Back pain is the largest single cause of disability in the UK, with lower back pain alone accounting for 11% of the total disability of the UK population (Greenough, C., 2016). Studies have suggested that the longer an individual is disabled by back pain, the less chance they have of returning to work and will have a higher cost of health care as a result. For instance, if an individual has been off sick with back pain for 1 month, there is a 20% chance of them still being off work one year later and for 6 months, there is a 50% chance of them being off work one year later (Waddell, G., 2004). Low back pain is estimated to affect at least 60% to 80% of the population at some time in their lives.
Back pain can vary in presentation, with pain levels ranging from a sharp, stabbing pain to a dull ache. Different symptoms indicate different causes. Back pain is any form of pain or discomfort on the back of the body from the bottom of the neck to the base of the torso.
Upper (thoracic) back pain.
Upper back pain commonly includes the thoracic spine, rib cage and associated muscles (such as upper trapezius, latissimus dorsi, serratus muscles, intercostals and the thoracic erector spinae muscles). The most common causes of upper back pain are muscular irritation (myofascial pain) and joint dysfunction.
The upper spine (thoracic) and rib cage are designed to be very strong, allowing us to stand upright while protecting the vital internal organs in the chest. Because this section of the spinal column has a great deal of stability and limited movement, there is generally less risk of injury or degeneration over time in the upper back in comparison to the cervical spine (neck) or lower back (lumbar spine).
Lower (lumbar or lumbosacral) back pain.
Lower back pain often involves long term postural problems and can be triggered by the simple picking up of an object (such as a sock!) or sleeping in a bad position. The lower back or lumbar spine carries the majority of the body's weight when upright so has larger vertbetrae to allow the pressure in each to spread. Unlike the upper back, there are no bones protecting the front of the lumbar spine or the organs within the abdomen, meaning there is less support and more movement available in this part of the back. As a result, the tissues associated with the lumbar spine can become strained, inflammed and painful. Due to the weight baring and mobility of this area, the lumbar spine is more prone to degeneration and injuries from a lack of preventative care.
How can osteopathy help back pain?
Through examination and testing, an osteopath can get a picture of which tissues are causing the presenting pain patterns and formulate a treatment plan to relieve the symptoms, rebalance forces through the spine and encourage tissue healing. In some cases the osteopath may refer for further investigation to ensure there is no underlying cause which may be exacerbated through manual therapy.
Uncommon but potentially serious symptoms.
Call NHS direct on 111 if you experience symptoms such as:
- numbness in any or both limb(s), around the bottocks or genital area.
- loss of muscle power
- difficulty breathing
- chest pains radiating to the neck or left arm
- loss of balance
- incontinence or loss of bowel/bladder control
- pain urinating or passing stools
- an aversion to light
- unexplained weight loss
- pain not relieved by medication and worse at night.