Diagnosis | Physical Activity | Medications | Self-Management
Your health professional typically will take a case history and do a clinical and neurological examination to determine whether you have any signs or symptoms that indicate whether other diagnostic tests are required. For most back pain, research has shown that X-rays or other investigative tests are not indicated. In fact some investigative tests, such as x-rays, if used indiscriminately can result in poorer health outcomes. Your health professional will assess whether you have any "Red Flags" or “Yellow Flags”. Red flags alert your health professional of the need for further action. Yellow flags alert your health professional to other factors that may need to be addressed to reduce your risk of developing unnecessary long-term disability, work loss or reduced quality of life.
Red Flag Symptoms
- Neurological: major motor weakness, disturbance of bowel or bladder control, saddle numbness
- Infection: fever, risk of UTI, IV drug use, immune suppressed
- Fracture: trauma, osteoporosis risk
- Tumour: history of cancer, weight loss, fever, pain worse supine or at night
- Inflammation: morning stiffness greater than 1 hour,
- Age: less than 20 years or over 50 years
Yellow Flag Symptoms
- Belief that back pain is harmful or potentially severely disabling
- Fear and avoidance of activity or movement
- Tendency to low mood and withdrawal from social interaction
- Expectation of passive treatment(s) rather than a belief that active participation will help
Physical activity helps improve physical and mental health. It plays a vital role in managing your back pain. If approached properly, physical activity can reduce stiffness and pain, increase energy and stamina, improve sleep quality and promote weight loss and long-term weight management.
It’s important to consult your health professional about a routine that is moderate and will strengthen the appropriate muscles in your back and reduce potential harm from doing exercises incorrectly. There are many fitness centres and organizations that have exercise programs which target people with back pain and arthritis. You can also find more information on simple steps to incorporate physical activity into your everyday life.
- Research Reviews on Exercise for Musculoskeletal Conditions - Reviews put together by the Cochrane Library on whether exercise is beneficial for back pain and other MSD conditions.
- Interactive Back Exercises Tutorial – Although there is no research evidence that identifies particular exercises as being better than others – This tutorial suggests some exercises that you can explore. The goal is keep you back and body active. Prolonged bed rest does not help back pain and it reduces your overall physical and mental health.
- Low Back Pain: Exercises - Test your knowledge on lower back pain and exercise, then peruse the recommended exercises to help you reduce lower back pain.
- Back Pain Exercises – A slideshow of exercises you can do to reduce back pain in just 15 minutes a day
- Exercise at Your Desk - A video of exercises you can do to reduce back and neck pain while at your desk.
- Yoga for Health - Key evidence from studies about yoga for back pain
- Low Back Pain Tips - This video discusses some causes of low back pain and some exercises you can do to help.
- Types of Exercises – Types of exercises to use for self-management from the Canadian Pain Coalition.
- Range of Motion and Strengthening Exercises – Experts at the University of Washington provide videos for increasing range of motion and strength. The shoulder videos can help with neck pain.
- Physical Activity and Chronic Pain – The benefits of physical activity as a treatment for chronic pain.
There is a range of over the counter and prescription medications used for treating back pain. It is best to check with your physician as to what is best for you.
Living with back pain can be difficult. Self-management techniques can help you live well with chronic back pain. Health professionals and researchers agree that self-care and life skills play vital roles in a person's pain management. Taking action to improve physical fitness, reduce stress and manage your condition can reduce your pain levels and give you more control over your life. The Arthritis Society and the Centre for Aging (University of Victoria) run Self-Management Programs in British Columbia
. CIRPD also provides various tips on evidence-based approaches to self-management
Red Flag Symptoms - IWH Adapted from: The Peterborough Back Rules chart template. G. Powell and The Peterborough Back Rules Working Group. September, 1997.
Yellow Flag Symptoms - Adapted from: Guide to Assessing Psychosocial Yellow Flags in Acute Low Back Pain: Risk Factors for Long-Term Disability and Work Loss. January 1997 edition.
Last Updated: March 2, 2015
Reviewed by: Marc White PhD, Scientific & Executive Director, CIRPD