Knowing what to do and what not to do in the first few days following a sudden episode of back pain can help speed recovery.

After the first couple of days of an injury, intermittent gentle exercise is usually beneficial, ice packs and heat packs can also ease symptoms, speed recovery and limit the long term effects. Specialist help can also facilitate a full recovery, reduce scar tissue improve healing.

Longstanding back pain is likely to involve varying degrees of wear and tear, postural changes and altered muscle tone and function. Anti-inflammatories and pain killers can help mask the symptoms but they do not address the physical mechanical factors that may be maintaining the problem or have lead to it in the first place. Whilst there is usually no quick fix for a chronic back pain sufferer if the right factors are addressed for that individual there is often much that can be done to physically rehabilitate someone with chronic back pain that will lead to longterm improvement in their symptoms.

The intervertebral discs provide shock absorption to the spine and maintain height between the spinal joints and nerves. The discs can become damaged from from incorrect lifting and prolonged slouching or twisting. However due the to limited nerve supply much of this damage can go unoticed until significant damage has accumulated.

"Facet joints" are the small knuckle sized joints that ocurr either side of a spinal segment. These joints can become strained, locked or develop longterm osteoarthritic changes.

Sciatica is characteristically felt as pain in the buttock and / or into the leg. The pain may be accompanied by numbness or tingling in the leg or foot and in severe cases weakness in certain muscle groups of the leg or foot. The problem occurs due to pressure or inflammation affecting part of the sciatic nerve, this nerve starts in the low back, passes through the buttock and extends down the leg to the foot. Identifying the severity and exact point at which the irritation occurs usually dictate the best way of managing this conditio, MRI scans can be very useful for this.

A trapped or compressed spinal nerve in the neck will usually cause pain radiating into the arm often accompanied by other sensations such as tingling, numbness or even weakness the arm or hand. Compressed nerves in the lower back can cause similar symptoms along the sciatic or femoral nerves into the legs and feet. Such nerve compressions are commonly the result prolapsed intervertebral discs or other degenerative changes in the spine. Severely compressed nerves in the lower back may cause a rare phenomenon known as "Cauda Equina Syndrome" whereby the nerves innervating the bladder, bowel and genitals stop working properly. Signs of Cauda Equine Syndrome usually include a combination of LOSS OF BLADDER OR BOWEL CONTROL, NUMBNESS OR TINGLING AROUND THE GENITAL AREA, LOSS OF SEXUAL FUNCTION AND PAIN AND WEAKNESS IN THE LEGS. Such sypmptoms require urgent assessment since if surgery is not performed quickly enough to release the pressure on these nerves permanent nerve damage may occur.

Other problems such as "trigger points" in the muscles of the spine, shoulder and hip girdle can mimic the pain and ache of a trapped spinal nerve. Unlike compressed spinal nerves, these types of "referred pain" can normally only be identified using sublte clinical tests and skilled palpation by a clinician experienced in trigger point therapy, such problems are often treatable with manual therapy including deep tissue massage, acupcunture and exercises.

Things to look out for include pain in children or teenagers who perform lots of backward bending movements such as in ballet or gynastics, as this could indicate a stress fracture in the spine. Older age groups such as people with osteoporosis are at risk of osteoporotic crush fractures of the spine. Pain can also be "referred" to the back from the internal organs such as the aorta/ heart, kidneys and bowel so it is important to aware of any significant changes in general health. Other signs such as pain that is getting progressively worse, particularly at night, fever, or unexpected weight loss could indicate serious problems such as infection or tumours in the spine, so these should always be reported to a GP or specialist.

Back pain and sciatica are relatively common during and after pregnancy. Pregnancy also increases the chances of developing disc problems (such as disc herniation or "slipped disc"). There are however a number of things that can be done to manage and prevent such pregnancy induced problems. In particular modified, clinical Pilates exercises can help regain the "core stability" that is often lost as a result of pregnancy.

Spondylolisthesis refers a spinal segment (vertebra) that has become shifted forward in it's position relative the vertebra below. This may be due to a develeopmental defect or due to degenerative changes in the bony architecture of the vertebrae. Mild cases may cause no symptoms at all, whereas more severe cases can cause back pain and/or sciatica that occassionally requires surgery to stabilise the segment and alleviate the nerve pressure.