Back pain is a common problem. Back pain is one of the most common ailments in the World. How is the back made up? The major feature is the spine. This is a highly complex and delicate structure which is made up of 33 small bones called vertebrae. In between each vertebra is a disc which acts as a shock absorber, and stops the bones rubbing together. The discs are made up of a jelly like substance, which is protected by a tough, fibrous outer casing. The spine is supported by specialised back muscles, and an array of ligaments, nerves and tendons. What causes back pain? As the spine is such a complex structure, it can often be difficult to pin down the exact cause of back pain. Probably the most common cause is when the back muscles begin to spasm. This can often occur after strenuous activity, or can be a reaction to repetitive strain. The muscle is damaged, or irritated, and goes into spasm to protect the area from further injury. This can be extremely painful, and can lead to muscle tears if undue stress is exerted. Other causes of back pain include arthritis, fractures and infections. In many cases experts believe back pain is a manifestation of emotional upset, rather than a physical problem. More serious causes can include a prolapsed disc, or degenerative diseases of the spine - but these are relatively rare. Are certain parts of the back more vulnerable? Yes. The lower - or lumbar - region of the back is particularly prone to injury. This because it bears the entire weight of the upper body, and is twisted and bent more than other parts. As a result it inevitably suffers more wear and tear. Why is back pain on the increase? Experts believe that a major factor is the modern tendency to lead a sedentary lifestyle, both at work and home. Spending long stretches of time sitting in one position - often with the back not properly supported - is not good for the spine. The reliance on comfy soft furnishing may seem appealing - but often it encourages us to adopt a poor posture. Back pain is much less common in places such as India, where many more people are used to sitting on the floor, which is thought to allow the back muscles to find their own natural position. What is the treatment? For most cases of back pain the only treatment is pain relief, often through the use of non-steroidal anti-inflammatory drugs such as aspirin. Physiotherapy, heat therapy, massage and hydrotherapy can help. How can you minimise the risk? The spine is naturally curved into an S shape. The best way to keep it healthy is to try to maintain this shape as much as possible. This is particularly important when performing tasks, such as lifting, that carry an increased risk of injury. Strengthening the back muscles, keeping fit by taking regular exercise, and maintaining a healthy weight can all help to minimise the risk of back pain. It is also important to have a mattress that properly supports the body while you are asleep. If you do have a bad back probably the worst thing you can do is take to your bed. Experts believe that it is best to stay as active as you possibly can. Could there be another explanation for back pain? Some lumbar and lower spinal pain is caused by patients having one leg longer than the other. This puts the pelvis out of alignment causing pain, which without correction leads to long term compensatory problems such as back pain. In this case it might be wise to consult a podiatrist who will measure the patient's limbs and if required provide either an orthoses - an orthopedic appliance used to support, align, prevent, or correct deformities - or arrange to modify the patients shoe to correct the difference.