Low back pain and Sciatica are incredibly common conditions in highly developed, civilised societies. According to some reports, more indiginous societies (i.e. tribes in the Amazon etc.) rarely suffer back pain. This is probably due to better core strength in less civilised peoples.
What should I do with acute back pain in a nutshell: 5-point plan:
- Initially, take painkillers that you are not allergic to i.e Ibuprofen (beware indigestion) and / or Co-codamol (beware constipation) over the counter and take them regularly for a few days. Always read the drug information sheet in the pack. Don’t take them long term.
- Read the NHS write up on back pain, it contains lots of good information.
- Buy Robin McKenzie “Treat your own back” (see below)
- Ask your doctor to refer you for physio if your backpain hasnt improved after 2 weeks or see your practice physiotherapist.
- Contact your doctor, should you have any “red flag symptoms” described in the NHS leaflet.
- If you suffer chronic back pain, improve your core strength with Pilates. There are many free courses, I am using “Trifecta Pilates” for my own back pain successfully. There are many sessions online.
More on Low back pain and Sciatica
These 2 conditions are the most common ones causing patients pain and disability. There is a really good overview on the NHS website . However, there are a few additional resources that I would like to share.
- The Book: Robin McKenzie, “Treat Your Own Back” for a quick fix.
- This is a 30 year old book based on a 60 year old method that my own doctor recommended to me and truly, with a few stretches, a lot of people are able to improve their back pain quite significantly. Thus, I believe it is the best £10 I ever spent on my own back.
- StartBack Tool
- The StartBack Tool is a good tool to assess the chance of Chronification in Low Back Pain. Click here to download and complete it. The scoring method is explained on the second page. If you score highly, seek help early, as you are much more likely to suffer this condition for a long time.
- The Back Pain Booklet
- Almost 20 years old, this booklet is still very relevant and helpful. Click here to download this file. It is double sided A5 and a bit tricky to print, but the content is very good
Why an MRI scan is commonly a useless investigation
An MRI scan is a tool to get a good 3D photograph of our spine. It is very sensitive to abnormalities like disc bulges, slippage etc. However, many people with disc bulges lead completely normal lives without any symptoms. Equally, people with entirely normal MRI scans suffer severe back pain. Click here for MRI scan results of the spine for normal people without back pain.
Should I see my GP with Low Back Pain?
Most GPs are not well placed to treat Low Back Pain. Apart from painkillers, with a various degree of side effects and health hazards attached to them, they often can do little to help back pain. However, many practices now employ senior physiotherapists (First Contact Physiotherapists), who can be helpful in the assessment and treatment co-ordination of Back Pain.
Of course there are exceptions where Low Back Pain has more serious causes and there is a good summary on the NHS website quoted above. If you think your symptoms may be more serious, you should see a health professional quickly.
What about painkillers?
Taking Painkillers short term is fine, but they suppress the pain, dont cure the problem. They also have lots of bad long term side effects (the affect your kidneys and increase your blood pressure, cause bowel spasticity and more_)
And very quickly, they become less effective. We call this “Tachyphylaxis” and furthermore, in patients taking long term painkillers there is a phenomenon called “Hyperalgesia”. I have seen it many times: Patients on long term painkillers have awful amounts of pain, some patients ended in suicide. And on top of this, a lot of painkillers are controlled drugs (CD4). So, if you are involved in an accident and driving with them you could end up in prison. You may have heard that half of the US is addicted to Morphine based painkillers.
So remember, grabbing painkillers is an easy short term solution, but pain is there for a reason. Back pain usually tells something i.e. that more needs to be done to strengthen your back and that you may sit too much. So, dont allow long term painkillers to rule your life, take action now. Take a fitness and lifestyle changing approach. Think “what can I do to make myself better” rather than medicalising what is essentially a social problem and often caused by too much sitting and too little activity / too little core strength.
Dr M Kittel, March 2020