15 Secrets about back care

Many of us will experience back pain at some point in our lives so it’s important to take good care of your back, and know what to do if you’re already a sufferer

1 Watch how you lift and carry
If I had to pick one thing which results in people getting back pain, it would be lifting. It’s surprising how many people don’t know how to lift correctly. The principle is simple – bend with your knees, not with your spine. When you’re carrying something, hold it as close to your body as you can. Holding a load far away from your body can put extra strain on the spine.

2 Don’t be a martyr
If you get sudden back pain, stop whatever it is you’re doing – mowing the lawn, changing the bed, lifting that box of files or fixing the U-bend. It sounds simple, but many people try and soldier on when they have back pain, claiming they just want to finish off the job. Don’t! You could be doing more harm than good.

3 Look after your ‘hamburgers’
Your spine is made up of vertebrae, which are a column of bones that protect the spinal cord. Between each vertebra is a disc that’s made of springy material called cartilage. Each disc resembles a tiny hamburger, and they are used as shock absorbers to cushion any impact against the spine. If too much pressure is put on them through twisting, straining and carrying heavy objects, they can bulge out to the side causing severe back pain. This is called a slipped disc.

4 It’s not always a slipped disc
However, many people assume they have a slipped disc if they get bad back pain, when slipped or prolapsed disc injuries probably only account for five per cent of backache cases. When it is a slipped disc, the pain is caused by the cartilage bulging out and pressing on the nerve root in the spine. If your back specialist suspects you of having a disc problem, they’ll carry out the Straight Leg Raising (SLR) test. This is when you lie on your back on a couch and the doctor will lift your leg upwards without bending it at the knee. If the doctor can bring your leg up to a 90-degree angle without pain, it’s unlikely to be a slipped disc. If it’s only a few degrees, it could suggest a disc is pressing on the nerve root.

5 Cold is as good as hot
Cold packs can be as effective as heat packs in alleviating back pain. If you do use heat or cold to soothe a painful back, make sure the hot water bottle or bag of frozen peas is not placed directly on you. Wrap it up in a tea towel to protect your skin.

6 Give it 24 hours before seeking help
If you get back pain, don’t rush (or rather limp) to your doctor or hospital straight away. If it’s only a small twinge, the pain might be gone by tomorrow if you take it easy, have painkillers and use hot or cold packs. If your back still hurts after a day or two, ring your GP surgery. Many now have their own physiotherapist attached to them who can advise you over the phone.

7 Diagnosis is tricky
It’s easy for doctors to recognise back pain, but often hard to identify what’s causing it as the spine is a very complicated mechanism and it’s not always easy to see the injury. People often think an X-ray will reveal the cause, but most of the time they don’t show anything helpful such as ‘soft tissues’, like muscles and ligaments – although they can pinpoint abnormality of the bones. Specialists trained in back care such as osteopaths, chiropractors or physios can help treat your back, usually through manipulating it and suggesting exercises.

8 Back pain isn’t always due to back strain
That is, the pain you feel in your back can be caused by other problems including osteoporosis, ankylosing spondylitis (a bone and joint condition that mostly occurs in young men), and, very rarely, a tumour. Period pain sometimes causes lower back pain because the nerves from the womb run up to the back, while having a kidney infection can result in a painful lower back, usually either side of the spine.

9 Keep active to ease aches
The worst thing you can do when you have a bad back is remain totally immobile, because that makes everything stiffen up. Until about 15 years ago, patients were told to remain horizontal for as long as possible, but many back specialists have realised that moving gently can actually help. Walking is generally good, as is Pilates and swimming, but avoid breaststroke as that puts quite a lot of strain on the upper part of the spine.

10 Watch your vices
Keep your lifestyle healthy and it will help keep your back well too. Smoking is bad for your back because it restricts blood vessels, so reduces the supply of blood to the spongy discs found between the vertebrae in your spine. This means they lack a healthy level of nutrients, water and blood to stay soft and can become painful. Watching your weight is important too as having a ‘spare tyre’ can put your spine under strain. Other everyday things that can potentially lead to back problems include wearing high heels – they force your bum out and stop you walking upright, and carrying heavy bags, especially on one shoulder.

11 Think about your car seat
People spend time looking at mattresses for their bed, but forget about the amount of time they spend in their car, and what that can do to their back. Car seats are a major cause of back pain so if you’re buying a new car, make sure you look at the seat positioning and spend some time sitting in the car to ensure it doesn’t cause you pain.

12 Try the two As
That’s acupuncture and the Alexander Technique. A study in the British Medical Journal in 2008 found those who practised Alexander Technique reported lessened pain and greater mobility that lasted longer than other pain relief methods. Similarly, in spring 2009, a NICE (National Institute for Health and Clinical Excellence) committee found non-specific low back pain (ie pain without disc problems) could be helped with a course of acupuncture.

13 Go alternative
Homeopaths may be able to help ease your backache. They’ll generally recommend treatments using arnica and bryonia. Make sure you visit a registered homeopath. Contact the Society of Homeopaths (www.homeopathy-soh.org) to find one near you. You can also try taking supplements. Omega-3 fish oils are anti-inflammatory, as are glucosamine and chondroitin, so may help with pain. A study in the journal Phytomedicine suggested that the herbal supplement, devil’s claw could help lower back pain, in a double-blind study. Bear in mind, these can help treat the pain and inflammation in backache, but if you have any ‘mechanical problems’ such as a slipped disc, you will probably need to see a specialist like a chiropractor or osteopath to have your spine manipulated.

14 Get in the water
Hydrotherapy is essentially doing exercises in water and is good for back pain sufferers. The water takes the weight off your back, and makes it easier for you to use your back muscles. If you’re in a warm pool, muscular spasm is relieved and pain reduced. Researchers at the University of Malaga in Spain have recently looked into how running in waist-deep water can help chronic back pain. It’s thought it helps strengthen abdominal muscles while stretching out the back, hip, hamstring and calf muscles.

15 Back pain causes sick days
The charity BackCare estimates on any day, one per cent of the working population are on sickness leave due to a back problem. Luckily, 90 per cent of people with acute back pain recover within six weeks as, if you rest and take care of yourself, the back can heal itself as inflammation gradually recedes and pain is reduced. Even a slipped disc may heal on its own, without the need for measures such as surgery. It’s thought the bulging disc may gradually wither away, or go back into its original position with adequate rest, mild exercise and a healthy diet.

Expert: Dr David Delvin
Dr David Delvin is the author of Backache: What You Need to Know (Sheldon Press, £7.99). He is the director of the Medical Information Service and has written 33 books and made over 900 TV appearances.

Compiled by Hannah Fox