One in two adults and one in three children or adolescents in Africa will suffer from back pain at any given time1.

Back pain is an extremely common problem that affects all populations around the world. Research has shown that one in two adults and one in three children or adolescents in Africa will suffer from back pain at any given time1.

Registered Johannesburg physiotherapist Pam Watts and Dr Vilash Boodhoo, a chiropractor from Durban, both report that 80%-85% of people, will at some stage of their lives, experience some form of back pain2, 3. “Mechanical back pain (meaning pain originating from the working parts of the back like the muscles and joints) is one of the most common causes of absenteeism from work, second only to the common flu,” says Dr Boodhoo3.

Furthermore, new research has shown that people who suffer from back pain have a reduced ability to financially sustain themselves and generate wealth1. Back pain affects people of any age, for a variety of reasons including injury, activity as well as some medical conditions. As people get older, the chance of developing lower back pain increases4. “Younger people may experience pain as a result of injury whilst the elderly will mostly experience back pain due to degenerative and arthritic changes in the spine,” explains Dr Boodhoo3.

The human back is composed of a complex structure of muscles, ligaments, tendons, disks, and bones, which work together to support the body and enable us to move around4. “Although chronic back pain is an enigma, acute back strain can be quite troublesome as well. The duration of back pain can vary from a few hours to months or years and pain may resolve on its own or may need to be dealt with professionally,” says Dr Boodhoo3.

According to Dr Boodhoo, the six main reasons for back pain include the following3:

  1. Bad Posture – Sitting for prolonged periods at a desk will lead to slouching and spinal strain. Bad workstations and poor ergonomics commonly lead to back pain. Technological advances have led to people spending too much of time looking at a screen or cell phone therefore causing bad posture.
  2. Lifting heavy objects incorrectly – Individuals often bend their backs in order to lift objects off the ground. Bending and twisting the spine while lifting an object may lead to severe spinal injury.
  3. Sports injuries, accidents and falls also account for a large number of people presenting with back pain – “A rugby player has a higher risk of a back strain compared to an office worker. That rugby player may sustain a force during a tackle that may cause a back strain,” explains Pam Watts2.
  4. Bad sleeping posture – Sleeping on your stomach or curling into the foetal position can lead to back pain.
  5. Cold conditions and use of climate control air conditioners – This can cause muscle spasm in the neck and back.
  6. Stressful situations – The link between stress and somatic pain is well known.

“If you think about our daily lives, we are probably exposed to most of these causes and therefore will be prone to back pain at some time or another,” he says3.

Furthermore, additional risk factors that could predispose someone to lower back pain include pregnancy, leading a sedentary lifestyle, older age, obesity and carrying excess weight, genetics, smoking as well as certain medical conditions such as osteoporosis, arthritis and cancer4. For a condition that is inevitably going to affect us at some point2, 3, what can we do to prevent it?

To a large degree, back pain can be prevented and managed1.

“Always adopt a good posture. A key factor is to avoid being seated for prolonged periods. Change your position often as muscles tire from being inactive. Our spines are intricate structures with multiple working parts and it is for this reason that spines ‘love movement’. Exercise regularly. When lifting, always bend your knees and avoid bending and twisting. Try to keep heavy objects close to your body. Sleep on your back or side and your knees can be slightly bent – do not curl. Keep your environment temperate to avoid muscle spasms and avoid stressful situations,” advises Dr Boodhoo3.

All this is easier said than done. What should you do when you do end up with back pain?

“In my current practice, I would always recommend the first treatment option to patients experiencing back pain to be an over-the-counter anti-inflammatory massage gel or cream that can alleviate mild to moderate back pain. A gentle rub at home with a gel can be quite beneficial for sports injuries like sprains and strain, acute muscle spasm and arthritic joints. The topically applied anti-inflammatory is absorbed locally near the point of pain and one can avoid ingesting an oral anti-inflammatory,” says Dr Boodhoo. “Compression, like a bandage, can be combined with a topical gel or cream to give further comfort and support to the area. Gentle home exercises and certain yoga poses will also help,” he says3.

There is a new gel on the market which is the first and only gel that offers everyday triple action5, which means that it provides anti-inflammatory (reduces the inflammation) 6, analgesic (relieves pain)and local anaesthetic (numbs the affected area to reduce pain) properties7Norflex® Gel was launched in South Africa in May to provide relief for strains and sprains as well as muscle, tendon or ligament injuries6.

Pam Watts says that most forms of back pain will usually resolve within six weeks. “If the person is unsure or worried about his or her back-pain, consultation with a qualified healthcare professional is encouraged”2.

She urges patients with the following symptoms to seek medical assistance as soon as possible. These include progressive leg weakness, loss of bladder or bowel control, unexplained rapid weight loss, loss of appetite, lethargy, constant pain that doesn’t ease with rest or at night, constant abdominal or back pain paired with chills and fever, back pain that is interfering with their daily activities as well as back pain experienced after an accident2.

Dr Boodhoo agrees that if your pain persists for longer than a few days, you will need to consult your primary healthcare professional. “Mechanical back pain can be treated with physical therapy by a chiropractor or physiotherapist. Once acute pain subsides, therapeutic exercises will be necessary to rehabilitate strained muscles. If your pain is severe or persistent, then a multi-disciplinary approach is necessary with medical treatment, investigations and physical therapy,” he concludes.

“Most people after an episode of back pain recover and can continue with their lives, but a small portion seem to get persistent bouts of back pain. Pain is a complex issue and it is worth making an appointment with a qualified healthcare professional to discuss the various treatment options available to you,” Pam Watts says2.

Dr BoodhooVilash, is a healthcare practitioner, specialising as a Chiropractor, in Sydenham, Berea, KwaZulu

Natal. Pam Watts is a Registered Physiotherapist with an MSc in Sports Physiotherapy from the University of Bath.

Disclaimer: This editorial has been commissioned and brought to you by iNova Pharmaceuticals. Content in this editorial is for general information only and is not intended to provide medical or other professional advice. For more information on your medical condition and treatment options, speak to your healthcare professional.”

For full prescribing information, refer to the package insert. For more information, speak to your healthcare professional. Further information is available on request from iNova Pharmaceuticals. Name and business address: iNova Pharmaceuticals (Pty) Ltd. Co. Reg. No. 1952/001640/07. 15E Riley Road, Bedfordview. Tel. No. 011 087 0000. IN2785/18.


  1. Back Week 2 to 6 September 2016 – Back Pain Can be Prevented and Managed. Faculty of Medicine and Health Sciences Stellenbosch University ( [online] 1 September 2016 [cited November 2022].
  2. Back Pain Q&A with Registered Physiotherapist Pam Watts.
  3. Back Pain Q&A with Chiropractor Dr Vilash Boodhoo.
  4. Nordqvist, C. What is causing this pain in my back? Medical News Today. February 2017 ( [online] 23 February 2017 [cited November 2022]
  5. South African Medicine Price Registry. Database of Medicine Prices. [online] [cited November 2022]; Available at URL:
  6. Norflex® Gel approved package insert, September 2001
  7. Difflam Gel [online] [cited November 2022]; Available from URL: http://www.myvmc.comdrugsdifflam-gel/.