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The term ‘chronic’ means something that has lasted for a long time. If you have experienced back pain that lasts for 3 months or more, it is referred to as chronic. Each of us feels pain in a different way, and back pain can be present anywhere along the spine. One of the most common sites is the lower back since it bears the weight of the rest of your spine and upper body, putting a lot of stress on the bones and soft tissues in the area. Around 80% of adults will experience lower back pain at some point during their lives.
To help understand chronic back pain, it is useful to know about the structures in your spine. The spine is made up of many bones, called vertebrae, which are ‘stacked’ on top of each other. These vertebrae are connected by tough bands of tissue, called ligaments, and a number of muscles attach to them as well. Soft rubbery discs separate the bones, cushioning them from impacts and allowing the spine to bend. Problems with these structures can cause them to function incorrectly and this will often lead to pain.
The causes of chronic back pain can differ depending on the location of the pain. For example, neck pain is often caused by problems with the muscles of the shoulders, the bones in the neck, or nerves in that region.
If you have chronic pain in your upper (thoracic) spine – below the neck, between the shoulder blades – which has not been caused by an injury, you should speak to your doctor immediately as this can sometimes indicate something more serious.
Lower back pain has a wide range of causes and risk factors. Being of older age, being overweight, sustaining an injury to your back or being pregnant can all increase your risk of developing chronic lower back pain. Below are some of the commonest causes of chronic lower back pain:
Your doctor will ask you some questions about your pain and other symptoms and perform a careful assessment to identify where the pain is coming from and how it is affecting you. Imaging such as x-rays, CT or MRI scans might be used by your doctor to help view the spine and confirm a diagnosis.
If you have any of the following symptoms, you should seek urgent medical attention as it may point to a more serious underlying cause:
There are a number of ways in which chronic back pain can be managed. The first line of management involves lifestyle modifications:
Sometimes, spinal injections to provide pain relief directly to the affected area may be offered. The treatments above will often be successful at relieving your chronic back pain, but if you are still experiencing pain then additional treatments can be considered.
If treatment has not been effective after 6 months, then surgery is the next option. Depending on the cause of your back pain, different operations are available, but not all types of chronic lower back pain can be managed with surgery:
Chronic back pain is an extremely common complaint, and it can range in severity. Pain in the lower back is very likely to affect you at some point in your life, and there are a number of treatments that can help to manage it, depending on the cause. Our specialists will be able to support you through advice about the options available to you and answer any questions you may have.