Back pain is the leading cause of disability worldwide.

Farmers often experience back issues, but you shouldn’t blame the pushing, pulling, lifting and long hours on your feet.

These activities can help keep your back strong and healthy if done gradually and practiced regularly.

It is also untrue that getting older is the cause of back pain. Research shows that evidence-based treatments for back pain work at any age.

There are several potential causes for back pain. Two of these are spinal stenosis and sciatica.

These two terms are often used by doctors when treating people with back pain.

Sciatica

Sciatica refers to irritation of a nerve called the sciatic nerve, which links the spine to the lower back and leg. Sciatica is most often caused by a disc bulge in the spine. Inflammation, muscle spasm or tension around the path of the sciatic nerve can also cause sciatica.

Symptoms of sciatica are pain or burning in the area supplied by the sciatic nerve: lower back, buttock, down the back of your thigh, outside of your calf and into the outside of your foot. This is the classic sign of sciatica, but it may not feel exactly like this.

You might also experience sensory changes (pins and needles, numbness), with or without weakness in your foot.

Sciatic pain varies widely and is often made worse by coughing, laughing, sneezing, bending over, sitting, or walking. It usually affects one leg only and can either develop gradually or come on suddenly after an injury.

Spinal stenosis

Sciatica is often a symptom of spinal stenosis. Stenosis refers to a loss of space in your spine which causes pinching of nerves or the spinal cord. Spinal stenosis usually happens in the lumbar spine (lower back). It is caused by bony overgrowth due to spinal osteoarthritis, disc degeneration, ligament thickening, or most often a combination of these. Stenosis usually develops over time and is typically seen in people aged over 50 years. Different people experience different symptoms depending on where the narrowing occurs in their spine.

Lumbar stenosis (lower back narrowing)

Lumbar stenosis is the most common type of stenosis, where narrowing occurs in the lower part of the spine. Common symptoms of lumbar stenosis are numbness or tingling and weakness of muscles in your leg or foot, pain or cramping in one or both legs, and back pain. These symptoms usually worsen after standing or walking. They often improve when you bend forward or sit down.

Pain is not always a symptom of stenosis. Severe compression of your spinal cord in your lower back can cause changes in your bladder or bowel, known as cauda equina syndrome. Incontinence, inability to empty your bladder or bowel fully or pins and needles or numbness in your groin or back passage is serious and needs immediate medical attention. This is, thankfully, extremely rare.

Cervical stenosis (neck)

Cervical stenosis is the second most common type of stenosis, in which narrowing occurs in the upper part of the spine. The most common symptoms are pain, numbness and tingling in your neck, arm, or hand or weakness in your arm. If the central canal becomes narrowed around your spinal cord, you may develop symptoms in both arms or legs.

You may also notice changes in your walking, balance, coordination, hand dexterity, and bowel and bladder. It is vital that this pressure on your spinal cord is monitored and potentially relieved by surgery.

If you are experiencing any symptoms related to sciatica or spinal stenosis, tell your GP. You may need to get an MRI scan to assess the health of your spine and explore whether you have stenosis or sciatica. A chartered physiotherapist can also guide you through exercises to improve your symptoms.