AS the leading cause of disability worldwide and the largest single reason for doctor sanctioned sick leave in Europe, back pain will affect roughly eighty per cent of us at some point.

For those lucky enough to not suffer, it may be looked upon lightly. However if an episode leaves you struggling to even move, you will understand why it has become such a large healthcare problem.

The back is one of the most complex systems in the body. At its centre lies the spinal cord, coming from the bottom of the brain.

This tube like structure is the central highway, carrying signals from the brain to the rest of the body. Side branches of this highway, spinal nerves, leave the cord most of the way down its length on both sides.

The cord is protected by bones called vertebrae, which have a hole in them through which the cord passes. Between each vertebra is a spongy disc, which acts like a shock absorber.

Many cases are labelled as “nonspecific back pain” where no cause is identified. Thankfully most episodes last six weeks, after which symptoms gradually disappear.

If the problem lasts longer than this time, it is labelled chronic back pain. There are many theories as to the rise in back pain, from our increasingly sedentary lifestyles, to obesity.

Occasionally back pain can be a sign of an underlying problem. If a nerve leaving the canal gets squashed by a disc, this can cause pain that shoots down the legs.

Rarely this may affect nerves affecting the bowel or bladder, and back pain with the feeling of needing to pass urine but not being able to do so, should make you attend A&E immediately.

Likewise do not ignore pain that keeps you awake at night, night sweats, unexpected weight loss, or a new lump or bump in your spine.

DESPITE the fact that most back pain is non-specific, its management has become one of the biggest debates in medicine.

We know that there is a complex interaction between the physical and the psychological, and that pain brings about a feeling of lack of control.

The system in the UK is geared to treatments where there is strong evidence for benefit.

Management commences with strengthening of the core muscles, which support the spine. Chiropractors, osteopaths and physiotherapists are excellent at helping people in this respect.

For anyone with back pain, and indeed even those who don’t have it, regular exercise and maintaining a sensible weight is key.

Long term strong painkillers have been shown to have limited benefit, but great potential for harm including falls, overdose and accidental death.

Unfortunately, the prescription of opioid medications is nine times higher in some parts of the North-East compared to the South.

Surgery is reserved for selected cases and there needs to be a clear reason. Without this there is unlikely to be any benefit.

Maintaining back health should be seen in the same way as brushing your teeth – a lifelong responsibility where we should develop good habits.