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Back pain

What is back pain?

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Acute Back pain

Acute back pain is usually caused by a sprain or strain in the back. It is so common it should be seen as an annoying but normal part of life.

80% of the adult population in this country will have a significant episode of back pain in their life. Around 10% of the population have back pain at any one time. 

It can come on quite suddenly, or over time, and can be caused by lifting or moving awkwardly, which can be extremely distressing and can sometimes stop you carrying out your everyday activities. However, more often than not, acute back pain comes on without any specific injury to your back. 

You will often hear that the best thing you can do for back pain is to lie down and rest. However, inactivity will prolong the episode of back pain.

Persistent Back pain

Persistent back pain can refer to recurrent back pain or pain that has lasted for several weeks and it can have a big impact on your day-to-day life. 

Persistent back pain can range from a mild pain or ache, to a more severe pain. This can depend on a variety of things, such as how happy you are at home or at work, if you are prone to depression or if you have had back pain before. 

Persistent back pain may require treatment such as medication or physiotherapy. In most cases though, your back will settle to a manageable level itself. It is important that you keep active and continue as normal, but if your pain is severe and unrelenting then you should seek medical advice.

Sciatic and femoral nerve related pain

Sciatica is a pain that travels from your back or buttock towards your foot (usually going below the knee). You can experience either pain, pins and needles, numbness, weakness or a combination. This can be caused by narrowing affecting the nerve in the back due to a disc bulge or other age related changes.

Spinal stenosis

Coming soon.

When to seek medical advice

On some rare occasions the nerves in the spinal canal may become compromised. This may lead to a variety of symptoms:

  • Loss or decreased sensation around the genital area or back passage.
  • A loss of sensation that you need to pass urine or inability to feel that your bladder is full.
  • Inability to hold on to your urine or bowels.
  • Inability to pass urine or get an erection.
  • Pain into both legs.
  • Progressive weakness in the legs.

Thankfully these are rare but if you feel you are experiencing a combination of these, you should contact to your GP (or spinal clinician if you have already been seen in the spinal service). If the symptoms are severe or progressing rapidly you should seek urgent medical advice and attend ED.

There are other rare but serious causes of back pain and you need to seek medical advice if:

  • you feel generally unwell and suffer symptoms such as fever, night sweats or unexplained weight loss
  • you experience pain at night, possibly worse than during the day that prevents you from sleeping due to increasing pain and/or difficulty lying flat.

If any of these symptoms occur, you should contact your GP.

Dealing with Back Pain

These are crucial for you to keep moving

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Keep Active

When you have back pain it is crucial for you to keep moving.

Movement is something you can do that contributes to your back getting better. Part of that process is allowing time for the body’s natural healing to occur and this will be much better if you continue to move, even if this causes some discomfort.

It will not do any harm – remember, the spine is designed to move. 


Big changes have been made to the way back pain is managed in the NHS. 

Through this website we are supporting the county’s GPs in giving you the help you need to manage your own back. After all, back pain is so common, you’re likely to have episodes of acute pain on and off throughout your life. 

Your GP will help guide your recovery and prevention of further back pain by using the right pain killers as needed, along with some good advice. 

When you need extra help, they can help you decide what’s best for you. As this website is strictly non-promotional, we do not recommend specific practitioners.


Nine out of 10 cases of sciatica will heal without any specialist treatment – and more than seven out of 10 patients will report improvement within four weeks. 

Keeping active is very important, but it may often be necessary to take pain killers to allow you to do this. 

You shouldn’t be afraid of masking the pain as much as possible, as keeping active will not do you any more harm. 

Your GP or physiotherapist will be able to recommend activities that will help you keep moving and stop your muscles getting out of shape 

It’s normal to feel some discomfort during recovery – but this is not harmful.  

Warning signs 

Rarely, the discs in your back can press on nerves that are responsible for bowel and bladder function. If you suffer from any of the symptoms below, you should visit A&E. 

  • Loss or decreased sensation around the genital area or back passage. 
  • A loss of sensation that you need to pass urine or inability to feel that your bladder is full. 
  • Inability to hold on to your urine or bowels. 
  • Inability to pass urine or get an erection.
  • Pain into both legs. 
  • Progressive weakness in the legs.

At work

You are better continuing with activity, including work, even if you are still in some pain. People who remain active have far better outcomes than those who don’t. 

If you are struggling with back pain: 

  • Inform your manager 
  • Seek professional advice 
  • Keep mobile 
  • Stay at work as long as possible, this helps with your rehabilitation and recovery 
  • Use pain killers to help you carry on – it’s the movement that will get you better, and the pain killers will allow you to move by easing the pain. 

If you have to go off work sick, use that time to get your back better – this might mean going out for walks, to the shops, etc. Don’t feel that just because you are off work you should not keep active – you must! 

Stay in touch with your workplace. Hopefully your employer will be trying to keep in touch with you as well. Be open-minded about getting back to work as soon as possible. This can be facilitated by changes to your normal job role, hours and even where you work. 

The longer you remain off work the more difficult it becomes to get back to work. 

Avoiding Back Pain

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Avoiding back pain at work

Many people spend at least eight hours a day at work and there is a lot that you can do to reduce the likelihood of developing or help manage back pain better. 

  • If you have to lift things at work plan the lift first, does it need to be done? Can you make it easier by dividing the load? Ensure you are strong enough for the task (by doing regular strength exercise) 
  • If you work in a static job, seated or standing make sure your work set-up is correct for you. 
  • Avoid prolonged static postures, for example sitting at a telephone station or VDU – take regular movement breaks. 
  • Use equipment provided to reduce the load on your body. 

At Your Desk 

Working at a desk all day can be uncomfortable for your body as it was not designed to be still for prolonged periods of time. 

  • Try to have your computer screen at eye level in front of you and your chair facing it.
  • Have your mouse and keyboard within easy reaching distance. 
  • Take regular breaks and get up and walk around the office regularly, to stretch out your muscles and get things moving again. 
  • If you are getting stressed or tense at your desk taking a break to relax your body and mind. Doing some abdominal breathing can be helpful. 
  • Be active when you are out of work to compensate for the time you spend inactive at work. 

Lifting & Handling  

 When lifting and handling heavy goods you have to be fit/strong enough for the task. 

  • Whether it’s heavy stacks of paper in an office or machinery – power through your legs and arms to lift. 
  • If possible, use lifting and moving equipment such as a trolley to aid you. 
  • Test the weight of an unknown item you are about to lift if able by pushing it with your foot. This way you know what to expect. 
  • Always plan ahead to ensure that where you are moving the item to is clear and uncluttered – this avoids having to hold the item for longer than needed. 
  • Most importantly do regular exercise that keeps you strong enough for activities such as lifting. 

On Your Feet 

If your job requires you to be on your feet all day, then it’s likely you will at some point have suffered from aches and pains, it is important to try and keep moving and walking around and to sit every so often. 

  • As with all jobs, getting regular exercise and keeping fit outside of work will greatly improve the strength of your body and reduce your chances of getting back pain. 
  • Take regular breaks to stretch your muscles – this will prevent stiffness and keep your circulation going. 

Avoiding back pain at home

Whether you’re out in the garden or cleaning the house – what you get up to at home can often have an impact on your back. 

But by following some simple tips and advice, you can keep your back in check and prevent any pain from happening. 

Gardening & DIY  

For many people, gardening is an enjoyable hobby that allows them to escape the hustle and bustle of daily life and get back to nature in the great outdoors. 

Some general tips when gardening: 

  • Take a moment to warm up 
  • Digging – take a wide stance and let your leg muscles do the work. If necessary, lever the spade using your foot if the soil is dense and heavy. 
  • Moving tubs – roll them onto their outer rims to avoid lifting as they are often very heavy and more than you would normally lift. 

If carrying can’t be avoided, the following tips should help: 

  • Ensure you’re wearing loose, casual clothing and sensible shoes 
  • Lift close to the body and pick up and set down using the powerful leg and arm muscles. 
  • Plan movements of compost bags/soil/chippings using wheels wherever possible 
  • Wheelbarrows – don’t overload as these can be awkward to move 

When bending: 

  • Loosen with some repeated bends first. 
  • Combine with bending the knees into a squat if easier, or bend your knees as far as possible with one foot in front of the other (lunge) 
  • Otherwise go down on one knee or both 
  • Take regular breaks changing position going for a short walk or stretching (time can fly when you are having fun in the garden!) 
  • If you are tired, STOP for a break instead of pressing on (there’s always tomorrow, pace yourself) 

Around the House 

Back pain affects around 8 out of 10 of us at some time, but by following a few simple tips you can ensure that you can do those everyday household activities without pain or discomfort. 

Keeping active

Regular exercise is vital in keeping back pain at bay by toning your muscles, allowing your body to carry out these tasks much better. Government guidelines encourage us to perform at least 150 minutes of moderate intensity cardiovascular exercise (or 75 minutes vigorous i.e.: running, spinning) per week over a few sessions. As well as 2 days including some form of strength training and balance training (remember many exercises combine these i.e.: spinning is cardio and strength, yoga can be balance and strength). 

People with good fitness levels tend to experience less back pain, so get out of the house and go walking, swimming or cycling for half an hour a day. Exercise classes such as yoga or pilates are also great for your back. Visiting the gym can also help. 

We would also recommend some online exercise videos found on the NHS website (If you are new to the exercises build up gradually).

Keeping active is also good for you if you’re already suffering from back pain. Even if exercising feels painful, it will not harm your back and keeping active is one of the best ways to allow your back to recover. 

However, it is also important to take care when exercising, gradually build yourself up from your starting point, working on strength and flexibility as well as cardiovascular (getting hot and sweaty) fitness. 

  • Warm up – make time to warm up before exercise. Gently stretch both your upper and lower body to get your circulation going and to loosen up your muscles. 
  • Right muscles – build strength in your legs and upper body so when lifting use the big muscles in your legs and arms that were designed to do the job efficiently – not your back. 
  • Correct equipment – It is crucial when exercising you have the correct equipment and clothing. For example, if running, always wear proper running shoes that fit properly. Also, if you are playing tennis or badminton, make sure you buy a racket that is not too bulky or heavy for you. 
  • Cool down – Gently stretching your muscles after exercise. It can loosen your muscles, helping to prevent stiffness later. 
  • If you hurt yourself while exercising follow the advice earlier on in this resource and you should again improve but remember when building up exercise again, start slow and gradually build up to reduce the likelihood of further problems. 

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Additional resources

Consent form for corticosteroid injection during COVID pandemic

Exercises to manage back pain

Sciatica information

Guide to back pain and what you can do about it

Managing Pain

How to make changes 

 Below are links to online resources providing evidenced based advice on the how we  

should be managing back pain. 

  • Information about back pain and simple exercises that might help (Chartered Society of Physiotherapy)    

Pain explanation  

Below are links to different online resources looking at explaining pain and our thoughts 

and beliefs around pain and back pain specifically.  

  • ‘Understanding pain in less than 5 minutes’ – Online video looking at the complexity of pain and the brain. 

  • ‘Separating fact from fiction’ – Online video by Peter O’Sullivan looking at our beliefs around back pain. 
  • ‘Why things hurt’ – Online explain pain video from Lorimer Mosley  
  • Tame the Beast – Website with information on persistent pain.  
  • Pain Tool Kit – Website created by a patient to help manage persistent pain providing education and knowledge on how to improve self-management.   
  • Pain-ed – Website providing patient and clinician information regarding pain and specifically back pain and Cognitive Functional Therapy  

Abdominal breathing, relaxation and sleep 

Stress and tension are common with persistent pain. For some it may be part of the underlying cause for many it’s a consequence as pain itself causes more stress and anxiety. What we know is that if we can use tools to help reduce our muscle tension and stress this can help with pain, sleep and function. Below are links you may find useful 

  • Sleep well with pain – Leaflet to help try and improve sleep 

 Local Services 

LiveWell Dorset – Weight management, stop smoking, exercise advice, lifestyle change  0800 8401628/ 01305 233105 

Steps to wellbeing – for help with feelings of anxiety, depression, bereavement and trauma/PTSD   

Welcome to the moodzone – for help with selfmanagement of stress, anxiety and depression  

Dorset Community Pain Service website – 

Understanding persistent pain – Booklet on persistent pain this booklet is commonly used by the Dorset Service 

General advice leaflets 

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