The purpose of this presentation is to raise awareness of the problems associated with back pain and how it can be treated. For more information about back pain Check out our blog under healthy living section on our website https://www.nationwidepharmacies.co.uk/nwp-news/back-pain-article/

2. WHAT IS BACK CARE AWARENESS WEEK?
This was founded in 1968 by Stanley Grundy who established the charity after suffering a back
injury caused by a sailing accident. He was concerned about the lack of information and
support for back pain sufferers at the time.
For nearly 50 years back care awareness week has been dedicated to educating people
throughout the UK and wider airfields in ways of preventing and alleviating (make suffering of
back pain less severe). The charity aims to significantly reduce the burden of back and neck
pain by providing information and advice to all people and organisations affected by back pain.
Back pain is a major health issue and costing the country and health services a high amount of
money and resources.
This year back care awareness week will be hosted on Monday 2ND October- Friday 6TH October
2017 the theme is focused on ‘Back Pain in Education’.
Back care awareness week aims to put the spotlight on the prevention of neck and back pain
especially in the workforce due to a high majority of absences are due to back pain.
Back pain does not have one specific cause there can be various reasons behind back pain but it
cannot be clearly identified.

3. POSSIBLE CAUSES OF BACK PAIN
• The human back is composed of a complex structure of muscles, ligaments, tendons, disks
and bones - the segments of our spine are cushioned with cartilage-like pads called disks.
Problems with any of these components can lead to back pain. In some cases of back pain,
its cause is never found.
• The most common causes of back pain are strained muscles, strained ligaments, a muscle
spasm. The factors that can lead to strains include lifting something improperly, lifting
something that is too heavy, the result of an abrupt and/or awkward movement.
• Ruptured Disks- each vertebra on our spine is cushioned by disks. If the disk ruptures there
will be more pressure on the nerve resulting in back pain.
• Bulging Disks- in much the same way as ruptured disks, a bulging disk can result in more
pressure on a nerve.
• Sciatica - a sharp and shooting pain that travels through the buttock and down the back of
the leg, caused by a bulging or herniated disk pressing on a nerve.

4. POSSIBLE CAUSES OF BACK PAIN CONTINUED
• Arthritis - patients with osteoarthritis commonly experience problems with the joints in the
hips, lower back, knees and hands. In some cases spinal stenosis can develop, which is
the term used to describe when the space around the spinal cord narrows.
• Abnormal curvature of the spine - if the spine curves in an unusual way the patient is more
likely to experience back pain. An example is scoliosis, a condition in which the spine
curves to the side.
• Osteoporosis - bones, including the vertebrae of the spine, become brittle and porous,
making compression fractures more likely.
• Cauda equina syndrome - the cauda equine is a bundle of spinal nerve roots that arise from
the lower end of the spinal cord. People with cauda equine syndrome feel a dull pain in the
lower back and upper buttocks, as well as analgesia (lack of feeling) in the buttocks,
genitalia and thigh. There are sometimes bowel and bladder function disturbances.
• Cancer of the spine - a tumour located on the spine may press against a nerve, resulting in
back pain.

5. POSSIBLE CAUSES OF BACK PAIN CONTINUED
• Infection of the spine - if the patient has an elevated body temperature (fever) as well as
tender warm area on the back, it could be caused by an infection of the spine.
• Other infections such as pelvic inflammatory disease (females), bladder, or kidney
infections may also lead to back pain.
• Sleeping disorders- individuals with sleep disorders are more likely to experience back
pain, compared to others.
• Shingles- an infection that can affect the nerves may lead to back pain, depending on the
nerves affected.
• Bad mattress- if a mattress does not support specific parts of the body and keep the
spine straight, there is a greater risk of developing back pain.

6. SYMPTOMS OF BACK PAIN
• Weight Loss
• Fever
• Inflammation on the back
• Persistent back pain- resting or lying down doesn’t help
• Pain down the legs
• Pain reaches below the knees
• A recent injury, blow or trauma to your back
• Difficulty urinating
According to the NHS the following groups of people should seek medical advice if they experience back
pain:
People aged less than 20 and over 55 years of age
Parents who have been taking steroids for a few months
Drug abusers
Patients with cancer
Patients who have had cancer
Patients with depressed immune systems

7. HOW IS BACK PAIN DIAGNOSED?
Most GPs (general practitioners, primary care physicians) will be able to diagnose back pain after carrying out
a physical examination, and interviewing the patient. In the majority of cases imaging scans are not
required.
If the doctor or patient suspects some injury to the back, tests may be ordered. Also, if the doctor suspects the
back pain might be due to an underlying cause, or if the pain persists for too long, further tests may be
recommended.
• Suspected disk, nerve, tendon, and other problems - X-rays or some other imaging scan, such as a CT
(computerized tomography) or MRI (magnetic resonance imaging) scan may be used to get a better view
of the state of the soft tissues in the patient's back.
• X-rays can show the alignment of the bones and whether the patient has arthritis or broken bones. They
are not ideal for detecting problems with muscles, the spinal cord, nerves or disks.
• MRI or CT scans - these are good for revealing herniated disks or problems with tissue, tendons, nerves,
ligaments, blood vessels, muscles and bones.
• Bone scan - a bone scan may be used for detecting bone tumours or compression fractures caused by
brittle bones (osteoporosis). The patient receives an injection of a tracer (a radioactive substance) into a
vein. The tracer collects in the bones and helps the doctor detect bone problems with the aid of a special
camera.

8. HOW IS BACK PAIN DIAGNOSED CONTINUED
Electromyography or EMG - the electrical impulses produced by nerves in response to
muscles is measured. This study can confirm nerve compression which may occur with a
herniated disk or spinal stenosis (narrowing of the spinal canal).
The doctor may also order a blood test if infection is suspected.
A chiropractor - the chiropractor will diagnose by touching (palpation) and a visual inspection.
Chiropractic is known as a direct approach, with a strong focus on the adjustments of the
spinal joints. Most good chiropractors will also want to see imaging scan results, as well
as blood and urine tests.
An osteopath - the osteopathic approach also diagnoses by touching and a visual
inspection. Osteopathy involves slow and rhythmic stretching (mobilization), pressure or
indirect techniques and manipulations on joints and muscles.
A physical therapist - a physical therapist's training focuses on diagnosing problems in the
joints and soft tissues of the body.

9. POSSIBLE CAUSES OF BACK PAIN CONTINUED
Back pain can also be the result of some everyday activity or poor posture. Common examples include
• bending awkwardly,
• pushing something,
• pulling something,
• carrying something,
• lifting something,
• standing for long periods,
• bending down for long periods,
• twisting,
• coughing,
• sneezing,
• muscle tension,
• over stretching,
• straining the neck forward such as when driving or using a computer, long driving sessions without a
break.

10. HOW TO PREVENT BACK PAIN
• Exercise- regular exercise helps to build strength as well as keeping your body weight down.
Low-impact aerobic activities are the best activities that do not strain the back. Talk to a
healthcare professional beforehand.
• Core strengthening exercises- exercises that work the abdominal and back muscles, helping to
strengthen muscles protecting the back.
• Flexibility- exercises aimed at improving flexibility in your core, including your spine, hips, and
upper legs may help too.
• Posture when standing - make sure you have a neutral pelvic position. Stand upright, head
facing forward, back straight, and balance your weight evenly on both feet - keep your legs
straight and your head in line with your spine.
• Poster when sitting- a good seat should have good back support, arm rests and a swivel base
(for working). When sitting try to keep your knees and hips level and keep your feet flat on the
floor - if you can't, use a footstool. You should ideally be able to sit upright with support in the
small of your back. If you are using a keyboard, make sure your elbows are at right-angles and
that your forearms are horizontal.

11. HOW TO PREVENT BACK PAIN CONTINUED
• Do not lift and twist at the same time. If something is particularly heavy, see if
you can lift it with someone else. While you are lifting keep looking straight
ahead, not up nor down, so that the back of your neck is like a continuous
straight line from your spine.
• Moving things - remember that it is better for your back to push things across
the floor, using your leg strength, rather than pulling them.
• Shoes - flat shoes place less of a strain on the back.
• Driving - it is important to have proper support for your back. Make sure the
wing mirrors are properly positioned so you do not need to twist. The pedals
should be squarely in front of your feet. If you are on a long journey, have
plenty of breaks - get out of the car and walk around.
• Your bed - you should have a mattress that keeps you spine straight, while at
the same time supporting the weight of your shoulders and buttocks. Use a
pillow, but not one that forces your neck into a steep angle.

12. TREATMENTS FOR BACK PAIN
Back pain can usually be treated with over the counter painkillers. Applying a hot compress or ice pack to the
painful area of your back may also help to relieve pain. Resting is helpful, but not for too long due to the
fact that it can cause the muscles to weaken, leading to further back pain episodes in the future.
If home treatments do not work out then doctors will recommend the following:
• Medications- Back pain that does not respond well to OTC painkillers may require a
prescription (nonsteroidal anti-inflammatory drug). Codeine or hydrocodone - narcotics - may also be
prescribed for short periods; they require close monitoring by the doctor.
• Physical therapy- The application of heat, ice, ultrasound and electrical stimulation, as well as some
muscle release techniques to back muscles and soft tissues to help alleviate pain. As the pain subsides
the physical therapist may introduce some flexibility and strength exercises for the back and abdominal
muscles. Techniques on improving posture may also help. The patient will be encouraged to practice the
techniques regularly, even after the pain has gone, to prevent back pain recurrence.
• Cortisone injections- anti-inflammatory drug which helps to reduce inflammation around the nerve roots.
This pain relief effect should wear off after less than six weeks.

13. TREATMENTS FOR BACK PAIN CONTINUED
• CBT (cognitive behavioural therapy) - CBT can help patients manage chronic back pain. The therapy is
based on the principle that the way a person feels is, in part, dependent on the way they think about
things. People who can be taught to train themselves to react in a different way to pain may experience
less perceived pain. CBT may use relaxation techniques as well as strategies to maintain a positive
attitude. Studies have found that patients with CBT tend to become more active and do exercise,
resulting in a lower risk of back pain recurrence.
• Complementary theories also help to relieve back pain including a variety:
• An osteopath specializes in treating the skeleton and muscles.
• A chiropractor treats joint, muscle and bone problems - the main focus being the spine.
• Yoga is a practice that involves specific poses, movements, and breathing exercises. Some forms
of yoga may help strengthen the back muscles and improve posture. Care must be taken that exercises
do not make back pain worse.
• TENS (transcutaneous electrical nerve stimulation) - a popular therapy for patients with chronic (long-
term) back pain. The TENS machine delivers small electric pulses into the body through electrodes that
are place on the skin. Experts believe TENS encourages the body to produce endorphins, and may
possibly block pain signals returning to the brain. Studies on TENS have provided mixed results; some
revealed no benefits, while others indicated that it could be helpful for some patients. A TENS machine
should be used under the direction of a doctor or health care professional.

14. TO FIND OUT MORE INFORMATION ABOUT DIFFERENT TYPES OF PAIN RELIEF
MEDICATIONS FOR BACK PAIN CHECK OUT OUR WEBSITE ONLINE PRIVATE DOCTOR
PAIN RELIEF SECTION
https://www.nationwidepharmacies.co.uk/online-doctor/pain-relief-139.html
ALSO CHE CK OUT OUR BACK PAIN BLOG
https://www.nationwidepharmacies.co.uk/nwp-news/back-pain-article/
NHS USEFUL LINKS
http://www.nhs.uk/Conditions/Back-pain/Pages/Introduction.aspx
http://www.nhs.uk/Conditions/Back-pain/Pages/Treatment.aspx
BACK CARE AWARENESS
http://www.backcare.org.uk/
http://www.backcare.org.uk/news/back-care-awareness-week-2-6-october-2017/
THANK YOU FOR READING!