About Back Pain

Low back pain is a common condition that remains one of the leading causes for medical treatment in the United Kingdom. The spine is composed of 24 bones (called vertebrae) with the sacrum at the bottom. Between each vertebra is a disc which allows movement. Lower back pain usually originates from the lower five vertebrae and discs, which is called the lumbar spine.

What is a disc?

The disc is the moving part in our spine (elastic mobile component). The disc in the spine is like a tyre, it contains rings of fibres (annulus) around the outside and gel material on the inside (nucleus). With time the gel material inside the disc shrinks, and the disc becomes like a flat tyre.

What is the relation between the disc and the nerves?

Inside the spine, there is canal where all the nerves travel and exit sideways (right and left). The nerves from each side of the spine join together to form the sciatic nerve. Bulging of a disc causes pressure on the nerves which in turn causes back and leg pain (sciatica).

Why do people get back pain?

The cause of back pain is multifactorial. Genetics, activities, mechanical stress and the aging process all play part in developing back pain. The disc in the spine is believed to be the main pain generator (the source of the pain).

How long does back pain last?

Back pain can be acute and last for days to a few weeks, or may become chronic and last for months and maybe years. When back pain becomes chronic, constant and increasing in frequency, it can become a source of functional disability. Chronic back pain can negatively affect the individual, leading to pain, loss of function, decreased quality of life, lack of predictability for the future and time off work.

Do people recover from back pain?

Most acute episodes of lower back pain are self-limiting, and resolve in few days with rest, simple painkillers and anti-inflammatories, and physiotherapy if needed. The vast majority of people with back pain recover quickly. However, a small number do not. They can become increasingly affected by their back pain and unable to perform daily activities that are important to their lifestyles. They can also become increasingly reliant on medications and seek progressive levels of conservative care management (chiropractic, pain management and injection therapies). Some of these patients plateau at an unacceptable level, will not or cannot tolerate (or accept) medication as their definitive and long term treatment option, and do not improve. They frequently seek a surgical solution.