health articles

Back Pain

Back pain is a common problem that most people will experience at some time. Back pain can develop as the result of an injury or due to chronic conditions, including osteoarthritis and inflammatory diseases like psoriatic arthropathy or ankylosing spondylitis. 1

Back pain can be distressing and can make it difficult to work, function and get about. If your back pain is affecting your movement and reducing your quality of life, the experienced doctors and physiotherapists at Virtually Healthcare can provide advice, investigation and treatment to reduce pain and restore your mobility.

What causes back pain?

Most back pain is caused by simple muscle or ligament strains. These can follow an accident or injury, or they may be triggered by poor posture or lack of exercise, causing muscle weakness and stiffening of the spine. Specific conditions can also cause back pain; these include:

Spondylosis: The spine’s bones, discs and ligaments get weaker as we get older. The discs are the soft tissue cushions between the spinal bones. They become thinner with increasing age, the spaces between the vertebrae narrows, making bony lumps called osteophytes develop. This is called spondylosis and is very similar to the changes caused by osteoarthritis in joints like the knee and hip.

Sciatica: The soft tissue pads between the vertebrae can ‘slip’ or bulge out, causing back pain and weakness. Sometimes the bulging disc can press on a nerve root, causing pain, tingling and numbness in the thighs, hips, and buttocks. This is known as sciatica.

Spinal stenosis: Birth abnormalities, ageing and osteoarthritis can make the spinal column narrow, compressing the spinal cord and nerve roots. Spinal stenosis causes back pain together with pain, weakness, and numbness in the legs. The symptoms usually start after a few minutes of walking and settle quickly when you rest.

Other less common causes of back pain include:

  • Vertebral fractures that may be linked to osteoporosis.
  • Infection.
  • Cancer that may have spread from elsewhere in the body.
  • Inflammatory arthritis such as ankylosing spondylitis.

Back pain management at Virtually Healthcare

Virtually Healthcare is an innovative GP practice, providing expert care in the comfort, safety and privacy of your home. The Virtually Healthcare service is designed to fit with modern lives. Consultations are easy to access, discreet and convenient, with virtual appointments available seven days a week.

The highly skilled team includes more than 40 clinicians working together to investigate and treat disease and help you optimise your health and wellbeing. As well as GPs, the team includes physiotherapists and practice nurses to offer a comprehensive primary care service.

During the pandemic, many patients are finding it more difficult to access Healthcare. Virtually Healthcare provides rapid access video or telephone appointments, with consultations available the same day if you contact us before 3 pm. Our clinicians can provide professional assessment and advice, arrange investigations, prescribe treatment or arrange for a face-to-face review.

At Virtually Healthcare, our focus is on you. Our patients can make an appointment with one of our experienced physiotherapists without a GP referral. The physios can arrange scans and tests. They will work with a Virtually doctor to arrange that a prescription is sent directly to your local pharmacy.

How to help yourself with back pain

  • Most back pain will settle with time and self-help measures. Physiotherapy and over-the-counter painkillers, and anti-inflammatories can also help you manage your symptoms and improve your recovery.

    Pain relief: Take regular paracetamol or over-the-counter anti-inflammatories (if you can tolerate them.)

  • Stay active: Try and continue with your normal daily activities. Regular pain relief will help you keep moving. Long periods of rest can increase stiffness, weaken the muscles and make the pain worse.
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  • Exercise like pilates, swimming and yoga can reduce back pain. Try for a programme that has been shown in research to help people with low back pain live more active lives and better manage their condition.
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  • Apply hot or cold compresses: A hot water bottle, wheat bag, or bag of frozen peas wrapped in a tea towel can help ease pain, relax muscle spasms and offer some temporary relief.
  • Movement modification: If lifting, sitting, or other activities trigger pain, changing technique or position can prevent pain and injury. The physiotherapists at Virtually Healthcare can provide specific advice and guidance.

Physiotherapy for back pain

Virtually Healthcare has two physiotherapists as part of our multi-disciplinary team. Your time is valuable. Physiotherapists are specialists in treating muscle, bone and joint conditions, making them the best professionals to assess and treat your back unless you have suffered an injury.

You can book an appointment with one of our physiotherapists without the need for a GP referral. They have extensive experience and expertise in the evaluation and treatment of back pain. They can:

  • Take a history of your pain and examine your back to assess the cause of your problem.
  • Arrange investigations if necessary.
  • Work with our GPs to prescribe painkillers or anti-inflammatory medication.
  • Recommend stretches and exercises to improve your mobility and help you get back to full fitness.
  • If your pain isn’t settling or they are concerned about your symptoms, they will arrange for your back to be reviewed by one of our doctors.

When to see a doctor with back pain

Make an appointment with one of the doctors at Virtually Healthcare if your back pain is severe and significantly affects your mobility and quality of life. It’s essential to seek urgent assessment and advice if:

  • The pain has lasted for a long time.
  • The pain follows an serious accident.
  • The pain is getting worse.
  • The pain is disturbing your sleep.
  • You have any new changes in sexual function, such as problems getting an erection.
  • You have incontinence or problems with your bladder or bowel function.
  • You have numbness around your anus or genitals.
  • There is weakness in your legs that makes it difficult to stand or move.
  • You have chest pain.
  • You have a fever.
  • There is swelling or a deformity.
  • The pain is worse when you sneeze, cough or open your bowels.
  • The pain is in your upper back, between your shoulders.
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Investigation and treatment of back pain

Your doctor will talk to you about your symptoms and suggest investigation and treatment based on their expert assessment. This could include:

  • Self-care and lifestyle advice.
  • Pain relief or anti-inflammatories.
  • Referral for physiotherapy to strengthen the muscles and improve movement and flexibility.
  • Referral to a hospital orthopaedic team for specialist investigation and treatment such as back pain injections, disc prolapse surgery, discectomy or disc decompression surgery.
Hot topics in back pain

How to prevent back pain when working from home

Working from home can give you backache. The increase in home working during the pandemic has been reflected in increasing numbers of patients complaining about back pain. It’s often a matter of ergonomics; uncomfortable chairs, tables that are the wrong height, and the use of laptops can all affect your posture and put pressure on your back.

  • Invest in a chair: Choose a chair with height adjustment, which will reduce the risk of muscle strain. Also, check that your torso and head are in a straight line and your elbows and knees are at right angles when you sit down.
  • Feet up: If the chair is too high for your knees to be at right angles, use a footrest, stool or pile of magazines to lift your feet.
  • Eyes forward: Looking down at a laptop screen can strain your neck and shoulders. Lift the laptop so that the screen is in line with your eyes and use a separate keyboard.
  • A change is as good as a rest: Change position regularly, alternating standing and sitting.5

Back pain in pregnancy

More than half of women suffer from back pain in pregnancy. It’s caused by your hormones and the extra work of carrying a baby. The hormone relaxin softens the ligaments between the pelvis and spine so that they can stretch to make room for the baby during labour. Later your expanding bump can add to the strain by altering your centre of gravity and increasing the arch of your back. With your stretched tummy muscles, your lower back often has to take the strain. If you’re struggling, there are ways to protect your back:

  • Stand upright. Hold your back straight, tuck in your bottom and tighten your tummy muscles. 
  • Sit up with a cushion supporting your waist. Keep your legs uncrossed and rest your feet on a small stool. 
  • When rising from lying down, roll onto your side and then onto your knees. This lessens the strain on your back.
  • Sit or kneel instead of bending.
  • Wear low, comfortable shoes; heels will throw your weight forward and exaggerate the arch or your back.
  • Exercise regularly to strengthen your muscles. Swimming, pilates and yoga are good, low-impact options. 
  • If you have to pick up a heavy item, hold it close to your body and bend your knees.


Types of consultations we offer

We offer written, telephone and video consultations with a range of male and female clinicians from GPs, nurse practitioners, and primary care specialists such as physiotherapy.