Back Pain: Common Culprits, Causes, and Solutions
Back pain is a widespread issue, affecting individuals from all walks of life, from elite athletes to those with sedentary jobs. Recent figures from the Office for National Statistics (ONS) reveal that approximately 2.9 million people in the UK experienced problems related to their back or neck in 2024, an increase from 2.6 million in 2019 [ONS]. Understanding the specific cause of back pain is crucial for effective recovery and prevention. Here, we explore five common conditions, their origins, and potential remedies.
Thoracic Facet Joint Pain
This type of pain originates from the spine, specifically between the shoulder blades, typically affecting the thoracic spine (T1 to T12 vertebrae). It’s particularly common between T3 and T6.
What it Feels Like
Thoracic facet joint pain often presents as a sharp pain, especially with twisting movements. It stems from tightening of back muscles, including the rhomboids, erector spinae, and trapezius. The pain can sometimes be mistaken for a shoulder issue, as these muscles assist in pulling, lifting, and head support.
Why it Happens and Who’s at Risk
Poor posture is a key contributor, particularly for those with desk-bound jobs or cyclists. The weight of the head, when held forward for extended periods, creates stress down the neck and through the back. Over time, this can lead to a hunch, irritating the thoracic facet joints. Inflammation can cause the synovial fluid within the joint capsules to become viscous, restricting movement. Joint misalignment can also be a factor.
How to Fix It
Treatment often involves consulting an osteopath or chiropractor. Massage therapy can also provide relief, though deeper perform on the joints may be necessary. Exercises like knee-to-chest (lying on your back and gently lifting both knees towards your chest, holding for 30-60 seconds) and self-massage with a rolled towel placed between the shoulder blades can be beneficial.
Stop it Happening Again
Maintaining good posture is essential. Regularly sitting up straight and pulling your shoulder blades back for 10 seconds can help activate back muscles. Ensure your monitor is at eye level and your spine maintains a natural curve when sitting.
Sciatica
Sciatica refers to pain that radiates down the sciatic nerve, the largest nerve in the body, causing tingling or numbness in the back, buttocks, and potentially down the leg.
What it Feels Like
Sciatica often manifests as inflammation of the sciatic nerve, potentially caused by muscle tightness. Other causes include a bulging disc at the base of the spine, arthritis, or spinal stenosis (narrowing of the nerve aperture). It can also occur when the nerve is compressed by the hamstring or scar tissue.
Why it Happens and Who’s at Risk
Prolonged sitting, whether at a desk or while driving, is a significant risk factor. Poor posture and heavy lifting can also contribute.
How to Fix It
Stretching can provide relief, particularly if tightness in the buttocks or hips is irritating the nerve. However, it’s crucial to seek expert diagnosis first, as stretching could worsen symptoms if a disc is involved. The “straight leg raise test” can help determine if a disc is pinching the sciatic nerve. Osteopathy, chiropractic, and physiotherapy can be effective, especially for muscle-related sciatica.
Stop it Happening Again
Regular movement and exercise are beneficial, but be mindful of the impact of running if a disc issue is present. Strengthening core muscles is significant, but heavy lifting, especially deadlifts with improper form, should be approached with caution.
Sacroiliac Joint Dysfunction
This condition affects the sacroiliac joint, where the pelvis and lower spine meet, causing pain and stiffness in the buttocks or lower back, potentially radiating down one or both legs.
What it Feels Like
Sacroiliac joint pain can be difficult to diagnose as its symptoms mimic other conditions.
Why it Happens and Who’s at Risk
The sacroiliac joint acts as a shock absorber. It naturally loosens during pregnancy, making it a common issue for expectant mothers. Sprains or strains from lifting or shoveling can also cause dysfunction. Prolonged sitting with poor posture is another irritant, as is stiffness in older golfers.
How to Fix It
Treatment options include osteopathy, chiropractic, or physiotherapy, with specific exercises targeting the sacroiliac joint. Trunk rotation exercises (lying on the ground with knees bent and dropping them to one side while keeping shoulders flat) can be helpful.
Stop it Happening Again
Regular stretching and strengthening of core and glute muscles are key preventative measures. Exercises like clamshells, monster walks, hip thrusts, and planks can help stabilize the pelvis.
Femoral Nerve Radiculopathy
This condition causes pain, numbness, tingling, or muscle weakness radiating from the back down to the groin and thigh.
What it Feels Like
It’s often seen in older individuals and results from irritation or compression of the femoral nerve.
Why it Happens and Who’s at Risk
Ageing and arthritis are significant causes, due to narrowing of the joints and deterioration of cartilage. Being overweight, pregnancy, and poor posture also contribute. Repetitive lifting, common in professions like construction and plumbing, can exacerbate the issue.
How to Fix It
Gentle, progressive exercises under expert guidance can reduce irritation and restore mobility. Nerve mobilization exercises (lying on your side, bending and straightening the knee while tucking and extending the chin) can be beneficial.
Stop it Happening Again
Strengthening the entire body, not just the core, is important. Regular exercise, including martial arts, can improve body awareness and proactive movement patterns.
Lumbar Facet Irritation Syndrome
This involves injury to the facet joints, which connect the bones of the spine, causing chronic, dull pain that worsens with extension and rotation.
What it Feels Like
Stiffness is common, often causing individuals to buckle forward. Muscle spasms are also frequent, and the nervous system can sometimes normalize these spasms.
Why it Happens and Who’s at Risk
Prolonged extension or rotation, often seen in sports like golf or cycling, is a primary cause. Ageing and poor posture also contribute.
How to Fix It
Chiropractic, osteopathic, or physiotherapy treatment may help unlock and open the joint. Stretching and low-impact exercise, such as walking and swimming, can also provide relief.
Stop it Happening Again
Regular exercise, particularly strength training, is crucial. Pilates, martial arts, and gym workouts (with proper form and moderate weight) can bolster back support.