背部疼痛

背部疼痛is a very common problem and will affect many of us at some point during our lives.

好消息是，在大多数情况下，这不是一个严重的问题，这可能只是由肌肉或韧带的简单压力引起的。

尽可能尽可能地继续进行正常的日常活动并继续前进。

即使您一开始有一点疼痛和不适，也不会使您的背部疼痛变得更糟。保持活跃将帮助您变得更好。服用止痛药可以帮助您做到这一点。

脊柱也称为骨干或脊柱，是身体最强的部分之一，使我们有很大的灵活性和强度。

It’s made up of 24 bones, known as vertebrae, one sitting on top of the other. These bones have discs in between and lots of strong ligaments and muscles around them for support. There are also the bones in the tailbone at the bottom of the back, which are fused together and have no discs in between.

从上到下的脊柱的两侧都是许多小关节，称为刻面接头。

脊髓在椎骨内部通过，以保护它。

脊髓通过颅骨的底部连接到大脑，并通过穿过脊柱骨骼之间的空间的神经与身体的其余部分连接。这些神经也称为神经根。

As you grow older, the structures of your spine, such as the joints, discs and ligaments, age as well. The structures remain strong but it’s usual for your back to get stiffer as you get older.

通常背痛没有一个简单的原因，但可能是由于以下一个或多个：

• 姿势不佳
• lack of exercise resulting in stiffening of the spine and weak muscles
• 肌肉菌株或扭伤。

除了上面列出的内容外，还有一些特定的条件与背面的疼痛联系在一起。重要的是要记住，严重的疼痛并不一定意味着存在一个严重的问题。下面列出了一些常见条件。

脊椎病

随着年龄的增长，脊柱中的骨骼，椎间盘和韧带随着年龄的增长而自然会减弱。这是我们所有人在一定程度上作为衰老过程的一部分发生的，但这并不一定是一个问题，并不是每个人都会感到痛苦。

As we grow older the discs in the spine become thinner and the spaces between the vertebrae become narrower. Little pieces of bone, known as osteophytes, may form at the edges of the vertebrae and facet joints.

The medical term for this is spondylosis and is very similar to the changes caused byosteoarthritisin other joints.

保持脊柱柔软和脊柱周围的肌肉强烈，将减少脊椎病的影响。

坐骨神经痛

背痛有时与腿部疼痛有关，可能会有麻木或刺痛感。这称为坐骨神经痛。

这是由于被压在或挤压的脊柱上的神经所致。对于大多数患有坐骨神经痛的人来说，腿部疼痛可能是最糟糕的部分，有时他们可能几乎没有或根本没有背部疼痛。

在大多数情况下，坐骨神经痛是由于神经压在神经上的凸出盘引起的。椎间盘的设计为凸起，因此我们可以轻松地移动脊椎，但是有时隆起会“抓住”神经根，并导致疼痛一直沿着腿和脚向下行驶。

大多数人康复很快，尽管在某些情况下可能需要几个月的时间。

尽快开始轻柔的运动将极大地帮助坐骨神经痛。看到一个也是一个很好的主意physiotherapist。

Spinal stenosis

有时，背部疼痛与腿部疼痛有关，腿部开始行走几分钟后开始，然后坐下时会很快变得更好。这被称为脊柱狭窄。

这可以从出生开始或随着年龄的增长而发展。

当某些东西在神经所在的脊柱中间的小空间上按下某些东西时，就会引起问题。这个空间称为脊柱管或神经根管，可以被骨头或韧带挤压。

症状通常会影响双腿，但一条可能比另一只腿差。当您坐下来休息时，疼痛通常会变得更好，如果他们走路有点弯腰，有些人会发现疼痛会减少疼痛。像坐骨神经痛一样，主要问题往往是腿部疼痛，而不是背痛。

在大多数情况下，坐骨神经痛和脊柱狭窄都不是严重的问题。但是，如果这些症状会导致您的麻烦，并极大地影响您的生活质量，那么您应该去看医生以获取进一步的建议，并讨论还可以做什么。

Other causes

背痛的其他较大原因包括：

• bone problems such as a fracture – often linked to thinning of the bones, which is known asosteoporosis
• 感染
• 肿瘤
• 炎症，例如在这种情况下ankylosing spondylitis。

Even though it's common, most cases of back pain tend to clear up without the need to see a doctor.

如果您的疼痛，您应该去看医生：

• is really bad
• 持续很长时间
• 阻止您工作或做自己喜欢的事情
• 影响您的日常活动
• 变差。

如果您的性功能有任何变化，例如，您还应该去看医生。

如果疼痛引起了您的重大问题，并阻止您继续进行正常的生活和工作活动，那么您的医生将检查您并提出问题。

这些问题将有助于预测您在背痛方面需要进一步帮助的可能性。如果您确实需要进一步的支持，您的医生将转介到物理疗法，以便您可以尽早接受治疗，以帮助疼痛并恢复正常的活动。

It’s natural to want to know what has caused your back pain. However, specialists may not be able to tell you for certain what has caused your back pain, even after carefully assessing you.

如果您担心腰痛的原因，可以公开谈论与医疗保健专业人员的任何担忧，因为减少任何恐惧都可能有助于加快康复的速度。

严重问题的警告信号是什么？

Very rarely back pain or pain that travels down the leg is a sign of a serious problem.

If you have any of the following symptoms, you should seek urgent medical attention:

• 难以控制或通过尿液
• 失去肠子的控制
• numbness around your back passage or your genitals
• serious weakness in your legs so you find standing really difficult
• 严重和持续的背痛会在数周内恶化。

上述症状可能与需要紧急医疗护理的罕见但严重的疾病有关。

国家准则建议，医生在决定是否需要进一步治疗之前诊断腰痛时应使用常识性的“等待和看到”方法，尤其是因为大多数背部疼痛病例都可以自行改善。作为患者，这种方法有时可能会令人沮丧，但是您可能会发现，如果您保持自助措施，则无论如何都不需要进一步的治疗。

如果您需要进一步的治疗，您的全科医生将能够通过与您讨论症状来评估您的背痛。简单检查后可以诊断出大多数问题，并且不太可能需要进行任何特殊测试。

测试

You may be sent for tests if:

• 您的背部受伤，例如跌倒不好
• 您的医生怀疑您的痛苦可能是根本的原因
• 疼痛持续了很长时间。

在这种情况下，可能需要进行磁共振成像（MRI）扫描或计算机断层扫描（CT）扫描。

X射线的常用程度要少得多，因为背痛通常是由软组织（例如韧带和肌肉）引起的，这些问题在X射线上看不到。

脊椎病的导致脊柱的变化可能会显示在X射线上。我们所有人发生的这些常见变化都可以出现在X射线上，而没有人会有任何痛苦或问题。因此，X射线并不特别有用。

Remember that sometimes even after a thorough investigation it might not be possible to say for certain what is causing back pain.

The most important things to do to treat back pain is to keep moving, continue with everyday activities and have a healthy lifestyle.

有些人担心，如果他们有背痛，做某些活动，例如举起事情，扭曲和转动可能会使他们的背痛变得更糟。重要的是要记住，我们的背部和刺是非常强大的，并且旨在移动。

实际上，过多的休息会使背部疼痛恶化。

Being active and continuing with your everyday activities as soon as possible, and as much as possible, will speed up your recovery.

There’s also evidence to suggest that how you respond emotionally to having back pain has an important impact on how quickly you get better. The more positive you are, the more active you are, the quicker your back will get better.

Remember, if you’re ever struggling don’t suffer in silence, talk to a healthcare professional.

Keep moving

保持活跃是如果背部疼痛，您可以帮助自己。

Keeping the muscles around the spine strong, will provide more support to the bones and joints and take pressure off them. The more you move, the more the back will keep its natural range of movement.

如果您长时间停止活跃，背部的肌肉会变得虚弱，您的健康状况降低了，这会使您的背部疼痛恶化。不动可能会使您的背部更加僵硬和痛苦。

定期运动会导致较短和频繁的背痛发作。它还释放了称为内啡肽的化学物质，这是人体天然止痛药。这些会改善疼痛，使您感到更快乐。

锻炼一开始可能会使您的背部感到有些疼痛，但不会造成任何伤害 - 因此不要让您脱颖而出。如果您要重新运动，请轻轻开始，逐渐增加您的运动量。常规和小练习是一种开始，然后每天尝试做更多的工作。

也尝试事先服用一些止痛药。随着时间的流逝，您的背部会变得更强壮，更灵活，这应该减轻疼痛。

背痛的运动类型

It’s better to choose a form of exercise that you enjoy as you’re more likely to stick to it. There are many forms of exercise that have helped people with back pain. Examples include:

• 游泳
• 步行
• yoga
• 普拉提
• 去健身房。

研究has found that a specially developed 12-week yoga programme can help people with low back pain lead more active lives and manage their condition more effectively. Many of the people who took part in the study also found that they had the knowledge to prevent further attacks if they felt an episode of back pain coming on.

You can find more information about the 12-week programme atwww.yogaforbacks.co.uk

如果您有兴趣尝试，许多社区和体育中心也会举办瑜伽课。在开始之前，请确保您与瑜伽教练交谈，以便他们知道您有背痛。

您可以找到一些您可能想尝试减轻我们的痛苦的练习例子后页练习。

Pain during exercise

You may feel some discomfort and sometimes pain when you exercise. This feeling is normal and should calm down a few minutes after you finish. It’s not a sign that you're hurting yourself. Exercise will help reduce pain and can help you manage your back pain better.

虽然您可以推动自己并进行剧烈运动，但重要的是不要过度锻炼。如果您在活动期间或之后无法应对的痛苦，则需要去看医生。关键是要轻轻开始，并逐渐增加您的数量。

一旦腰痛清除，人们通常会停止锻炼。但是，如果您停止行使所有改进，将在几周内消失。因此，重要的是要继续定期运动，并且在疼痛消失时不要停止，并且感觉好些。

If you’re ever having any trouble exercising, it can be a good idea to see a GP or ask for a referral to a physiotherapist for tailored exercise advice. If you're a member of a gym, there may well be personal trainers there who can give you expert advice. Make sure you tell them about your condition.

Painkillers

Simple止痛药such as paracetamol may help to reduce symptoms and allow you to continue with your everyday activities. You should use them as and when you need them but it’s best to take them before the pain becomes very bad. It’s important that you take them regularly and at the recommended dose, especially when you’re having a flare-up of your back pain.

非甾体类抗炎药（NSAIDS）像布洛芬一样，您可以在化学家和超市购买，也可以提供帮助。

您可以使用止痛药和NSAID进行大约一周至10天的短暂治疗。如果这次之后他们没有帮助，那么他们就不太可能了。但是，如果他们确实有帮助，但是当您停止服用疼痛时，疼痛会恢复，您可以尝试另一个短课程。

还有一些抗炎面霜或凝胶可以摩擦到受影响的区域。请注意不要通过服用NSAID平板电脑并同时涂抹NSAID奶油来超过剂量。

如果您对可以服用哪种药物和剂量有任何疑问或疑虑，请与医生或药剂师交谈。

有时，如果您真的在痛苦中挣扎，则其他药物被用来治疗背痛。阅读我们的治疗部分以获取更多信息。

热量/冰袋

Applying a heat pack to the affected area can ease pain and stiffness. You can use a reusable heat pad which you can buy from chemists and sports shops, a microwavable wheat bag or a hot-water bottle.

A warm bath or hot shower can have a similar soothing effect.

An ice pack bought from a chemist, or even just a bag of frozen peas, can also be helpful.

您可能会发现，整天或一周之间的热量和冰疗法之间的交替会有所帮助。

You could experiment with hot and cold packs to find what works best for you.

Make sure you protect your skin from direct contact with heat or ice packs to avoid burns or irritation of your skin. A tea towel over the heat or ice pack is one way to do that. Read the instructions carefully if you have bought a heat or ice therapy product. Applying ice or heat for about 15 to 20 minutes at a time is normally enough.

姿势

坐在家里，上班或车上时，请尝试保持良好的姿势。例如，在工作或开车时保持尴尬的位置会影响背部的软组织，以支持您的脊椎，并增加您的疼痛或恢复时间。

尝试经常改变姿势，因为在同一位置保持太久可能对您不利。

补充医学

据信有许多不同的补充治疗可以帮助缓解疼痛，而有些人在使用它们时会感觉更好。

However, on the whole these treatments aren’t recommended for use on the NHS because there’s no proof that they definitely work.

Acupuncture

有时针刺可能会减轻疼痛。人们认为，通过转移或改变从疼痛组织中发送给大脑的痛苦感觉，并刺激人体自身摆脱疼痛的激素（称为内啡肽）来起作用。

Massage

Massage是一种手动技术，它使用有节奏的笔触，揉捏或敲击动作来移动身体的肌肉和软组织。按摩可以降低焦虑和压力水平，缓解肌肉张力和疲劳，并改善循环，这都可以降低疼痛水平。

正确举起

Learning to lift correctly may help to prevent further episodes of back pain.

Bend your knees when lifting and allow your spine to move as necessary, without twisting it. When doing tasks like carrying shopping, try and split the load between both hands. Keeping the weight close to your body also helps.

饮食和营养

没有特殊的饮食可以帮助或防止背痛。

但是，如果您超重，则应该考虑改变饮食并进行一些规律锻炼为了帮助您减肥，因为这会减少背部的压力。

What’s recommend for us all is a well-balanced and healthy diet, which is low in saturated fats, sugar and salt. It’s also a very good idea to eat plenty of fresh fruit and vegetables, and to drink plenty of water.

如果您需要减肥，关键是要定期燃烧的能量比每天消耗的能量更多。

阅读更多有关饮食。

疼痛管理计划

疼痛管理计划may help you control your pain and teach you how to live with long-term pain. They’re usually outpatient sessions and involve learning about pain from a physical point of view, but also how it affects your mood and emotional well-being. The sessions will then look at what you can do to overcome difficulties.

阅读更多有关疼痛和关节炎。

服用一些止痛药，保持活跃并进行一些特定的运动通常是对背痛患者的最有用的治疗方法。但是，有些人将需要进一步的治疗。

疗法

理疗

理疗can be useful to improve your strength and flexibility. Exercise is one of the most effective treatments for back pain. A physiotherapist can help oversee your exercise programme and recommend specific exercises to help.

手动疗法有时被称为“动手”疗法，例如操纵和动员脊柱关节，可以帮助清除背痛的咒语以及运动。这些手动疗法技术通常由骨质病，脊医和物理治疗师进行。

These therapies might not be suitable for all back conditions. Talk to your doctor if you’re thinking of trying one of these. And make sure you explain to the therapist what condition you have.

阅读更多有关理疗。

职业治疗

如果您的背痛引起了日常活动的问题，例如敷料，洗涤和驾驶，您可能会发现看到一个很有用occupational therapist。They may suggest different ways of doing things to reduce the strain or recommend aids or gadgets that will help you. However, it’s important that you don’t come to rely on aids or gadgets instead of trying to get back to your daily activities.

Find out more about职业治疗。

Talking therapies

背部疼痛, especially if it lasts for a long time, can affect people’s mood. If you are feeling really low or anxious, it’s important to talk to someone such as a partner, relative, friend or a doctor. ‘Talking therapies’ can be useful.

例如，认知行为疗法（CBT）可以帮助背痛的人。目的是通过将他们分解为较小的部分来帮助人们以更积极的方式处理问题。您的医生也许可以将您推荐给CBT，或者您可能想考虑私人。

保持社交和身体活跃是帮助低情绪和焦虑的重要组成部分，这也有助于疼痛。简单的事情，例如加入当地休闲中心，体育俱乐部，步行小组，园艺小组，或者只是出去并定期见到朋友喝咖啡，这确实可能对您有所帮助。

毒品

如果标准止痛药or NSAIDs不适合您，您的医生可能会建议一些其他治疗方法。

阿米替林

阿米替林可以放松肌肉并改善睡眠。通常，您会开处方最低剂量以控制症状。如果起始剂量不起作用，则可以逐渐增加剂量。这种方法将有助于降低副作用的风险，包括干嘴，嗜睡和视力模糊。

如果你经历这些副作用should stop the medication and discuss this with your doctor.

阅读更多有关阿米替林。

gabapentin/pregabalin

Gabapentin和Pregabalin通常不作为“普通”背痛的一线治疗方法。尽管它们可能没有太大帮助的背痛，但它们可能通过减少神经的刺激来帮助坐骨神经痛。他们可能需要花六个星期的时间，有时甚至更长。

As with all drugs there can be side-effects, so they won’t be suitable for everyone. You should discuss this with your doctor.

注射

有时注射对背痛或坐骨神经痛有用，这更严重或通常的治疗理疗和止痛药工作不够好。For sciatica, these injections are called epidurals, and involve an injection of a steroid, which is a strong anti-inflammatory medicine, and anaesthetic, near the spine or through the tailbone, to try and help with pain from a ‘trapped’ nerve root.

Another type of injection, called radiofrequency denervation, might be used if it is thought that the back pain comes from natural changes that happen over time to the small joints in the spine called facet joints.

您的医生会派您去看专家，讨论是否可以选择背痛或坐骨神经痛。这些注射并不总是成功的，但是它们确实可以帮助某些人。

手术

很少有背痛的人需要手术。有时，脊柱狭窄或严重坐骨神经痛需要操作，以释放神经，尽管大多数医生会建议先尝试其他措施，包括药物，包括药物，理疗or injections.

Urgent surgery may be needed if you lose bladder or bowel control or the use of your legs, but this is extremely rare.

Getting back to work sooner rather than later will help most people with back pain.

这将有助于您的背痛本身，因为保持活跃并保持背部肌肉移动将帮助您早日康复。这也会使您对自己感觉更好，因为已经证明休假会影响人们的心情。

In the past, people were advised to rest up in bed and we now realise that it does more harm than good and that it's better to keep moving, even if you need to take some simple painkillers to allow you to do so.

Most people are able to return within 2-3 days, although the length of time off work varies with the individual and the type of job you do.

您不需要等到背部问题完全消失。在许多情况下，您下班时间的时间越长，您就越有可能出现长期问题，而重返工作岗位的可能性就越小。

获得雇主的支持

重要的是要与您的雇主保持联系，并讨论可以采取什么措施帮助您重返工作岗位。如果您的工作涉及繁重的举重或其他要求的任务，则可能需要履行更轻松的职责，并且一段时间的时间较少。

如果您在工作中有职业健康顾问，他们可以帮助您建议您适合做什么工作，并安排对工作或工作场所的任何简单调整，以帮助您应付和保持工作。

获得其他支持

If you're having difficulties travelling to or from work or need an item of equipment, the Government’s访问工作计划可能能够提供帮助。

如果由于背痛而缺席了两周后您无法重新上班，那么您应该与GP和雇主谈谈理疗or other treatment to get you moving again.

您可以通过本地获得进一步的建议Jobcentre Plus和政府的适合工作指导。

我们的研究有助于改善下背部疼痛的管理。我们位于基尔（Keele）的初级保健中心的研究人员开发了起始背部工具，该工具用于帮助临床医生在决定下背部疼痛的患者需要哪种治疗方法。

这种有针对性的治疗方法已显示导致患者报告的残疾减少，减少工作时间以及为NHS和更广泛的社会节省大量成本。包括皇家全科医生和尼斯等组织建议使用“起始背部工具”进行非特异性的腰痛，并已被英国和全球的服务采用。

我们正在支持研究研究为什么有些脊柱脊柱病的人有很多疼痛，而另一些人几乎没有疼痛。这项研究将检查有或没有下背痛的人如何移动和功能，结果将有助于物理治疗师以正确的方式为患者提供正确的护理，从而使理疗更有效，并改善患者的结局和生活质量。

We’re also looking at the role genes play in causing back pain. Our researchers are looking closely at bony lumps caused in spondylosis known as osteophytes, and the problems they can cause by putting pressure on nerves. For this work we’re using zebrafish to study spinal conditions with the aim to help understand how specific genes cause spinal osteoarthritis. Zebrafish are good models to use because of surprising similarities within their anatomy to the human spine.