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Back pain

Find out more about the causes of back pain, as well as the benefits of back pain treatment at Albyn Hospital, Aberdeen

Back pain is an extremely common condition. Most of us will experience some form of back pain in our lives. That doesn’t mean that when back pain occurs it is any less worrying, or has less of an effect on our daily lives.

Degenerative back problems, commonly known as ‘wear and tear’, are widespread. Most discomfort, particularly lower back pain, is not sinister in nature. Having said this, it is important to see a specialist to rule out problems that could get worse without treatment, or which require intervention now.

In this article, we will look at the causes of back pain, how it is investigated, and the possible treatments you could receive.

“We will all get an episode of back pain in our lives.”

Mr A.Giamouriadis, Consultant neurosurgeon and spinal specialist, Albyn Hospital 

Albyn Hospital is a centre of excellence for the management of spinal problems and back pain.

Our specialist spinal surgeons and pain doctors can help diagnose and manage the cause of your back pain.

This specialist expertise is supported by an experienced multidisciplinary team of healthcare professionals, with dedicated private nursing teams providing care within a friendly and comfortable environment.

In order to understand back pain, a small amount of knowledge of how the spine is constructed is helpful.

The bones of the spine are called vertebrae, which are stacked on top of one another like building blocks.

There are five main areas of the spine:

  • Cervical (neck)
  • Thoracic (upper back)
  • Lumbar (lower back)
  • Sacral (the back of the pelvis)
  • Coccygeal (the ‘tail bone’)

Between the vertebrae are intervertebral discs, which act as shock-absorbing spacers. When someone says that they have ‘slipped a disc’, it is these that they are referring to.

In the centre of the vertebra is the spinal canal through which the spinal cord travels. Nerves exit the spinal cord at every level. Surrounding the spinal column are tendons, ligaments and muscles.

Back pain can be caused by any one of these components, which is why consultation with a specialist is essential.

Discomfort in the back, especially lower back pain, is extremely common.

Usually, back pain is not accompanied by other symptoms. Depending on the cause, however, it can be associated with tingling, numbness or shooting pains in the buttock and down the leg.

There are a handful of more concerning symptoms. These include back pain with numbness in the genitals or buttocks, sudden loss of bowel or bladder control, unexpected weight loss, chest pain, a high temperature, pain after significant trauma to the back, or if the pain is much worse at night.

If you experience any of these symptoms, you should contact your GP or other medical assistance urgently.

When you are seen by one of our back pain specialists, they will ask a number of questions about your pain. This is called ‘taking a history’ and is essential for the specialist to diagnose the cause of your pain, exclude any other causes of your pain, and help decide, with you, the best course of treatment.

They will ask questions that include where you feel the pain, if there are any associated symptoms, how long you have had pain, whether anything makes it better or worse and about any other medical conditions you might have.

The examination will include feeling your spine and the tissues surrounding it and may involve you performing movements so that the specialist can see how the back pain affects you.

The specialist may also examine the function of the nerves coming from your spine by checking movement, touch and other senses.

Based on their assessment, your specialist will decide what, if any, investigations are needed.

On some occasions, they will feel that they can accurately diagnose the cause of your back pain and that no further investigations are needed, and they will explain the reasons why.

Often they will request images of your spine to look at bones, nerves and surrounding tissue. These imaging techniques could include:

  • X-rays – these can give a good view of some of the bones
  • CT scan (Computerised tomography) – can give excellent images of bony structures and some soft tissues
  • MRI scan (magnetic resonance imaging) – excellent for soft tissues, especially nerves

Other specialist studies may be requested, which could include:

  • Electromyelography (EMG) – assesses the health and function of muscles and the nerves that supply them
  • Nerve conduction studies (NCS) – show how fast and how well your nerves conduct impulses

Depending on your symptoms, other investigations such as blood tests or bone scans may be needed.

There are many reasons you might experience back pain.

Most back pain is musculoskeletal in origin. This means that it is due to wear and tear on the body’s joints, tendons, ligaments and muscles, rather than having a more worrying cause.

The causes of back pain can be divided into a number of categories.

Congenital causes of back pain

Congenital causes are those that you are born with, rather than those acquired over time, or that occur suddenly. They can include:

  • Irregularities in the way the spine curves, e.g. scoliosis, lordosis, kyphosis
  • Congenital problems with the formation of the spine, e.g. spina bifida

Injuries

Injuries to the spine are very common in daily life. They can vary from the very mild, such as sprains and strains, through to significant trauma that causes fractures.

Degenerative changes

Degenerative changes occur over time due to the stresses of daily life on the joints, ligaments and tendons of the spine. These conditions can include disc degeneration, spondylosis and arthritic or inflammatory changes.

Nerve/spinal cord problems

Diseases that involve the spinal cord will often cause nerve symptoms in the body, including weakness, numbness, tingling, or problems with bowel and bladder. Some of the causes can include spinal cord compression, spinal canal stenosis, herniated discs and sciatica.

Back pain from non-spinal sources

Not all back pain is due to problems in your spine. Other medical conditions, especially in the abdomen or chest can sometimes manifest as back pain. These can include kidney stones, endometriosis, fibromyalgia and pregnancy.

There are many different treatments for back pain, some of which will depend on the underlying cause of your symptoms.

This is why it is essential to get assessed by a specialist to ensure that the cause of your pain is known and you can therefore choose the best possible course of treatment for it.

It is important to remember that the treatment for most back pain may consist of painkillers and exercises, but does not usually involve surgery.

Conservative treatment

Once our specialists have taken a detailed history, examined you and got the results of any specialist investigations that they have ordered, you may be prescribed what is often referred to as ‘conservative treatment’. This consists of therapy options, that do not include surgery or significant interventions.

It will likely include:

  • Painkillers (analgesia) – this will usually start with simple pain relief such as paracetamol and ibuprofen, but with specialist prescription can include drugs such as opioids, high strength anti-inflammatories, muscle relaxants and neuropathic/nerve pain agents.
  • Specialist physiotherapy exercises – our expert physiotherapists will discuss with you a range of exercises that will work with your abilities to reduce pain, increase your function and build your back strength.

If these back pain treatments aren’t improving your condition, you may need a more advanced pain treatment.

Advanced pain treatments

In addition to the painkillers and exercise above, our specialist pain doctors may consider you for advanced interventions for specific causes of back pain. These often take the form of injections to structures in the back to numb pain and reduce inflammation.

Interventions can include:

The more suitable medical treatment for you will depend on the cause and severity of your back pain.

Surgery for back pain

“It is important to be honest with patients — the treatment of back pain is often non-surgical”

– Mr A.Giamouriadis, Consultant neurosurgeon and spinal specialist, Albyn Hospital.

Surgery for back pain is an advanced option, and one that will only be suitable for certain people depending on the cause of their back pain. A specialist spinal surgeon will explain to you what procedure is recommended based on your symptoms, progression of your back pain, any reduction physical activities, and your imaging results.

Only a small percentage of patients with back pain will go on to need an operation, but some conditions (such as sciatica) are much more likely to require surgery than others.

Surgery can be performed in several ways, depending on the expertise of the surgeon, with one major difference being between open procedures and those performed using minimally invasive techniques.

Surgical options for back pain can include:

All surgical procedures come with some risks. It is important that you discuss the benefits and risks of any surgical procedure with your surgeon before deciding to proceed. 

There are a number of actions you can take that may aid your recovery from back pain or prevent it from progressing.

Education

“The first thing is education — 100% of our patients get education.”

Dr S. Kanakarajan, Consultant Anaesthetist and Pain Specialist, Albyn Hospital

With the aid of our expert team of back pain specialists, we can help you learn about the causes of pain, and show you ways that you can change your lifestyle to reduce your discomfort.

Exercise & back pain exercises

If you are experiencing back pain, you may feel inclined to significantly reduce your physical activity or even have a period of bed rest. This is unlikely in most cases to help your pain, and may even make it worse.

If they are unused, the muscles that surround your spine and give it stability become weaker, predisposing to further deterioration in your back pain.

Our expert back pain specialists, including physiotherapists, can advise you on the best way to keep moving and help you with back pain exercises that will strengthen your back and reduce your pain.

Maintain a healthy weight

If you are overweight or obese, your spine has to carry much greater loads both at rest and when you are moving. This places greater stress on all parts of the spine, including intervertebral discs, joints and surrounding muscles.

Losing weight can be one of the best things you can do to help reduce back pain.

Avoid being sedentary

Related to exercise is the advice to avoid remaining in one, usually sitting, position for a long time. The back is a dynamic structure and will react to being unused for prolonged periods by causing pain.

If you have a job that involves sitting for long periods, try to form routines and habits that will see you moving regularly.

Make work adjustments

If you are experiencing back pain, especially if it is related to actions you have to undertake at work, then some adjustments may be necessary. This can include changes to seating, ergonomic alterations and reduced heavy lifting.

“It is important to see a specialist about your back pain to rule out a problem that requires intervention.”

– Mr A.Giamouriadis, Consultant neurosurgeon and spinal specialist, Albyn Hospital

Albyn Hospital is a centre of specialist knowledge in the diagnosis and management of back pain for Aberdeen and the north of Scotland.

We have a long history of back pain treatment expertise with a full multidisciplinary team to aid in your recovery.

Surgery for back pain

If your condition requires surgical intervention, our spinal surgeons are experts in the latest minimally invasive spinal surgery techniques.

These allow for much smaller cuts to the skin, less trauma to underlying tissues, and a quicker return to normal life.

Specialists in pain management

Our pain management specialists are backed by a full team of doctors, nurses and physiotherapists.

If it is decided that you need an intervention for your back pain, including injections, epidurals or other treatments, you will be supported throughout by our team. This will include post-intervention therapy and exercises designed to ensure that you get the maximum benefit from your procedure.

Imaging expertise

We utilise the very latest in imaging techniques for back pain. Your images will be reviewed and reported by a specialist neuroradiologist to ensure that you have the correct diagnosis and treatment.

The latest technology

Our team use a specialist app to help you manage your back pain. This includes a pain diary to aid in your consultation, information about back pain treatment, and updates regarding interventions.

Albyn Hospital is located in the west end of Aberdeen. It is the only independent hospital serving Aberdeen, the whole of Aberdeenshire and the north of Scotland.

Albyn hospital has a full multidisciplinary team of expert staff to manage your back pain, supported by the very latest in imaging technology with expert interpretation.

If attending an outpatient appointment, you will be seen in one of our 15 modern consulting rooms.

If an intervention or surgery is required, then one of our three modern operating theatres will be used. If you need to stay in after your procedure, one of our 28 private rooms will be at your disposal.

We aim for you to recover in a relaxed and friendly atmosphere with medical and nursing staff present day and night.

Back pain is an extremely common condition, with most of us having an episode at some time during our lives. The symptoms can vary from mild to severe back pain.

Most back pain does not require surgery and will get better with time and movement.

It is important to get your back pain checked out by a specialist to ensure that it does not require an intervention to prevent deterioration.

The Albyn Hospital is home to specialists who can diagnose the cause of your pack pain, help you to manage it and, if an intervention is required, guide you through the process with care.

If you are struggling with back pain, book your appointment online today.

Specialists offering Back pain

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Mr James Walkden

Consultant Neurosurgeon

BMedSci, MBChB(Hons), FRCS(SN), FEBNS

Albyn Hospital

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Dr Ravi Nagaraja

Consultant in Anaesthesia & Pain Medicine

MBBS, DA, FRCA, FFPMRCA

Albyn Hospital

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Dr Saravana Kanakarajan

Consultant in Anaesthesia and Pain Medicine

MBBS, MD, FCPS, FRCA, FFPMRCA

Albyn Hospital

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Mr Anastasios Giamouriadis

Consultant Neurosurgeon, Brain and Spine Surgeon & Senior Clinical Lecturer

FRCS

Albyn Hospital

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Mr Andrew Frost

Consultant Spinal Surgeon

MB ChB BSc (hons) MRCS, FRCS (T&O)

Albyn Hospital

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