Back Pain

Back pain, particularly lower back pain, is very common: the Institute of Osteopathy puts the number of people in the UK living with it at around 10 million. The NHS says it usually improves within a few weeks, but it can last longer or keep coming back, and that is often the point at which people look for help. General, acute and chronic back pain and lumbago are among the conditions osteopaths commonly help with.

What does back pain feel like?

Most back pain is what clinicians call non-specific: it is not caused by a disease or a serious injury, but by the muscles, ligaments and joints of the spine being strained, stiff or irritated. It can be a dull ache across the lower back, a sharp catch when you bend or twist, or stiffness first thing in the morning that eases as you get moving. Pain that spreads into the buttock or down the leg can be sciatica, which is assessed slightly differently.

If the pain has lasted longer than three months it is described as chronic, even if it flares and settles in between. Chronic back pain is still very treatable, but the approach shifts from simply easing the flare-up to understanding what keeps it coming back.

What causes back pain?

• lifting or carrying awkwardly, or a sudden twist
• sitting for long periods, including driving and desk work
• a lack of general movement and strength in the back and hips
• pregnancy, as posture and load change through the trimesters
• age-related changes in the spine, which are normal and often painless
• stress and poor sleep, both of which can make pain feel worse

How can osteopathy help with back pain?

NICE guideline NG59, which sets out how low back pain and sciatica should be managed in the NHS, says clinicians should "consider manual therapy (spinal manipulation, mobilisation or soft tissue techniques such as massage) for managing low back pain with or without sciatica, but only as part of a treatment package that includes exercise." That is exactly how we work: hands-on treatment to ease pain and improve how the spine moves, alongside advice and exercises you can do at home so the improvement holds.

At your first appointment Abdul takes a full history and examines how you move, where the pain comes from and what makes it better or worse. Treatment may include gentle joint mobilisation and manipulation, soft tissue work on tight muscles, and, where appropriate, dry needling for the short-term relief of chronic low back pain. You will leave with a clear explanation of what is going on and a plan that fits your work, sport and daily routine.

What can I do while I wait for an appointment?

The NHS advice for most back pain is to keep moving. Resting in bed for long periods tends to make things stiffer and slower to settle. Try to:

• stay active and carry on with your normal activities as far as you can
• take an anti-inflammatory such as ibuprofen if it suits you, checking with a pharmacist if you are unsure
• use a heat pack or hot water bottle, wrapped in a towel, for stiffness, or an ice pack for a fresh strain
• try gentle back stretches and exercises, stopping if anything makes the pain clearly worse

When should I see a GP or get urgent help?

Most back pain is not a sign of anything serious. Ask for an urgent GP appointment or call NHS 111 if you have back pain and feel hot, shivery or generally unwell, if the pain is severe and started suddenly, or if it is getting worse quickly. Call 999 or go to A&E if you have back pain with:

• pain, tingling, weakness or numbness in both legs
• numbness or tingling around your genitals or bottom
• new difficulty controlling your bladder or bowels
• chest pain
• pain that started after a serious accident

Part of a thorough osteopathic assessment is checking for these signs and sending you to the right place if they appear.

Sources

• NICE guideline NG59: Low back pain and sciatica in over 16s
• NHS: Back pain
• Institute of Osteopathy: Muscle and joint conditions
• General Osteopathic Council: Is osteopathy safe?