The surge in pain-centred studies may be leading to an enlightened sector – but it can also result in overwhelmed sufferers, struggling to understand their symptoms. The Chartered Society of Physiotherapy is therefore helping you to simplify back pain for patients, and dismantle a few false beliefs along the way.

What Can Cause Back Pain?

In most cases, it’s not possible to identify the exact cause of back pain. It is important to know that any kind of structural damage is rare. While it can be painful and upsetting, this type of back pain usually gets better quickly. It can be managed through advice and remaining active.

Many physical or psychological factors can cause back pain, and often a combination of these are involved.

They could be:

• Physical factors – such as ‘protecting’ the back and avoiding movements, or a simple strain

• Psychological factors – including a fear of damage or not getting better, feeling down or being stressed

• More general health and lifestyle factors – like being tired and rundown, not getting enough good quality sleep, being overweight, or not getting enough physical activity

• Social triggers – such as difficult relationships at work or home, low job satisfaction, or stressful life events, like a family death or illness

Crucially, it’s important for the individual to know that all pain is 100 per cent real and never ‘all in their head’, even when factors like stress or mood are involved.

Each of the factors can turn up the volume on their pain and gaining a greater understanding of when that can happen puts the patient in a stronger position to recognise them and learn how to turn down the dial again.

Sometimes there are specific causes for back pain, especially when there is leg pain, pins and needles, or numbness too. This can be caused by irritation or compression of the nerves in the back.

Symptoms to be Aware of

These symptoms are very rare, but an individual should contact a doctor if they experience any of them:

• Difficulty passing urine or having the sensation to pass water that is not there

• Numbness / tingling in the genitals or buttocks area

• Loss of bladder or bowel control

• Impaired sexual function, such as loss of sensation during intercourse

• Loss of power in their legs

• If they are experiencing pain that runs down the back of both legs

• Feeling unwell with their back pain, such as a fever or significant sweating that wakes them from sleep

Communication is Key

A quiz has been designed as a tool to assist clinicians in learning what messages can be helpful or unhelpful when communicating with people seeking care for back pain. It also highlights the importance of their communication style.

To access the video, visit

The Moment of Truth

The Chartered Society of Physiotherapy is at hand to bust myths and reinforce what the latest evidence says is best for your patient’s back.

Myth One: Moving will make the back pain worse

Truth: People fear twisting and bending but it’s essential to keep moving. Gradually increase how much you are doing, and stay on the go

Myth Two: I should avoid exercise, especially weight training

Truth: Back pain shouldn’t stop you enjoying exercise or regular activities. In fact, studies found that continuing with these can help you get better sooner – including using weights where appropriate

Myth Three: A scan will show me exactly what is wrong

Truth: Sometimes it will, but most often it won’t. Also, even people without back pain have changes in their spine so scans can cause fear that influences behaviour, making the problem worse

Myth Four: Pain equals damage

Truth: This was the established view, but more recent research has changed our thinking. Modern physio takes a holistic approach that helps people understand why they are in pain

For more information, and to see more myths and facts, visit mythbusters.