How to treat or minimise back pain

Simon Cabot, a physiotherapist and back specialist with Vitality partner Nuffield Health, believes the solution to chronic back pain is available to all of us. It’s simply: keep moving. Stats show that four out of five adults will experience back pain at some stage… and we give you tips how to not be one of them.

Research from Backcare, a UK charity that provides advice and information about back pain, suggests that four out of five UK adults will experience it at some stage in their lives, and that we’re especially vulnerable between the ages of 35 and 55.

Simon Cabot, the clinical lead physiotherapist at Nuffield Health in Canary Wharf, London, has been working as a back specialist for 17 years. He believes there is one piece of advice that’s applicable to all issues relating to our backs, and that’s to keep moving. “Backs are far more robust than we think, but when most people feel pain, they worry that moving will make the problem worse and lead them to a lifetime of chronic pain. In fact, the opposite is true,” he says. “The important thing is to remain active but do the right amount of movement that is comfortable for the individual, then build upon it to improve their fitness.”

Simon explains that the body – our muscles included – is made up of 70 per cent water, and gets across his point with the analogy that if water stays still, it starts to stagnate. Move the water and it remains usable. “Moving from one posture to another – even a bad posture – every 10 minutes is better than sitting still in a good posture for an hour. Just shifting around in your chair is better than nothing. Our bodies are designed to move, our whole physiology requires movement to get blood and other fluids pumping through the body to maintain our cells and tissues.”

Back pain can present itself in a variety of ways, such as after lifting something heavy, and it can build over a period of time. But the sensation is different to the stiffness you can feel following a good workout in the gym or after a few hours in the garden. “Pain is when the feeling is sharp, or pins and needles,” explains Simon. “If that’s what you’re feeling and it hasn’t settled down after three or four days, make an appointment to see a physiotherapist because there’s a good chance that what you’re looking at is an underlying problem.” Whether you’ve never experienced back pain, get the occasional twinge or have an ongoing problem, Simon can recommend ways to remain healthy and self-manage back issues, with exercises to improve your back’s overall wellbeing.

How to keep the back pain at bay

“Staying active is the best way to keep your back healthy. Nearly every movement we do travels through the back, so any form of motion we do will benefit that area. Think of your body as an expensive car: you wouldn’t leave it idle in the garage, or fill it with low-grade oil, or thrash it on the motorway if it hadn’t been used for a while. So keep your body moving and well maintained with regular exercise, preferably something you enjoy so you’ll stay motivated. Eat a balanced diet packed with healthy foods that are rich in nutrients and minerals, so the body can properly do all the functions you’re asking it to do. And don’t traumatise the body with sudden, vigorous bouts of exercise: build fitness slowly. Be considerate to your body and your back will be good to you!

“It’s crucial to learn to lift properly. Calculate 20 per cent of your own body weight and try never to lift anything heavier than that. As for the right lifting technique: go into a squat position, bend the knees and keep your back straight. And if the object is too heavy, or just an awkward size or shape, ask for help.”

Feeling some twinges? Try a trip to a physiotherapist

“Consider a visit to a physiotherapist. Sometimes with back trouble, it’s a case of a stitch in time saves nine. You may only need to see a physio two or three times to put right what’s likely to be a small issue.”

Ignore it, though, and it can result in a dozen physio apppointments, a lot more pain and possibly time off work. “A GP is likely to propose medication and refer you for a scan. For anyone over 30, that scan is likely to reveal something such as a degeneration of the spine or a bulging disc, both of which are normal and a natural part of the aging process, but it’s the kind of thing that can make people anxious. A physiotherapist, meanwhile, is a back specialist. They understand how the back works, what’s good and bad, and how to control many problems with an exercise plan that can be done at home. If they spot anything more worrying, they will refer a patient to their GP for a consultant referral.

“A physiotherapist will ask questions to discover contributing factors to the problem, such as how often you drive, what job you do, the hours you work. For some people it might mean a workstation assessment to improve how they sit, or to set an alarm on their phone so they get up and walk across the office every half-hour. For others the back pain could be linked to stress, so a 20-minute ‘mindfulness’ session at the end of the day could help relieve the issue. There is no magic bullet, but often a combination of factors are helped with a variety of solutions.”

Suffering from back pain right now?

“If you are not already seeing a physiotherapist, make an appointment as soon as it’s convenient. With backs, 90 per cent of the pain is very tricky to actually diagnose. There are so many pain provocative structures in our backs that it is difficult to be categorically accurate. It’s more likely the trouble’s caused by a bit of everything: if your muscles are tight, that will restrict the joint, and if your joint is restricted, that will tighten the muscle. Often the place the pain makes itself felt is not the source of a specific problem, it’s just the part of the back that is overcompensating.

“A physiotherapist will design an improvement programme to realistically fit in with a patient’s lifestyle. It’s no good telling a rugby player to do pilates three times a week, or suggesting someone stretches every morning when the only time they can spare is 10 minutes at the end of a long working day. The important thing is to create a bespoke self-treatment plan that will not only help the patient get better but also make them feel more in control and not dictated to by the pain. Some back conditions such as spinal stenosis, which is a narrowing of the spinal canal, or osteoarthritis, are hereditary but very rare. Sometimes an operation is necessary, but even these conditions can be managed and improved with the right education programme that puts the patient in charge. Back pain is a temporary thing – and patients do get better.”

Do you need physio?

Vitality members with Out-patient Cover can undergo treatment at more than 1,400 clinics across the UK through our physio network. Just refer yourself and our network will manage your claim. Submit a claim online at member.vitality.co.uk.

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