take time before you take part in any sports after a back problem. If you take part in sports too soon you could flare things up again. Be prepared however for slight discomfort at first. You should only take part in sports when you can move freely. Remember to stretch and warm up fully before sports.

Other problems

Can my back problem cause trouble anywhere else?

Your back problem may cause hot, burning, shooting, or stabbing pains into one or both of your legs (sometimes called sciatica). You may also get pins and needles. This can be due to nerve pain. If you have these for more than one week, you may be able to take other, more appropriate medication. You should speak to your pharmacist about this.

Doctor

Do I need to see my doctor?

  • Not normally. If you follow the right advice and take the right medication, your back problem should improve over the next six weeks.

If you experience a sudden onset of any of the following you either need to attend A&E or contact NHS111 as soon as possible:

  • Difficulty passing or controlling urine.
  • Problems with sexual activity.
  • Numbness and / or loss of feeling and or pins and needles around your back passage or genitals eg wiping after toilet.

If your condition progressively worsens or persists for longer than 6 weeks you need to seek further medical advice.

Facts and Figures

  • 90% of the UK population get back pain at some point.
  • Most back pain settles within six months.
  • Keeping active is the best thing to help your back pain.