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WHAT CAUSES BACK PAIN?

POSTURAL STRESS
Poor posture stresses your spine. Ligaments are overstretched, muscles tire and joints and nerves are put under pressure.

MUSCLE STRAINS
Minor back muscle strains are rare and quickly improve on their own, but more severe strains will need physiotherapy treatment to relieve pain and promote healing.

LIGAMENT SPRAINS
Stretching ligaments too far or too quickly makes them tear and bleed into surrounding tissues, causing swelling and pain. Stretching can be the result of prolonged poor posture Motor vehicle and sporting accidents are common causes.

DISC PROBLEMS
Discs are anchored to the vertebrae, above and below, so they cannot 'slip' out of place. They can lose disc height with age, but most disc problems arise from injury. Discs can bulge (prolapse), herniate or even rupture.

SCIATICA
The sciatic nerves run from the lower back, through the buttocks and down the back of your legs. Irritation anywhere along this pathway will cause pain in the back and legs.

ARTHRITIS
Vertebral and facet joints can be affected by arthritis, causing degeneration and inflammation within the joint and the growth of bony spurs on the edges of the vertebrae.

Everyday activities can trigger back pain

How Your Back Works

Your back is a complex system of interlocking components:

	Vertebrae are the bones that make up the spinal column.
	Discs seperate the vertebrae and act as shock absorbers.
	Facet joints between the vertebrae guide spinal movement.
	Ligaments hold the vertebrae together.
	Muscles are attached to the bones.
	They control and produce movement

Here is some useful advice to help you prevent back pain:

LIFTING
With your feet shoulder-width apart, bend at the hips and knees. Grip the load firmly and hold it close to your body, tighten your stomach muscles and use the strong muscles of your legs to lift. Keep your back as straight as possible. Avoid twisting - turn by using your feet, not your back.

POSTURE
Think tall: chest lifted, shoulders relaxed, chin tucked in and head level. Posture should be stable, balanced and relaxed when sitting, walking or standing.

SITTING
Don't stay seated for too long - stand up, stretch and walk around. The right back support will also help.

EXERCISE
Stay in shape - healthy body-weight is less strain on your back. Your physiotherapist can show you how to keep your back flexible and strong with correct back and abdominal exercises.

DRIVING
Good support from your car seat will prevent back pain. If you need more lower back support, use a lumbar roll or a rolled-up towel.

SLEEPING
Your mattress should be firm enough to support your natural shape.

Depending upon the cause and type of pain, physiotherapists treat back pain in a variety of ways:

	advice and early activation (recent research indicates that one of the most important treatments for low back pain is that the patient is encouraged to move).
	Mobilisation / manipulative physiotherapy.
	McKenzie therapy .
	Specific stabilisation exercises .
	General exercises.
	Traction.
	Ergonomic advice.

Manipulative physiotherapists have post-graduate training in the management of musculoskeletal disorders and have more ways to help your back move well and stay well.

Ongoing 'maintenance treatments' should not be required once your back has been successfully treated by a physiotherapist. If severe pain persists, other causes will need to be investigated and it will be recommend that you see a doctor.

A doctor's referral is not required to see a physiotherapist in private practice. Physiotherapists in private practice are listed in the Yellow Pages under 'Physiotherapists'. Physiotherapists also work in NHS hospitals and community health centres.