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Ask the expert: 5 questions about back pain

“Why do I have back pain?” 

Low back pain is an extremely common problem. So common that it is normal to get some back pain from time to time. Most of the time it is caused by muscular spasms due to fatigue or inflammation. It is rarely serious and usually improves by keeping active, doing gentle exercise and taking simple pain killers. It is best to avoid prolonged periods of sitting, or bed rest.     

“What is sciatica?” 

This is the term often used to describe the electric shock type pain that passes down the leg when you have a trapped nerve in the lower back. Most of the time, true sciatica will go all the way down to the foot, and may have tingling or pins and needles as well. This can be very painful, and whilst it is distressing it will more often than not go away on its own within a few weeks. As for muscular lower back pain the advice for sciatica is to take painkillers, to try and keep mobile, and to seek advice from your doctor if it doesn’t settle. For those people who do not settle quickly (only about 10%), treatment with medication, injections or surgery is usually successful. 


“What is spinal stenosis?” 

People with spinal stenosis experience pain that builds up in the leg (or both legs) when standing or walking. This typically makes the legs feel “dead” or “heavy”, and the pain often settles quickly on sitting down or leaning forward. This typically affects older people, and is due to a gradual narrowing of the nerve tunnel in the lower back. This is rarely dangerous, and often comes and goes somewhat. If it progresses and is not helped by pain killers, then special nerve pain killers can help, and ultimately surgery may be beneficial. 

 ”When should I worry about my back pain?” 

 Serious causes of back pain are extremely rare, and are generally identified using the following key features: 

  • Back Pain that is worse at night  
  • Back Pain associated with weight loss, hot sweats  
  • Back Pain in someone with a history of cancer  
  • Back pain with weakness in the legs  
  • Back Pain with difficulty in passing urine  

All of these can suggest a more serious cause and you should seek urgent medical attention. 

“What is Cauda Equina?” 

Cauda equina syndrome is a serious but rare set of problems when multiple nerves in the lower back are suddenly squashed, commonly by a large slipped disc.

The key problem is if you lose the feeling of needing to urinate, have numbness around your bottom or “saddle” area, or have pain in both your legs. This can come on very quickly, and is not always combined with back pain. This can lead to long-term problems, and so if these symptoms occur together, urgent advice should be sought in all cases.


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