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Back problems and treatments

We take a look at two common back problems, sciatica and brachialgia, exploring causes, symptoms and available treatments, and share tips on looking after your back.

How common are back problems?

We don’t tend to think about our back until something goes wrong. But even mild back pain and back problems can make your life miserable, affecting even basic daily tasks.

Back pain is very common, affecting up to 80% of people at some point in their lives.

For a smaller percentage of people, this becomes a serious problem. Back issues are the most common cause of job-related disability and account for a significant number of days off work.

Although pain in your back is a very common symptom of back problems, issues with your spine and nerve can also cause symptoms elsewhere, for example your arms or legs.

This is the case for two of the most common back problems: sciatica and brachialgia.

What is sciatica?

Sciatica is a condition where your sciatic nerve, which runs from your lower back to your feet, is compressed or irritated.

Symptoms of sciatica include pain, tingling, numbness and weakness. You might experience these in your bottom, the back of your leg(s) or your feet and toes.

Sciatica pain can vary widely from person to person. It may be a mild tingling, a dull ache, or a burning sensation. In some cases, the pain may be so bad you can’t move.

Most people experience sciatica pain in just one side. Some people will have sharp pain in one area and numbness elsewhere. You might feel weakness in your legs.

Sciatica may come on gradually or very quickly. For most people, it will get better in four to six weeks.

What causes sciatica?

The most common cause of sciatica is a slipped disc (also called disc herniation). This is when the cushioning tissue between your spinal bones pushes out.

Spinal stenosis is another common cause. This is where the part of the spine that your sciatic nerve passes through becomes narrowed.

Other causes of sciatica include spondylolisthesis (when a bone in your spine slips out of position) and back injuries. More rarely, the cause may be a disorder of the piriformis muscle, a pelvic injury or fracture, or a tumour.

Sciatica pain may get worse after standing or sitting, when sneezing, coughing, or laughing or when bending backwards or walking more than a few yards, especially if caused by spinal stenosis.

What treatments are available for sciatica?

Sciatica is a symptom of underlying back problems, but these tend to go away in time. So, your GP may first recommend exercises, stretches and mild painkillers to deal with the immediate symptoms.

Bed rest is not recommended. You’ll probably be advised to take it easy for just a couple of days, before slowly starting your usual activities again. However, you shouldn’t take any action before speaking to a doctor, just in case.

If you are in significant pain and discomfort, you may be referred to physiotherapy, or to a specialist to help you cope with the pain.

In cases of very severe sciatica, you may need to have painkilling injections or, very rarely, surgery.

What is brachialgia?

If you have a trapped or compressed nerve (normally in your neck) that causes pain in your arm and/or hand, this is called brachialgia.

Symptoms are similar to those caused by sciatica in the legs. As well as arm pain and hand pain, you might experience tingling or pins and needles, and perhaps numbness or weakness.

Like sciatica, brachialgia can come on very quickly, but also can come on gradually.

Most people will find their symptoms gradually ease without the need for invasive treatment.

What causes brachialgia?

The causes of the trapped nerve in the neck that lead to brachialgia overlap with those of sciatica.

These include spinal stenosis, a bulging or ‘slipped’ intervertebral disc, bony spurs called osteophytes or osteoarthritis of the spine (spondylosis).

What treatments are available for brachialgia?
Similarly to sciatica, brachialgia is a symptom of underlying back problems that normally go away by themselves. Initial treatment will focus on addressing your pain.

You might be recommended physical therapy, like hydrotherapy or massage, or be advised on stretches and exercises that can ease your pain.

If you are in severe pain, you might be recommended injections into the nerve, or even surgery to correct the problem causing your brachialgia. These treatments won’t be suggested unless other, less invasive methods have failed.

How to look after your back

Don’t wait until you’re in pain before you think about caring for your back. These simple tips can help you care for your spine and may ward of back pain and problems.

Maintain good posture

The first thing to remember is posture, as it's a major cause of back problems. Remind yourself to stand up straight, and if you need support when you're sitting or driving, use a lumbar roll (a specialist cushion) to support your lower back.

Avoid bending down for routine tasks such as emptying a washing machine. Instead, lower yourself by bending your knees, allowing your spine to keep relatively straight.

Look after the supporting muscles

Your spine is a bit like the mast on a ship: it's long and tall and depends on the rigging around it to keep it stable.

Similarly, our internal 'rigging' (the muscles in our back, abdomen, buttocks and thighs) has the job of holding the spine stable and straight. If they're out of condition, or out of kilter, the forces on your spine are no longer neutralised and you start to get back problems.

A physiotherapist, chiropractor or osteopath can give you advice on building up the muscles around your spine. They will likely recommend regular exercise, too, as improving your fitness can reduce the chances of back pain.

Avoid unnecessary strains

As well as regular exercise and good posture, you can protect your back by avoiding unnecessary stresses and strains in everyday life. This can be as simple as wearing comfortable shoes, sitting in a properly ergonomic chair, and making sure to lift with your knees, not your back.

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