Chronic low back pain: what are we talking about?
According to the Swiss League against Rheumatism, back pain is called chronic when it lasts more than 12 weeks. Four in five adults have back pain at least once in their lives, and 85% of back pain is described as non-specific: no precise cause, such as a disease of the spine or an organ, can be identified.
The word "degenerative" on an imaging report is often worrying. The League points out that there is not necessarily a link between visible wear of the spine and the pain you feel. To understand what "degenerative" means on an MRI, read our dedicated article. If the pain travels down your leg, read our article on sciatica. For the causes and treatment of chronic back pain in general, see our Back pain page and the article Back pain without surgery. This article focuses on everyday life.
Back pain in the morning when you wake up: a stiff back
Many people describe a stiff back in the morning that loosens up with movement. A few simple ideas:
- Start in bed: knees bent, gently rock your legs from side to side.
- Get up by rolling onto your side and pushing up with your arms.
- Move before you sit down: a few steps, a warm shower, then breakfast.
According to the Swiss League against Rheumatism, morning stiffness lasting more than 30 minutes, pain that wakes you mainly in the second half of the night and that improves with movement point rather towards back pain of inflammatory origin, which is treated differently: talk to your doctor about it, not as an emergency but without waiting too long.
Back pain at the office: sitting, standing, lifting
The Swiss League against Rheumatism names lack of exercise and prolonged sitting among the factors behind chronic back pain, and highlights the role of stress at work. It recommends frequently alternating between sitting, standing and lying down, and taking every opportunity to move: stretches on your chair, taking the stairs, short walks.
At the office, this can mean:
- changing position regularly, even briefly;
- taking phone calls standing up, walking over to talk to a colleague;
- setting the screen at eye level and keeping your feet on the floor.
When lifting, keep the load close to your body and spread it out, rather than searching for a "perfect" posture. The UK NICE guideline stresses returning to work and usual activities: staying in your normal life is part of the care.
Chronic low back pain: what to do? Move every day
For the League, daily physical activity plays a central role in preventing back pain, and staying in bed for several days is ineffective, or even harmful. It mentions endurance sports such as brisk walking, Nordic walking and swimming, and targeted strengthening of the back, abdominal, pelvic floor and diaphragm muscles. The cantonal leagues offer suitable back classes.
The aim is not to wait for the pain to disappear before moving, but to find a tolerable dose of activity and then increase it gradually. NICE does not recommend belts or corsets for low back pain.
What does the research say?
The NICE NG59 guideline recommends supporting people to self-manage their low back pain, offering group exercise programmes and, if needed, manual therapy (mobilisation, massage) only as part of a package that includes exercise. It advises against routine imaging. The Swiss League against Rheumatism stresses that interdisciplinary programmes, combining movement with pain and stress management, help in chronic back pain. Medication should always be discussed with your doctor.
How to sleep with low back pain
There is no ideal position that suits everyone. A few options to try:
- on your side, with a pillow between your knees;
- on your back, with a pillow under your knees;
- on your front, if that is your position, with a flat pillow under your pelvis.
Poor sleep makes pain harder to bear, and pain disturbs sleep. Regular hours, fewer screens in the evening and a moment of relaxation before bed are part of looking after your back.
Handling a low back pain flare-up
Chronic low back pain has ups and downs. The League notes that you can learn how to respond in a flare-up so that pain does not take over. Prepare your plan in advance:
- reduce the load without stopping moving: short walks, frequent changes of position;
- use what usually helps you: warmth, breathing, relaxation;
- take any medication agreed with your doctor, as agreed;
- return gradually to your usual pace as soon as possible.
Warning signs: when to seek care without waiting
The vast majority of low back pain is benign. The following signs, however, call for a prompt or urgent medical opinion:
Seek care immediately (emergency department) if you have:
- numbness between the thighs or around the anus, difficulty passing urine or loss of bladder or bowel control;
- weakness in a leg that is getting worse;
- back pain with fever or a general feeling of being unwell;
- back pain after a fall or accident;
- suicidal thoughts: chronic pain can weigh heavily on your mood, and asking for help straight away matters.
See your doctor promptly if:
- the pain clearly changes in character or new symptoms appear;
- you lose weight for no reason, have night pain, or have a history of cancer and new or unusual pain;
- you are over 50 with new back pain, or have osteoporosis;
- your mood is very low or you feel you can no longer cope: talk about it without waiting.
In the vast majority of cases, none of these signs is present.
Looking beyond the back
The first consultation lasts 1.5 to 2 hours (CHF 182). Bring your medical file, your test results (MRI, reports) and a list of your medications. We review your situation and build your plan together. Follow-up is then adapted to your progress. We work alongside your GP and the other professionals caring for you, including your physiotherapist.
Which approaches may have a place at Centre Algos?
Depending on your situation, several approaches can be combined, alongside your medical care and physical activity:
- Naturopathy: sleep, diet, stress management and daily rhythm, to work on the lifestyle habits that can influence pain.
- Cupping: applied to the lower back, it can help release muscle tension.
- Breuss massage: a gentle massage along the spine that can help the back relax.
- Percutaneous hydrotomy: subcutaneous micro-injections; it may be considered when the situation is suitable, after assessment, once warning signs have been ruled out and in agreement with your medical care. Price on quotation, set at the first consultation according to your situation.
Everyone responds differently: the aim is to live your days better and stay active, without promising a result.
When to seek care
What is happening in your case
This text gives general pointers. What keeps your back pain going, in your particular daily life, deserves a real conversation rather than a generic answer.
A question before you decide? Book a free 10-minute call to see whether our approach suits you.
