Back Pain

Back pain is the most common complaint in the Pain Management clinic – it is in fact so widespread that an estimated one in three of us will suffer from back pain at some point in our lives. In the majority of cases, pain is felt in the lower back.

What Is The Back?

The back is a large, complex area of the body consisting of many parts – bone, nerves, joints and muscle – all of which are connected together.

Back pain can be used to describe pain anywhere along the spine from the neck or cervical spine, through to the thoracic spine that supports the chest wall, down to the lumbar spine, sacrum and coccyx. It is divided into four separate regions:

  • Cervical region (the neck)

  • Thoracic region (the chest)

  • Lumbar region (lower back)

  • Sacral region (pelvic area)

In the centre of the back is the spinal column – formed of 33 individual vertebra stacked upon one another. Between the vertebra are intervertebral discs, their function is to act as shock absorbers when the body is in motion, as well as preventing the vertebra from grinding against each other. The spinal column houses and protects the spinal cord – this runs through the vertebra from the brain, all the way to the lower back – carrying messages to and from the brain, to the rest of the body.

What Is The Difference Between Referred And Mechanical Pain?

Health professionals characterise back or spinal pain in terms of 'mechanical' or 'referred' symptoms.

Referred spinal pain is pain in the spine which is also perceived to radiate elsewhere e.g. an arm or a joint such as the shoulder or hip – A classic example is sciatica – where compression of the sciatic nerve in the lower back causes pain to be felt down the back of the leg to the foot. Referred pain is often indicative of narrowing in the spine with nerve irritation resultant from the narrowing.

Mechanical symptoms are those were pain is felt only in the spinal area itself and is often caused by inflammation in the intervertebral discs and facet joints. In the sacral area the sacro-iliac joints can become involved.

Causes Of Back Pain

There are a wide variety of possible causes of back pain, many of which are a result of everyday routines and activities such as:

Poor posture

Slouching or engaging in other forms of poor posture whilst standing or sitting.

Sitting for prolonged periods

Working at an office desk for hours on end is a well known contributor of back related pain and discomfort for many. Driving for extended periods of time can also cause pain.


Awkward sleeping positions and or an unsuitable mattress may cause consistent pain and discomfort in the back.

Repetitive strain injury

Overusing a particular group of muscles, most commonly during sport or regularly lifting heavy objects can cause injury to the back.

Some individuals are more predisposed to the risk of developing back problems, this includes the following:

  • Being overweight
  • Being pregnant
  • Stress/depression
  • Smoking
  • Corticosteroids

Medical Conditions Which Cause Back Pain

Herniated Discs

One of the most common causes of back pain – a ruptured or herniated disc may cause the disc’s inner material to seep out, this can compress or irritate nearby nerve roots which are exiting the spinal cord. A herniated disc can cause severe pain which may be felt in different locations in the body, depending on where the compression occurs.


This describes a neck injury caused by the sudden movement of the head – the result of a strong impact, usually a car accident. The excessive movement suddenly over stretches and damages tendons and ligaments in the neck.

Frozen Shoulder

A painful condition whereby the area surrounding the shoulder thickens and becomes inflamed, restricting the sufferer’s movement.

Spinal Spondylosis

This term refers to degeneration of the spine – it encompasses a wide range of conditions which are often a result of the break down of the body’s natural wear and repair cycle caused by ageing.

Spinal Stenosis

Narrowing of the space around the spinal cord in the spinal column can result in the compression of the nerves.


This refers to the abnormal curvature of the spine.

Cancer or Infection

In some cases, back pain may denote a more serious underlying condition such as a tumour or infection.


A thorough medical examination and detailed history will be required as well as any necessary tests. These may include:

  • MRI Scans

  • SPECT CT Scan

  • Blood Tests

  • X Rays (X-rays are not indicated unless there are RED FLAG symptoms and/or signs of infection or possible cancer)


It is often very much part of a chronic pain syndrome and the best approach to treatment is via the biopsychosocial, this takes into consideration the following factors – biological (genetics etc.), psychological (individual personality, mood, behaviour) and the social (cultural and economic circumstances).


Over the counter medication may help relieve back pain. However in the case of chronic pain, a pain management consultant may need to prescribe stronger medication depending on the condition.


Specific back strengthening exercises and manipulation can help to significantly improve a range of back pain related conditions.

Psychological Treatment

Chronic pain can be extremely stressful and worrying leading to depression and anxiety. Psychological treatment may be able to help individuals cope with their painful condition and the stress of how to it affects other areas of their day to day life.


In some cases of back pain, surgery is necessary. This is however, usually a last resort when all other forms of treatment have proved unsuccessful.

Prevention Is Better Than Cure

Looking after your back and maintaining a healthy lifestyle can reduce your chances of developing back pain in the future. In particular:

  • Staying active

  • Healthy diet

  • Avoid over straining muscles

  • Maintaining correct posture

  • Taking regular breaks when sitting for prolonged periods



For the latest availability please call 020 7060 5109 or fill out the form below. Please note that there may be a 1-2 week appointment lead time.

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