This article is designed to help you decide if you need to see a doctor. Please read it and check the section on signsand symptoms to look out for.If these do not apply to you, please use the how to help yourself section before requesting an appointment. If you have any doubts or concerns please do not hesitate to contact the surgery.
Back pain is very common. In fact, it is one of the most common reasons for time off work in the UK. In most cases, back pain is uncomfortable but not dangerous. Back pain is usually caused by spasm or strain in the muscles that support your spine. You will usually feel pain over your lower back. Sometimes this pain may go into your buttocks or your thighs. If the pain passes down into your lower legs or feet, it may be a warning sign of a more serious cause. See below to work out whether you need to see a doctor.
Simple backache
If you fall into the category below, you are unlikely to need to see a doctor:
- Age 20-55 years
- Pain in the lumbar and sacral region of your back (your lower back, below your waist), and possibly your buttocks and thighs
- "Mechanical" pain (worse when you move, especially in certain directions)
- Feeling generally well in yourself
Nerve root pain
You should see your doctor about this, but are unlikely to need referral to a specialist, at least within the first 4 weeks:
- Leg pain on one side, worse than low back pain
- Pain goes down to foot or toes
- Numbness & tingling in same direction
- Straight leg raise (lifting your leg up at right angles to your body) reproduces leg pain
- Weakness or numbness in one part of your lower body
Signs and symptoms to look out for:
See your doctor as soon as possible if you fall into this category:
- Under age 20 or getting symptoms for the first time over 55
- Non-mechanical pain (not worse when you move, especially in certain directions)
- Mid back pain (over the spine at the level of your rib cage)
- Past history of cancer, steroid tablets or HIV infection
- Feeling generally unwell
- Weight loss for no obvious reason
- Widespread neurological symptoms or signs (such as weakness or numbness over a wide area)
- You have been told you have an abnormality in the shape of your spine
Medical emergency
Seek help immediately if you get:
- Problems with continence (of bowels or waterworks)
- Sudden weakness in your legs
- Problems with your gait (normal walking pattern)
- Numbness over your pelvis or 'saddle' area
How you can help yourself in the short term:
Simple painkillers like paracetamol can help. If these are not effective, you should try a codeine-based preparation. You can also take a non-steroidal anti-inflammatory tablet, such as ibuprofen, especially if the pain is severe. It is quite safe to take these at the same time as you are taking a paracetamol or codeine based painkiller.
If you have a history of indigestion, asthma or an allergy to aspirin or non steroidal anti-inflammatory tablets, you should avoid taking any anti-inflammatory tablets unless you have consulted your GP or pharmacist. You should not take anti-inflammatory tablets such as ibuprofen if you are pregnant. It is worth taking painkilling tablets regularly when your back pain starts, and for a few days afterwards. After five to seven days, you can try taking painkillers only when you have pain. As long as you do not have any of the warning signs opposite, you should continue to move about normally. This will prevent your back from stiffening up, and can speed up your recovery. You should, however, avoid lifting, especially if you have to bend to do so. Heat, such as a hot water bottle placed over the site of pain, can also help. Physiotherapy, osteopathy or chiropractic treatment can all be useful, and are safe as long as you do not have any warning signs.
In the medium term:
If you are overweight, you should try and reduce your weight. Exercise that strengthens your muscles, without putting strain on your joints is particularly good for your back. Swimming is a good example of this. If you get recurrent back pain, you should avoid contact sports, such as rugby, or sports that involve a lot of sudden, jarring movements, such as squash. Look for possible causes for your back pain. Common reasons include an awkward sitting position at work, heavy lifting or stopping to lift. If you have an occupational health advisor at work, talk to them about improving your working position.