The back story
Back pain is a leading cause of disability. BBC Breakfast's Dr Rosemary Leonard reports on a condition that can strike at any age
According to a survey in the British Medical Journal, almost half of all adults in the UK reported back pain lasting more than a day during the past year. And with such an intricate, delicate structure supporting us, it's not surprising.
The spine is made up of 24 bones, or vertebrae, separated by discs of rubber-like tissue which act as shock-absorbers and allow it to bend. The whole structure is held together by ligaments, with tendons connecting the back muscles to the vertebrae.
As well as providing support, your backbone also protects the spinal cord – the central nerve that runs down from the brain.
Most back pain is caused by a slight injury to the ligaments or muscles through lifting a heavy object, slouching in chairs, driving in a hunched position or standing or bending for too long.
Any slight shift in position of the vertebrae or spinal discs can put pressure on one of the major nerves as they leave the spine. This happens most commonly in the lower back, affecting the sciatic nerve that runs across each buttock, then down the outer legs to the toes. It can also occur in the neck, causing pain in the nerves that supply arms and hands. This can be accompanied by pins and needles, numbness and weakness.
The spine is like a central scaffolding for our entire body
In older people, back pain can be due to arthritis or osteoporosis, and, as discs tend to become less flexible, this can cause stiffness and pain, especially in the morning.
Rather alarmingly, studies over the past 10 years show that back pain is increasing in children, affecting around 13 per cent of those aged 10, rising to over 21 per cent by age 16. An MRI scan study found degenerative disc changes already present in some children by the age of 15.
In the past, people with back pain were often told to rest. But the advice now is to keep as active as possible and ease discomfort with anti-inflammatories and paracetamol. Prompt treatment, such as physiotherapy, can help relieve spasms, and more severe pain can be eased by muscle relaxant drugs from your GP.
You can do a lot to help: lose weight if necessary; avoid sudden movements and lifting heavy items; keep muscles strong and supple with stretching exercises. Also watch your posture, wear flat shoes with cushioned soles, and try to reduce stress levels.
Treatments to try
- Acupuncture can stimulate nerves in the back muscles and other tissues. Good for muscle strains and sprains, also helpful for chronic lower back pain, especially if confined to one side.
- Alexander Technique makes you more aware of balance, good posture and movement. It can also help prevent harmful muscle- and joint-tightening habits.
- Relaxation is vital. When we are tense, the body can't repair itself and makes fewer natural painkillers. Learning to relax is a real skill, and can help all types of back pain.
Next issue: Dealing with stress
For more general health information visit www.tesco.com/health
If there's a health topic you would like covered, email tesco@cedarcom.co.uk or write to Dr Leonard at Tesco magazine, Cedar Communications Ltd, 85 Strand, London WC2R 0DW. We regret that she cannot answer any letters privately.
Q
I spend several hours a day working at a computer, and my back always aches by the end of the day. How can I prevent this happening?
A
Your back should be upright at your desk and the screen at eye level, so you don't hunch over. Your hips and knees should be level and your feet flat on the floor. Using a footstool may help, as may a cushion supporting the small of your back. Change your position slightly every few minutes, to prevent stiffness in your muscles.
Q
I've had recurrent back pain for years, and wondered whether I should get a new mattress. I've seen some that are recommended for people with back problems, but they seem very expensive. What should I look out for?
A
The best mattress for backs is one that is medium/firm, supports shoulders and buttocks, and keeps the spine straight. One that is too firm will leave parts of your spine unsupported; one that is too soft allows your spine to sag. There's no need to buy a special one – instead, try out lots, lying on each for at least 10 minutes, to find one that's comfortable for you. And your pillows should only give your head slight extra support – nothing too high.
Q
My teenage son often complains that his back aches. He carries a heavy bag to school every day and I'm sure this is part of the problem. Any suggestions?
A
Buy him a rucksack, with broad straps, and, ideally, a waist strap as well, as that ensures the weight is spread more evenly. Don't let his back become an excuse for being a couch potato. Encourage him to take lots of exercise, especially cycling and swimming – backstroke in particular is good for backs, no matter what your age.