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Back pain and discomfort: the most common conditions that could be the source of your pain

17/05/2021

Lower back pain is extremely common, with almost two in three of people experiencing some form of low back pain at some point in their lives. The pain can affect anyone, and can range from a muscle aching to a shooting, burning or stabbing sensation. In addition, the pain may radiate down your leg or worsen with bending, twisting, lifting, standing or walking.

But what are the most common causes of back pain and what treatment is available for people with these conditions? Mr Lee Breakwell, Consultant Orthopaedic Surgeon at Claremont, takes a closer look.

Why do I have back pain?

Low back pain is an extremely common symptom, and is normal for some people. It is rarely serious, and often responds to simple painkillers and gentle exercise. It is best to avoid prolonged periods of sitting or bed rest.

The majority of people experience muscular spasms due to fatigue or inflammation and again these respond to simple painkillers and anti-inflammatory medications. Most back pain is attributable to so-called ‘wear and tear’, which is a normal part of ageing where the tissues change with time making them more susceptible to stiffness and pain. Surgery is rarely needed to treat back pain.

What is Sciatica?

This is the term often used to describe the electric shock type pain that passes down the leg when you have a trapped nerve in the lower back. Most of the time, true Sciatica will go all the way down to the foot, and may have tingling or pins and needles as well. This can be very painful and while it is distressing it will more often than not go away on its own within a few weeks.

The advice for sciatica is to take painkillers, try and keep mobile, and to seek advice from your doctor if it doesn’t settle. For those people whose sciatica does not settle quickly (about 10% of people), treatment with medication, injections or surgery is usually successful.

What is Stenosis?

This term describes the type of pain that builds up in the leg or legs when standing or walking. This typically makes the legs feel ‘dead’ or ‘heavy’, and the pain often settles quickly on sitting down or leaning forward. This typically affects older people, and is due to a gradual narrowing of the nerve tunnel in the lower back. This is rarely dangerous, and often comes and goes somewhat. If it progresses and is not helped by painkillers, then special nerve pain killers can help, and ultimately surgery may be beneficial.

What is Cauda Equina Syndrome?

Cauda Equina Syndrome is a serious but rare set of problems when multiple nerves in the lower back are suddenly squashed, commonly by a slipped disc. The key problem is if you lose the feeling of needing to urinate, have numbness around your bottom or ‘saddle’ area, or have pain in both your legs. This can come on very quickly.

Cauda equina syndrome requires surgery, because the longer it goes untreated, the greater the chance it will lead to permanent paralysis and incontinence.

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