Back on track

If you’ve never had a back problem, count yourself lucky. For Amy McPherson, having a sore back made her feel “old and miserable”, although she was only 21 at the time. Now 37, the writer and business analyst first developed a problem while working in a Sydney office. It was only annoying at first but became increasingly severe over the next five years. McPherson, who now lives in London, has always believed in taking a natural approach to her health. With regular yoga, chiropractic treatments and exercise, she has managed her pain successfully.

McPherson’s experience is very common. It’s estimated that 70–90 per cent of people will suffer from lower back pain at some time in their lives. About 3.7 million Australians currently have back problems, estimates from the Australian Bureau of Statistics (ABS) 2014–15 National Health Survey show. Around $1.2 billion of annual Australian healthcare expenditure can be attributed to back problems, according to ABS figures.

Fortunately, back pain is rarely serious — less than 10 per cent of people will have a problem that requires medical intervention, according to Dr Tim Mitchell, a back pain researcher and specialist musculoskeletal physiotherapist (as conferred by the Australian College of Physiotherapists). Only about 1 per cent will have “red flag” pathology, indicating a serious issue that requires urgent treatment, he says.

Nonetheless, for many people, back pain can be distressing to the point where it interferes with daily activities and negatively impacts on quality of life. It can also affect those caring for the sufferer — usually family and friends.

Nor are spine problems limited to pain in the lower back. They can manifest as pain in the middle and upper back; pain, tingling, numbness or weakness in the legs; stiffness and reduced mobility; even changes to bladder and bowel function.

Help is available, fortunately, and research is constantly providing fresh insights into why our backs get sore and how best to treat them. Most back problems can be successfully managed without the need for strong drugs or invasive procedures.

This means 90–95 per cent of people have non-specific pain that is not associated with a specific pathology (disease).

Back pain basics

Back problems stem from a wide range of causes, including poor posture, injuries and certain diseases. Some common causes include osteoarthritis, osteoporosis, disc disease and certain conditions.

Back pain is classed as either specific or non-specific. Specific back pain includes the rare variety accounting for less than 1 per cent of cases related to cancer, infection, fracture or an inflammatory process. Specific back pain can also be caused by nerve compression in the spine, resulting in pain and loss of power and sensation in the legs. This accounts for about 5 per cent of cases.

This means that 90–95 per cent of people have non-specific pain that is not associated with a specific pathology (disease). While this type of pain can still cause back muscles to seize up and movements to hurt, it usually settles within a week or two.

Back pain is further classified according to how long symptoms have lasted. Acute pain lasts up to 12 weeks, or the time it takes for tissues to heal. Sometimes, there will be an identifiable