Back pain is a common problem which can range from a mild twinge in the back to severe debilitating pain. There are many different causes of back pain and while some of them can be serious the vast majority are mild and will resolve with gentle mobilisation and time.

The serious causes of back pain include:

• Significant nerve compromise;
• Fractures;
• Cancers; or
• Infection

While these are rare and represent less than 1% of back pain presentations your GP can assess you for this. Most of the time the exact cause of back pain is unknown and cannot be found. This is why scanning your back with X-rays or CT scans is often of no benefit because while they may find some wear and tear, most backs will have this and correlating this with the pain is often impossible. Pinpointing the exact cause or in fact doing scans often doesn’t change the treatment anyway.

It is important to differentiate acute back pain which by definition lasts for less than 3 months from chronic back pain which lasts longer than 3 months because the management of each is different especially when it comes to medication.

Acute back pain is best managed with some gentle mobilisation, looking after your back and simple analgesia such as paracetamol or anti-inflammatories. Other measures such as hot packs or physiotherapy to strengthen the muscles in your back may be of benefit. Stronger pain killers can be useful for the short term in acute back pain, however they must be used with caution in chronic back pain.

If your pain becomes chronic – that is lasts longer than 3 months, then it becomes increasingly important to manage your pain closely with your GP. This includes appropriate medications, referrals to helpful adjuncts such as physiotherapy and also managing the potential psychological effects of chronic back pain. As we learn more and more about the management of chronic back pain including the potentially damaging side effects of strong pain killers, your GP becomes central to ensuring a swift and safe recovery.

This article has been written by Dr Clark Wasiun