Back pain and osteoarthritis

What is back pain?

A total of 33 vertebrae make up the spine: seven cervical (upper), 12 thoracic (middle), five lumbar (lower) and five sacral. Discomfort or pain in any area of the spine may be a sign that the joints, muscles or other parts of the back are injured, strained or not working properly.

Back pain is very common with four out of five people experiencing it at some time in their lives. Most bouts of back pain get better in a few weeks with little treatment.

What are the symptoms?

Spine

Back pain can be felt in the back, as a sharp pain, ache or spasm. It can be felt in the middle of the back or on either side. Your back may feel stiff, making it difficult to turn or bend in certain directions. Sometimes pain can be felt in one or both of the legs, too. This can be a symptom of sciatica, a condition affecting the sciatic nerve or a nerve root. This nerve runs from the spine all the way down the leg.

What causes back pain?

There are many joints, muscles and other structures in the back that can cause pain. In most cases it is not even possible to find a cause of the pain. It can be worrying not knowing exactly what is wrong. The good news is that research shows you do not need to know the exact cause of the pain to be able to deal with it successfully. It is rare for back pain to be caused by a serious medical problem.

Should I see a doctor for back pain?

You should talk to your doctor or other health professional if your pain is bothering you. They will ask you about your symptoms and examine you. In most cases x-rays and blood tests are not helpful in finding out the cause of back pain unless there has been a obvious injury or strain. They may check for any serious medical problems that could be causing your pain, but these are rare. You should see your doctor if:

Your pain does not settle down after a few weeks, or starts getting worse.
You have symptoms such as losing weight, tingling or numbness in the legs or feet, sweats and chills, problems controlling your bladder or bowel.
You have osteoporosis (decreased bone density) and you start getting back pain.

When will my back pain settle down?

For most people back pain settles down fairly quickly. This usually takes several weeks but can vary for different people. After two months, 9 out of 10 people will have recovered from back pain. About half of the people who get back pain will have it again within a couple of years. Between attacks, most people return to normal activities with very few symptoms. It is important to learn ways to prevent another bout of back pain. See your doctor or physiotherapist for advice.

What can I do for my back pain?

Talk to your healthcare team. It is common to worry about the cause of your pain and how it will affect you. Talking to your doctor or another health professional about your worries can be helpful. You will usually find there is no serious cause and there are ways you can deal with it.
Learn about back pain and play an active role in your treatment. Not all information you read or hear is trustworthy.
Always talk to your doctor or healthcare team about treatments you are thinking about trying. Reliable source of further information are also listed in the section below. Self-management courses aim to help you develop skills to be actively involved in your healthcare. Contact your local Arthritis Office for details of these courses.
Learn ways to manage pain. Talk to your healthcare team about ways to relieve your pain. Some people have found massage and acupuncture helpful with longer-term back pain. There are also medicines that can help with back pain. It's best to start with simple analgesics and measure their effect before trying others.
Always talk to your doctor or pharmacist about your medicines, as even natural and over-the-counter medicines can have side effects.
Stay active. Your back is designed for movement. The sooner you get back to normal activities the sooner you will recover from a bout of back pain. You may need to rest or reduce some activities when the pain is bad. But resting for more than a day or two usually does not help and may do more harm than good. Traction has been proven not to be useful for back pain. See a physiotherapist or other health professional for advice about exercises to keep your back moving.
Acknowledge your feelings and seek support. It is natural to feel scared, frustrated, sad and sometimes angry when you have pain. Be aware of these feelings and get help if necessary. You can learn skills to recognise and calm anxiety or strong emotions if you find they start to affect your daily life. See the ‘Awareness of thoughts & emotions treatment’ sheet.

There are many other treatments for back pain that have not been well proven. Some unproven treatment may still be useful, however further research is needed. These treatments include:

manipulation of the spine
herbal medicines
transcutaneous electrical nerve stimulation (TENS)
heat and cold (eg. hot water bottles, heat packs, ice packs).

Your healthcare team can give you more advice and information about whether any of these or other treatments might be useful for you.

Other resources

Independent living centres (ILCs) These centres provide information about products and services to help people remain independent and improve their quality of life. They are located in each capital city. See www.ilcaustralia.org.au or call the National ILC Infoline on 1300 885 886to find your closest centre and more information. (In Queensland, the Independent Living Centre is called LifeTec).