Back Pain

Updated 17 September 2014

Top 3 causes of backache

Back pain is one of the most common reasons we go to the doctor. Here’s everything you need to know to help your aching back.


It’s one of the most common reasons we go to the doctor. Here’s everything you need to know to help your aching back.

To be human is to have a sore back. By the time we reach age 50, 9 out of 10 of us will have experienced back pain, the leading cause of disability in people under 45. Doctors prescribe everything from acupuncture to surgery to bring us relief, and as a society, we spend the same amount of money trying to cure back pain as we do cancer. If you’re reading this article, you’re probably desperate for your own fix. Here’s our guide to what may be causing your problem and how to stop it.

Top 3 causes of backache

Cause 1: spinal problems

Herniated disc: In between our vertebrae, small sponge-like pads that act as cushions to absorb everyday shocks to our spinal column, can rupture or bulge due to aging and injury, putting pressure on the nerves in our spine and causing significant pain.

Sciatic pain felt in the sciatic nerve, which runs down your leg, is caused by pressure from a herniated disc.

Arthritis: Osteoarthritis often affects the lower back and can cause a painful narrowing of the spinal canal called spinal stenosis.

What can be done?

You might be surprised to learn that back surgery is the treatment of last resort. Because the structure of the spinal column is so intricate and the nerves running through it so numerous, back surgery is a risky procedure that only works about 50% of the time. Most experts recommend exhausting other approaches, which are 90% successful in reducing pain, before going under the knife.

Home treatment

Strengthen your stomach so that it can help your back muscles do their work and decrease the pressure on your spine. Try daily stomach crunches or holding the plank for several minutes a day if your back will allow it.

Try medication: over-the-counter anti-inflammatory and/or prescription muscle relaxants can bring down inflammation in the back and quiet spasms, decreasing pain.

Physical therapy can strengthen your back muscles and increase flexibility to help your back return to working condition.

Epidural injections: doctors can deliver powerful anti-inflammatory medication(steroids) directly into the spine, lowering inflammation profoundly and quickly.

Acupuncture: a study published in the Archives of Internal Medicine found that acupuncture (in which tiny needles are inserted into pressure points on your body) was more effective at relieving back pain than traditional approaches such as medication

When should you consider surgery?

  • You have tried other interventions such as physical therapy, exercises, medications and epidurals that haven’t worked.
  • You have pain that shoots from the lower back to below the knee or is accompanied by numbness or tingling in your feet.
  • You feel you can no longer live with the pain you are experiencing.

Cause 2: emotional stress

When we’re stressed, we tend to hold a lot of tension in our lower back, which, in turn, can severely exacerbate and prolong back pain.

What you can do?

  • Exercise both to relieve stress and strengthen back muscles.
  • Apply an ointment with camphor and menthol that activates cold receptors and desensitizes heat receptors to decrease pain.
  • Try willow bark though it’s from the same root as aspirin, willow bark, which is sold at health food stores in capsule form, has been shown to be as effective or even more effective than aspirin and other pain relievers.
  • Get a massage: massage decreases tension across the shoulders and brings blood flow and oxygen to the area. Thai massage is particularly effective for back pain, because it stretches your body at the same time as you are massaged, teaching your body how to relax and release pain.

Cause 3 : daily habits

Little things you do every day can add up to a big pain in the back.

  • High heels 7.6 cm put 7 times more pressure on your feet than flat shoes, throwing off your posture and spinal alignment. In fact, nearly half of women who wear high heels will experience a foot injury that can cause back pain.
  • Heavy bags and thick wallets carrying more than 10% of your body weight creates an imbalance in your posture and strains the muscles in your back and shoulders. Likewise, thick wallets inserted into your back pocket are wedges that disrupt the balance of the pelvis and spine and can actually contribute to arthritis.
  • Driving people who drive cars for more than 4 hours a day are 6 times more likely to miss work due to back problems than those who drive under 2 hours daily.
  • People who sit for extended periods doing their jobs, have more back problems than those who do manual labour.
  • Slouching: bad posture can put the equivalent of 100 extra kilograms of stress on your lower back.
  • Lifting: the worst thing you can do for your hardworking back is to bend and twist while trying to lift something, which gives the disks in your backno support. That’s when they can slip and pinch nerves.

What you can do?

  • Switch to pumps and never ever wear 7.6cm or higher heels.
  • Do a daily bag edit: when you get home for the day, search through your bag for the extra things you picked up and won’t need the next day. Keep your bag’s weight to a few kg's and switch your carrying shoulder often. If you must bring a heavy bag on occasion, balance it with another bag on your other shoulder. Consider purchasing a back-friendly backpack or messenger bag.
  • Keep your wallet under 0.5cm thick: edit receipts weekly, carry only your crucial cards and avoid having wads of small bills.
  • Take driving breaks every 1 and a half hours and stretch.
  • Get up and move if you work at a desk all day and stretch every 20-30 minutes. Try putting your hands on your hips and bending backward until you feel a stretch.
  • Set up a healthy workstation: most office chairs are designed for men around 1.778 metres tall who weigh 180 kilograms. This means the rest of us have to customise chairs to give us the proper back support we need. Purchase a lumbar roll or try using a partially inflated beach ball behind your lower back for support. Make sure your feet are planted on the ground with your knees at hip level or slightly lower. Keep your arms relaxed at your sides with your elbows directly under your shoulders. Have your computer monitor an arm’s length in front of you with the mouse at easy reaching distance. If you talk frequently on the phone at work purchase a head set or ask your employer to purchase one for you.
  • Lift a heavy object bending your knees and keeping your back straight.
  • Stretch your back out to keep your spine flexible by doing the butterfly stretch regularly. Lay face down with your stomach resting on a pillow. Put your forehead on a rolled towel to keep your neck in a comfortable neutral position. Bring your arms out to your sides with elbows bent to 90 degrees. With your lower body relaxed, squeeze your shoulder blades together and lift your chest off the mat. Hold for 3-6 seconds and release. Work up to 3 sets of 5-10 repetitions. 


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Backache expert

Susan qualified as a Physiotherapist in 1990, and completed her master’s degree in Physiotherapy in 2013 at the University of Pretoria. She has a special interest in human biomechanics, as well as the interaction between domestic and work-related ergonomics.

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