What causes back pain?

The most common kind of back pain, which is experienced by around 80 per cent of adults (4 in 5 people), is known as either “non-specific” or “mechanical” Lower Back Pain (LBP).  Non-specific back pain is called that because the cause of the pain is not immediately obvious, while “mechanical” back pain is the result of an identified medical condition.  Osteopaths are experts in finding the cause of “non-specific“ back pain and treating it. They are also trained to identify medical conditions that need further investigation or medical treatment.  If LBP persists for longer than 12 weeks, it is considered a chronic condition; this happens in around 20 per cent of cases.

Both of these kinds of LBP may feel worse when you’re moving around and be relieved by sitting or standing, or they may improve with gentle movement and be worse for sitting or standing still.  They can develop suddenly or gradually over a period of time.  They may occur as a consequence of poor posture, from having lifted something awkwardly, resulting in a minor injury like a sprain (pulled ligament) or a strain (pulled muscle), or be the result of protective muscle spasm around a joint that has got stuck.

Some of the medical conditions that can cause mechanical back pain include:

  • A herniated (“slipped”) or prolapsed disc – where the disc between two vertebrae in the spine bulges and may press on a nerve (note that the disc does NOT slip – the name is completely wrong, but for some inexplicable reason people who should know better continue to use it!). In the case of a prolapsed disc the wall of the disc splits and the jelly-like ‘nucleus pulposus’ is squeezed out into the spinal canal.  This can cause numbness and pain in the back and tingling, pain or weakness in other parts of the body.
  • Sciatica – this is an irritation in the nerve that runs from the lower back to the feet. It can cause pain, numbness, tingling and weakness anywhere from the lower back, buttocks, down the leg to the feet.
  • Ankylosing Spondylitis – an inflammatory condition affecting the ligaments connecting the vertebrae in the spine. This can cause extra bone to grow in the ligaments that connect the vertebrae.  The symptoms are pain and stiffness.  It’s usually worse in the morning, and eases off with movement.
  • Spondylolisthesis – where a bone in the spine slips out of position. Again, this can cause pain, numbness, stiffness and a tingling sensation.

The treatment of these conditions is different to those for non-specific back pain, and can require surgery if other treatments have been ineffective.

Some things you could try yourself to help with LBP are:

  • Stay active. Gentle exercise like walking or swimming is best, as there’s less strain on the body.  There are also Yoga and Pilates stretches which are aimed specifically at easing back pain.  There are lots of videos available online that will show you how to do these exercises and for some people they really can help – BUT it depends on the cause of the LBP: remember “non-specific” LBP only means we haven’t yet found out the cause.  It is really worth consulting an Osteopath first to ensure the exercises are appropriate.
  • Hot and cold compresses. A hot bath or a hot water bottle on your back can really help with the pain If it is coming from tight, spasmy muscles.  Alternatively, a cold compress such as an ice pack or a bag of frozen vegetables can be useful in the short term if the pain is due to inflammation.  You can also try alternating between the two in order to drain away inflammation and encourage blood flow through the area.  We recommend two minutes of cold and one minute of hot alternating for up to 15 minutes finishing with cold.  Be aware:  DO NOT put ice (or a bag of frozen peas) directly onto your skin; wrap it in a cloth or towel before applying it to the affected area.
  • Relax and keep positive. Try to keep doing the things that make you happy and relaxed.  Those who can keep a positive mental attitude have been shown to recover more quickly.

You should definitely seek advice in the following situations:

  • If the pain doesn’t go within 6 weeks
  • It stops you from doing day-to-day activities
  • It worsens or becomes severe
  • If you struggle to cope with the pain and find it’s affecting your mood or your sleep.


In general, if a pain has lasted for more than three days you might consider getting checked: by that stage the initial acute inflammatory response will have subsided and if the pain persists then something is still causing it.  The sooner you find out what, the sooner you can start treating it (and very often, the easier it is to treat).

If you want to seek further advice you could make an appointment to see an Osteopath: we use a holistic approach, treating the whole body, not just the symptoms a patient presents with.  We may recommended specific exercises and regular exercise to ensure that the treatment is as effective as possible and to help prevent the condition from recurring later.

If you’re suffering from “non-specific” LBP and would like to speak to a member of our team, please contact us here.