QUESTION: I've been told that I am suffering with non-specific low back pain. I have had this now for several weeks after I felt my back go after lifting a cooker. Why am I not getting better and what is the best treatment?

ANSWER: Around 19 in 20 cases of sudden onset low back pain are classed as "simple low back pain" because the pain is not due to any underlying disease that can be found.

In some cases the cause may be a sprain (an over-stretch) of a ligament or muscle and it seems as if, from your description, this is what has happened in your case.

Another cause could be a minor problem with a disc between two vertebrae, or a minor problem with a small joint between two vertebrae, known as a facet joint.

Simple does not mean that the pain is mild -- it can range from mild to very bad. The pain is usually eased by lying down flat, and is often made worse if you move your back, cough, or sneeze.

Most bouts improve quickly, usually within a week or so.

In about three in four cases, the pain has either gone or has greatly eased within four weeks. In about nine in 10 cases the pain has gone or has greatly eased within six weeks.

However, once the pain has gone it's common to have further recurrences from time to time in the future. Also, it's common to have minor pains "on and off" for quite some time after an initial bad bout of pain.

In a small number of cases the pain persists for several months or longer (chronic back pain).

The usual advice is to continue with normal activities as far as possible.

This may not be possible at first if the pain is very bad. However, move around as soon as possible, and get back into normal activities as soon as you are able.

As a rule, don't do anything that causes a lot of pain.

However, you will have to accept some discomfort when you are trying to keep active. Setting a new goal each day may be a good idea. For example, walking around the house on one day, a walk to the store the next, etc.

In the past, advice had been to rest until the pain eases. It's now known this was wrong. You're likely to recover more quickly and are less likely to develop chronic (persistent) back pain if you keep active when you have back pain rather than rest a lot.

Past advice used to be to sleep on a firm mattress, but there's no evidence to say that a firm mattress is better than any other type of mattress.

If you need painkillers, take them regularly. This is better than taking them "now and again" just when the pain is very bad. If you take them regularly, the pain is more likely to be eased for much of the time and enable you to exercise and keep active.

Do consult your doctor if the nature of the pain changes or if you are unhappy with your progress.

If you have a question about health and wellbeing, write to: Ask the Doc, Sunday Mercury, Weaman Street, Birmingham B4 6AY, or e-mail SundayMercury@mrn.co.uk.

Source: Sunday Mercury; Birmingham (UK). Provided by ProQuest Information and Learning. Powered by Yellowbrix.

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