David Cameron's bad back explained
The Prime Minister has a bad back. Actually, not so much a bad back as a “phenomenally bad back”, as he said himself.
Cameron's back problems first emerged during the Cameron family holiday on the remote Hebridean island of Jura, forcing him to cancel some of his favourite outdoor activities, including deer stalking.
So good news for the deer was bad news for the PM, who has since been for treatment in Oxford, after which he tweeted: “I've been treated for a bad back/protruding disc at Nuffield Orthopaedic Centre today." he said. "The staff say all will be back to normal very soon.”
Many of us have experienced the pain and discomfort of a bad back, but what causes otherwise healthy men, with no history of back problems, to suddenly develop them? Here’s our guide to this always irritating, often debilitating condition.
As it turned out, the Prime Minister’s problem was a protruding disc, more commonly known as a “slipped disc”. Discs are the soft material that separate the vertebrae in the spinal column.
Slipped discs are often caused simply by advancing age, as the Prime Minister, 46, found out. “‘When you get into your mid-40s stuff like this starts to happen,” he said.
But according to the NHS, bending awkwardly, heavy lifting, being overweight, weight lifting, smoking, or a traumatic injury to your back can all be to blame. Sometimes the cause isn’t known.
A slipped disc can be very painful, or not painful at all, depending on whether the protruding material presses on nerves or the spinal cord or not. Lower back pain is often the first symptom, which will sometimes spread to other parts of the body.
Less commonly, a slipped disc can cause a tingling in the legs, muscle spasms in your arms, legs or buttocks, numbness or muscle paralysis, and even loss of bladder control.
Sciatica, a shooting pain that travels through the buttock and down the back of the leg, can be caused by a bulging disc.
Happily, most slipped discs heal themselves, with the pain gradually receding as the disc moves away from nerves. But it can take between four to six weeks, during which time you may need painkillers. You should remain active if you can and gentle exercises can help the healing process, though not reaching, lifting or prolonged sitting. You may be referred to a physiotherapist.
Back pain is common - and can be severe
Other back problems
But a slipped disc is only one of numerous potential back problems. The NHS calculates that half of us will experience back pain - from mild to severe, fleeting to chronic - at some stage in our lives.
In fact, the NHS reckons that back pain is the most cited reason for missing a day of work in the UK.
Slipped discs are common, but our backs are a complex structure of muscles, ligaments, tendons, discs and bones, and problems with any of them can lead to back pain. Many problems affect the lower back.
According to Dr Peter Ullrich at spine-health.com, “a back muscle strain or ligament strain is one of the most common causes of acute lower back pain. Lifting a heavy object, twisting, or a sudden movement can cause muscles or ligaments to stretch or develop microscopic tears.”
Poor sleep can also cause back problems, especially if you are sleeping on a mattress that doesn’t support the back properly.
Again, in most of these cases, back pain will recede naturally - eventually. Dr Ullrich says that the vast majority of lower back pain cases get better within six weeks, and doctors will often give sufferers an exercise plan as part of the treatment.
Other self-help treatment includes rest, but only for the first two or three days, after which gentle exercise is recommended. According to Dr Ullrich, “heat and ice packs help relieve most types of low back pain by reducing inflammation. Often patients use ice, but some prefer heat. Both can be used alternately.”
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Lifting any heavy weight incorrectly, at the gym or otherwise, can cause back problems
Stress-related back pain
Most of us put our back pain down to a physical cause. But perhaps surprisingly, many cases of back pain are due to stress.
“The majority of sufferers don’t have anything structurally wrong at all,” says Dr Adam Al-Kashi, head of research and education at back charity Backcare.
“We have a tendency with back pain - which we don’t with, say, headaches - to instantly put it down to a physical cause, a slipped disc or whatever. But stress can manifest itself in back pain just as it does in headaches.”
According to Backcare, psychological stress may help to explain up to 90% of back pain cases. “We are physically more robust than we often think,” says Dr Al-Kashi.
More serious causes
Most back pain is uncomfortable, annoying and sometimes debilitating, but not serious. Occasionally, however, back pain is a symptom of a more serious condition.
For example, bladder, kidney or spinal infections can all cause back pain, as can - rarely - a tumour on the spine that presses on nerves.
Shingles, a sometimes extremely painful infection of the nerves, can also cause back problems.
In healthy young or middle-aged men serious causes of back pain are rare - you’re far more likely to have strained it playing football - but if back pain persists see your GP anyway, if only for reassurance and stronger pain killers.
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It's not commonly known but back pain is often caused by stress
Preventing back pain
Once back pain develops it can become chronic, coming and going almost (it may seem) at random. That’s why prevention is so important.
Perhaps the most important thing you can do first, according to Backcare’s Dr Al-Kashi, is to deal with the stress in your life, whether that’s at work or at home.
After that, parcel company UPS recommend that everyone learns the correct way to lift heavy objects. Lift by bending the knees and keeping your back straight, and keep the object close to your body. Never hold an item higher than your armpit or lower than your knees, the company says, and don’t move anything alone that weighs more than 20% of your body weight. When you lift something, don’t pivot or twist - change direction with your feet.
Another important tip is to sit properly, especially if your job entails sitting for a long time. Keep your knees and hips level. Change your position frequently, at least once every half hour.
After that, the best thing you can do for your back is exercise. Walking and swimming are great ways to increase strength and endurance in your back. Building core muscle strength also acts like a buffer against back problems.
And if you exercise regularly you’ll also lose weight. Being overweight is a risk factor for back problems because it puts a strain on back muscles.
As the Prime Minister discovered, back problems can ruin a holiday. Sometimes they can last for a lot longer than that, so in this case, as in so many, prevention is far better than cure.