Back pain: getting moving again, and when to see a doctor

What usually causes it

The NHS says it is not always obvious what causes back pain, and it often gets better on its own. A common cause is an injury such as a pulled muscle. Sometimes a slipped disc, sciatica or ankylosing spondylitis is behind it. Very rarely, back pain is a sign of a broken bone, cancer or an infection.

Sciatica is pain from an irritated or compressed sciatic nerve. It usually affects your bottom and the back of one leg, with sharp or burning pain, tingling, numbness or weakness, and it often hurts more than your back does. It usually gets better in a few weeks to a few months.

What you can do at home

• Stay active and carry on with your daily activities as far as you can. Do not stay in bed for long periods.
• Take an anti-inflammatory painkiller such as ibuprofen if it is suitable for you. The NHS says paracetamol on its own is not recommended for back pain. Ask a pharmacist if you are unsure.
• Use an ice pack wrapped in a tea towel to reduce pain and swelling, or a heat pack wrapped in a towel for stiffness and spasms.
• Try gentle exercises and stretches, and stop if the pain gets worse. Walking, swimming, yoga and pilates may help.

With sciatica, keep moving even if it hurts, because the NHS says movement is not harmful and can help you get better faster.

When a video consultation suits it

See a doctor if your back pain has not improved after a few weeks of home care, is stopping your day-to-day activities, or you are struggling to cope. A video call lets a doctor hear how it started and watch you bend, walk and move. They can talk through options such as physiotherapy, manual therapy or a talking therapy to help you cope with pain, and decide whether you need an examination.

Prop your phone on a shelf so you can step back, and wear loose clothes. Expect questions about how it started, where it spreads, whether you have numbness or tingling, what makes it worse, your work and sport, and what you have already tried.

When you need to be seen in person

Ask to be seen if you have lost weight without trying, there is a lump or swelling in your back or it has changed shape, the pain does not improve with rest or is worse at night, it is worse when sneezing, coughing or pooing, or it is in the upper back between your shoulders. Get urgent help the same day if you feel hot, cold, shivery or generally unwell, or the pain is severe, started suddenly or is getting worse quickly.

Signs that need 998

Call 998 or go to an emergency department if you have back pain with pain, tingling, weakness or numbness in both legs, sciatica on both sides, loss of feeling around your genitals or anus, new difficulty peeing or controlling your bladder or bowels, changes in sensation during sex, chest pain, or pain that started after a serious accident. These can be signs of a serious back problem that needs hospital treatment as soon as possible. Do not drive yourself.

Which doctor to see

A general practitioner or family medicine doctor is a sensible first call for new back pain. For pain that is not settling, or when a scan or injury needs a specialist view, an orthopaedic doctor can help. Back pain doctors listed on medicAI work at independent facilities licensed by DHA in Dubai or DoH in Abu Dhabi, and those facilities provide your care.