---

This information sheet has been given to you by Paramedics because they have treated you for lower back pain. It contains important information on how to look after yourself and what to do if your condition changes.

Key messages

• Most people will suffer from lower back pain at some point in their life.
• Most back pain does not require treatment in an Emergency Department.
• For most people, treatment should focus on pain relief, maintaining gentle activity and referral to your local doctor or physiotherapist.

What is lower back pain?

The spine consists of many bones called vertebrae, which are joined together. Each vertebra has a pair of facet joints above and below the vertebra. Between each pair of vertebrae lies a disc which acts as a cushion and provides shock absorption. Muscles and ligaments help provide stability to the spine.

Irritation or damage to any area of the back muscles, spine or surrounding structures can cause back pain. It commonly occurs in the lower back. Up to 90% of Australians will suffer from back pain in their life at some stage.

What causes lower back pain?

Back pain is usually caused by an injury to the back such as over stretching during lifting, bending or twisting. This may result in damage to muscles, ligaments or the discs.

Factors that can contribute to back pain include:

• unsafe practices and lifting techniques in the workplace or home
• bending, twisting (especially when lifting objects) e.g. doing household jobs, gardening, painting
• repetitive or sustained poor posture
• obesity
• lack of physical activity
• pregnancy
• smoking.

Treatment

Lower back pain can usually be managed with pain relief and physical therapy. X-rays are helpful only in certain cases as they only show bones and not soft tissue structures such as ligaments, discs and nerves.

Most back pain tends to improve within a few days to a few weeks, and a therapist such as a physiotherapist, chiropractor or osteopath can assist with exercises, advice and treatment. Bulging discs and pinched nerves may take longer to heal. Few people require surgery. Hospital admission is rarely required for people with mild back pain.

Home care

In the first two to three days you should aim to minimise pain and assist healing.

• Wrap ice cubes in a damp tea towel, use frozen peas or a sports ice pack (never apply ice directly to the skin) and apply to the back for twenty minutes, every one to two hours when awake.
• Avoid ‘HARM” – Heat, Alcohol, Re-injury and Massage for the first few days as this will increase inflammation and swelling (even though it may feel good at the time).
• Avoid activities you do not really need to do. Stop doing an activity if it is making your back pain worse.
• Sit as little as possible until the pain settles. Avoid extended car travel unless absolutely necessary.
• When resting, lie in a comfortable position, supported by pillows if necessary.
• Keep moving. Walk as much as feels comfortable. Initially this may not be far and may require the use of crutches or a walking frame. Walk regularly and gradually increase the distance.
• Take pain relief when necessary, for example paracetamol (such as Panadol or Dymadon) or anti-inflammatory medication (such as Ibuprofen). Codeine is best avoided because it can lead to constipation.
• Seek advice from a physiotherapist.

Most back pain improves with time. Do not let pain rule your life. Find other ways to do the things that cause you pain.

How can I prevent back pain?

• Stay active, control your weight, and maintain good posture at all times.
• Do back exercises to keep your back flexible and strong.
• Speak to a physiotherapist.
• When lifting, use your legs and not your back. Hold objects as close to your body as possible and use both arms.
• If working at a desk, make sure it is set up properly so that you have good posture – do not twist, do not look up or down at the computer screen.

Seeking help

Call the ambulance on 000 if you have any of the following:

• loss of control or loss of sensation of bowel or bladder movements
• loss of sensation around the back passage (rectum) and inner thigh region
• significant loss of power in your leg movements.

In a medical emergency go to the nearest hospital emergency department or call an ambulance (dial 000).

Victorian Virtual Emergency Department (VVED) is also available to treat non-life-threatening emergencies. You will be connected to emergency doctors and nurses who will provide medical advice. Please note you will need a device (mobile phone, tablet, computer) with a camera to use this service.

Contact VVED through the website vved.org.au. If you experience issues, please call 9485 9070

Want to know more?

• Ask your local doctor or health care professional.
• Visit the Better Health Channel www.betterhealth.vic.gov.au

Ambulance Victoria is a critical link in Victoria's healthcare system. We welcome your comments as they assist us to improve our services. If you wish to provide feedback, please contact Patient Experience and Consumer Participation Department either via patientexperience@ambulance.vic.gov.au or telephone 1800 875 137.