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Spine health and back pain

Many of us would have experienced a niggle or some form of back pain at some stage in our lives, but when it doesn’t go away or get any better, it can have a significant impact on a person’s quality of life.

Back pain is one of the main reasons people visit their GP or miss work. In Australia, back problems are the third highest cause of disease burden, with chronic back pain affecting one in six Australians.

As part of Spinal Health Week, this month’s blog takes a closer look at the causes, treatment, and management of back pain.

What is back pain?

Back pain refers to pain that affects your spine or the surrounding muscles, nerves, and tissues, including from your neck all the way down to your buttocks.

Your spine is a complex structure made up of 24 vertebrae, disks, joints, ligaments, and muscles. It is key to supporting your body and holding it upright, protecting your spinal cord, and allowing your body to sit, stand, walk, twist, and bend.

The spine is divided into five different areas:

  • Cervical — includes your neck region, from where your skull is attached to your spine, down to your shoulders.
  • Thoracic — the region where your ribs attach to your spine.
  • Lumbar — lower back.
  • Sacrum — the 5 vertebrae that fuse to form a triangular bone that is attached to your pelvic bones.
  • Coccyx (tailbone) — the 4 joined (fused) vertebrae at the base of your spine, where your pelvic floor ligaments and muscles attach.

While back pain can affect any of these areas, most back pain occurs in the lower back. Back pain can either be acute, lasting for a short time only, or chronic and lasting more than three months.

According to the Australian Institute of Health and Welfare, around 4 million (16%) Australian’s were estimated to be living with back problems in 2022, with $3.4 billion spent on the treatment and management of back problems, representing 2.2% of the total health system expenditure.

Back problems also contributed to 1,112 deaths and were the third leading cause of overall disease burden in Australia in 2023.

Common Causes of Back Pain

Some of the more common conditions that affect spine health and that can cause back pain include:

  • Arthritis and arthritic conditions, like ankylosing spondylitis
  • Back strains and sprains
  • Birth defects, such as spina bifida.
  • Bone spurs
  • Curvatures of the spine (scoliosis and kyphosis)
  • Herniated disc
  • Neuromuscular diseases, such as amyotrophic lateral sclerosis
  • Nerve injuries, like spinal stenosis, sciatica and pinched nerves
  • Osteoporosis
  • Spinal cord injuries, including spinal fractures and paralysis
  • Spine tumors and cancer
  • Spine infections, like meningitis and osteomyelitis

Some people may also experience back pain that has no specific cause. There are a number of factors that can make this non-specific back pain worse, including:

  • Soft tissue injuries
  • Stress
  • Smoking
  • Lack of exercise
  • Overweight or obesity
  • Sudden increase in load on the spine — for example, lifting heavy objects or children, when you’re not used to it
  • Mental health conditions, such as anxiety or depression

The good news is that most cases of back pain are benign and not caused by a serious medical problem. However, if you experience any of the following symptoms along with back pain, see your GP right away or go to your local hospital’s emergency department for urgent medical assistance:

  • New incontinence (bladder or bowel) or numbness around the genitals or back passage.
  • Leg weakness, especially on both sides, or difficulty walking.
  • Numbness or pins and needles affecting both legs.
  • Severe pain that does not improve with rest or is worse at night.
  • Unexplained weight loss, fever, or chills.
  • History of cancer (previous or current).
  • History of significant trauma (fall, car accident).
  • Use of steroids or immunosuppressants.
  • Over age 70 with new-onset back pain.

Prevention

The best way to help prevent back pain is by keeping your back and core muscles strong through strengthening exercises, such as planks, and building flexibility through stretching exercises, at least twice a week.

Regular low-impact aerobic activities, such as walking and swimming, can also help to increase your strength and endurance.

Other protective measures include:

  • Bending your knees and keeping your back straight when lifting items.
  • Maintaining a healthy weight.
  • Using good posture (sitting up straight, not slouching).
  • Not smoking.
  • Managing stress levels.

When to See a GP

Back problems are among the most commonly managed conditions in general practice.

While most acute cases of back pain will eventually pass on their own, without the need for specific treatment, you should see your GP if you experience pain that:

  • Has lasted more than two weeks with no improvement.
  • Keeps returning after brief periods of improvement.
  • Limits your work, sleep, or daily activities.
  • Is accompanied by numbness or tingling in one leg.
  • You are managing with over-the-counter medication for more than a few days.

Your GP will take a thorough history and examine your back, legs, and nerve function.

If you have had back pain for a while, or have other medical problems, they may refer you for tests, including blood or imaging tests, to help identify the cause of your back pain. They may also prescribe medication, recommend a treatment plan, or refer you to a specialist for further treatment.

If you are experiencing any back pain, book in with one of our GPs to discuss your concerns. Appointments can be made online or by contacting us directly on (08) 9208 6400.

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