What is a back injury?

Back injuries are very common. A back injury is caused when there is damage to your back's:

• bones or joints
• muscles
• nerves
• connective tissue

This can cause pain and discomfort.

Injuries can affect any part of your back, but injuries most often happen in your lower back. Common injuries include:

• sprains and strains — when you overstretch a muscle or tear a ligament in your back
• herniated disc — when a spinal disc bulges out of shape and irritates a nerve
• fractured vertebrae — a break in any of the bones in your back
• spinal stenosis — the narrowing of the space where your spinal cord sits or of the small spaces where your nerves leave your spine
• spondylolisthesis — one of your vertebrae slips forward, leaning on the vertebra below, squashing the nerve between the 2 vertebrae

Back injuries can vary in seriousness, depending on the cause of your injury and the damage done. Most back pain is linked to minor strains. This can be very painful but will improve over a few days to weeks.

What are the symptoms of a back injury?

If you have injured your back, you may have the following symptoms:

• pain or tenderness (sore to touch)
• pain that gets worse when you move, cough, sneeze or laugh
• difficulty bending, walking or standing up straight
• muscle spasms
• bruising
• swelling
• pain that radiates down your arms or legs

A compression fracture of your vertebra can cause a hunched posture and a small decrease in your height.

It is important to find out the cause of your symptoms so they can be treated properly.

What causes back injuries?

You can injure your back:

• doing sport
• working around the house or in the garden
• in a car accident
• lifting heavy objects
• from a fall

There are many risk factors that make a back injury more likely, such as:

• your age
• physical fitness
• being overweight
• the type of work you do
• osteoporosis

Back strains happen when you pull or twist a muscle or tendon in your back. A back sprain happens when a joint is forced out of its normal position. This may be from a fall, sudden twist, or a trauma.

A fractured vertebrae is often caused by ageing and your spine weakening.

When should I see my doctor?

You should see your doctor if you have:

• back pain from an accident, such as a car accident or falling off a ladder
• back pain that does not improve after a few days
• back pain that is getting worse
• pain that continues for more than 4 weeks
• severe pain that wakes you up
• back and abdominal pain

If you have a bad back injury, you should see a doctor right away. Signs of a severe back injury are:

• changes in urinating (weeing) or passing stools (poo)
• difficulty breathing or shortness of breath
• blood in your urine
• weakness or numbness in your arms, legs, hands or feet
• numbness in your genitals, groin area or anus
• fever
• paralysis

How are back injuries diagnosed?

Your doctor will ask about your symptoms and general health. They will examine you to check whether the nerves from your spinal cord are working properly. Make sure you tell them if you have any problems with going to the toilet.

Usually, you will not need any tests. Scans and x-rays are usually only needed when you have:

• problems with bladder and bowel control
• weakness or numbness in one or both legs
• risk factors for fractures — such as being female, over 70 years, having cancer, being in an accident, or being on corticosteroid therapy

Scans and x-rays do not usually show the cause of your pain or change how your pain is treated. They may expose you to unnecessary radiation.

Your doctor may refer you for physiotherapy or for other tests.

How are back injuries treated?

Treatment will depend on your back injury and how severe it is. Most minor back injuries get better by themselves within 6 weeks.

Minor back injuries can usually be treated with simple measures such as:

• staying active
• simple pain-relief measures

Staying active

The most important thing you can do is to continue to stay as active as possible. You may find that you can do a bit more each day. A common myth is that bed rest will cure back pain. In fact, bed rest slows down the recovery period and can add to your pain.

Depending on your job, you may need some time off work to allow your back to heal. It's a good idea to try and get back to work as soon as possible. This may be part time or on reduced duties, but it will help you recover more quickly.

Pain relief

You may find that simple pain-relief methods are helpful, such as:

• heat packs
• relaxed breathing

Your doctor may suggest short term pain relief medicines, such as paracetamol or anti-inflammatory medicines. These may help to keep you moving while you are recovering.

Stronger pain medicines, such as opioids and benzodiazepines, aren't recommended. This is because they can lead to tolerance and dependence.

You can talk with your doctor or pharmacist about the best pain relief for your back injury.

Quitting smoking

Research shows that smoking may slow your recovery. If you need help to give up smoking, you can call the Quitline on 13 7848 (13 QUIT).

Can back injuries be prevented?

Ways to prevent back injuries depend on the cause of those injuries.

Adopting a healthy lifestyle may lower your risk of back injury in the future. This includes:

• a balanced diet
• regular exercise
• losing excess weight
• keeping your bones healthy

Another good way to prevent back injuries is to lift and carry safely. If you are picking up a heavy load, lift with your legs, not your back.

Complications of back injuries

Complications of your back injury will depend on what has caused the injury.

Most minor back injuries will not lead to complications. More serious back injuries can lead to long-term disability that may affect your mobility or independence.

Resources and support

healthdirect's page on back pain has more information on causes and treatments for back pain.

Mybackpain.org.au has a range of information and resources on managing low back pain.

If you want to know more about back injuries or need advice on what to do next, you can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.