Medical Information

Explore detailed information about a range of joint problems and treatments, including medications, surgery, physiotherapy and rehabilitation. Reading this will help you understand more about your own condition. There is also a glossary with explanations of many medical terms used in orthopaedics. You can find out even more by following the links page to other related websites, journals or professional medical associations.

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Back Pain

Back pain is a common condition with 4 out of 5 of us getting back pain at some time. However, most episodes of back pain get better in a short time and simple painkillers are all that is required. Returning to normal activities is the best way to cope with back pain.

This booklet will be useful for people who have recently developed back pain, but it is primarily aimed at people who have more persistent (‘chronic’) back pain. It explains some of the causes of back pain and what can be done to help it and prevent it happening again.

What is the anatomy of the back?
The back is a complicated structure built around the bones of the spinal column. The spinal column consists of 24 bones (vertebrae) sitting one on top of another. It sits on a large bony bowl – the pelvis – and is topped by the skull. The bones of the spine are connected to one another by the discs at the front and by the facet joints at the back. The discs help to absorb the normal loads on the spine and, with the facet joints, give the spinal column its flexibility.

What causes back pain?

Sprains and strains
Sprains of the back are a part of everyday life and the back is usually very good at taking these ‘knocks’. Most cases of back pain are due to sprains, which usually heal themselves within a short time. The body responds to this type of injury by trying to immobilize the painful area. This sets up muscle spasm or ‘cramp’ which can last several weeks and can be very painful. The affected muscle then tends to become weaker. It is therefore very important to exercise the affected muscle to reduce the spasm and try to improve its strength.
Back pain may be localized to the back but will sometimes be associated with pains in the leg – ‘referred pain’ or sciatica. It is called sciatica because it affects the sciatic nerve which runs from the spine to the leg. The pain is often accompanied by an abnormal feeling and is felt in the buttock, thigh and calf and can go all the way down to the big toe. Sciatica may be caused by muscle spasm following an injury, jolt or sprain to the spine. Generally this type of pain will last only for a short time and will ease with movement. However, sciatica may be associated with a ‘slipped’ or ‘prolapsed’ disc. This is where the inner jelly of the disc bulges (or ‘prolapses’) through the outer fibrous ring. It can then press on a nerve and cause pain. When sciatica occurs as a result of a slipped disc then it is likely to be more persistent, lasting perhaps 6 weeks before it begins to settle down. If you notice weakness of the muscles in your leg, especially if you cannot pull your foot up towards you, or if you lose bladder or bowel control, you should see your doctor urgently.
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