Back pain is a common condition and, in several countries, it is the largest cause of work-related absence. Back pain can be very uncomfortable, but it is not usually serious. Back pain can affect anyone, regardless of age, but it is more common in people who are between 35 and 55 years of age.

In the majority of cases, the cause of back pain can be linked to the way that the bones, muscles and ligaments in the back work together.

The structure of the back

The back is a complex structure consisting of:

• 24 small bones (vertebrae), that support the weight of your upper body and form a protective canal for the spinal cord.
• Shock-absorbing discs (intervertebral discs) that cushion the bones and allow the spine to bend.
• Ligaments that hold the vertebrae and discs together.
• Tendons to connect muscles to vertebrae.
• A spinal cord, which carries nerve signals from the brain to the rest of the body.
• Nerves.
• Muscles.

The lower part of your back is known as the lumbar region, which is made up of five vertebrae, known as L1, L2, L3, L4 and L5. The lumbar supports the entire weight of your upper body (plus any extra weight that you are carrying), and it is under constant pressure, particularly when you are bending, twisting and lifting.

Lower back pain

Lower back pain, also known as lumbago, affects seven out of 10 people at some time in their lives. Lower back pain is a pain or ache on your back, in between the bottom of your ribs and the top of your legs.

Lower back pain can come on suddenly or gradually, and is sometimes the direct result of a fall or injury. The complex structure of your lower back means that even small amounts of damage to any part of the lumbar region can cause a lot of pain and discomfort.

Pain in your lower back is usually a symptom of stress or damage to your ligaments, muscles, tendons or discs. In some cases, if a nerve in your back is pinched or irritated, the pain can spread to your buttocks and thighs. This is known as sciatica .

In most cases of back pain your back will heal itself, and staying active and continuing with your usual activities will normally promote healing. Back pain will usually last from a few days to a few weeks. Pain that lasts longer usually clears up after about six weeks.

However, in severe and persistent cases of back pain, it is important to seek medical advice so that a correct diagnosis can be reached and appropriate treatment given. Treatment for back pain will usually depend on the underlying cause of the condition. For example, pain that is caused by some types of arthritis may be treated using specific medicines.

Symptoms of back pain 

Relax

Worrying unduly about your back can make the pain worse. Feeling tense can cause muscle spasms and increase the pain signals that are getting to your brain. Feeling worried about how serious a painful back is, when it’s going to get better and whether it’s going to hurt when you move, can be an additional stress.

The symptom of lower back pain is a pain or ache anywhere on your back, in between the bottom of the ribs and the top of the legs. The majority of cases of back pain usually clear up quite quickly.

However, if you experience back pain together with any of the following symptoms, visit your doctor as soon as possible:

• a fever,
• weight loss,
• inflammation or swelling on the back,
• constant back pain that doesn’t ease after lying down or resting,
• pain that travels to the chest or pain high up in your back,
• pain down the legs and below the knees,
• a recent trauma or injury to your back,
• loss of bladder control,
• inability to pass urine,
• loss of bowel control, or
• numbness around the genitals, buttocks or anus.

You should also seek medical advice if you’re experiencing back pain and:

• you’re under 20 years old or over 55 years,
• you have taken steroids for a few months,
• you are a drug abuser,
• you have or have had cancer, or
• you have a low immune system due to chemotherapy or another medical condition (for example, HIV/AIDS).

Ask your doctor for advice if your back pain has developed gradually and has got increasingly worse over several days or weeks.

Related articles:

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2. Treat­ing back pain
3. How to pre­vent back pain
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5. Treatments for ankylosing spondylitis — Chronic arthritis
6. Arthritis
7. Living with arthritis
8. Real life stories – how arthritis affected our lives
9. Irritable hip — acute transient synovitis
10. Parkinson’s disease: what you need to know

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