Oh, My Aching Back: The Low Down on Low Back Pain

Overview

Low back pain can turn the simplest of movements—from lifting a child to reaching for something on a shelf—into pure agony. That's because the lower back plays such a key supporting role in everyday activities. You need a strong, flexible back to stand and walk, as well as to lift, bend, and twist.

While very common—affecting four out of five adults at some point—low back pain is usually not a cause for concern. It only turns out to be serious in one out of every 200 people. Most sufferers recover from low back pain within a few weeks, especially if they do the right things.

Could Stress Be Making My Back Ache?

Stress produces muscle tension that can lead to pain. In one study, healthy people who scored high on a distress questionnaire were more likely to develop low back pain than those who scored low. All in all, the researchers believe emotional factors may account for about 16% of low back pain cases.

Should I Rest in Bed When My Back Hurts?

Rest may feel best, but it could do your back more harm than good in the long run.

Studies show that people with acute back pain who go about their everyday activities as much as possible do as well—and sometimes better—than those who rest in bed for a few days. Also, those who resume normal activities despite their pain are less likely than those who rest to experience chronic back pain in the future.

The reason is that activity nourishes the spine. Movement naturally causes the body to pump fluid into the spongy discs that separate and cushion the vertebrae in your back. Prolonged inactivity also can cause back muscles to weaken and become stiff, which may, in turn, worsen your back problem.

So, rather than lingering in bed, ease back into your normal routine as soon as possible. This doesn't mean that you should go for a three-mile run or lift heavy items right away. You will probably need to slow your pace and stick to light activities for a while.

Ask for help with heavy lifting and other strenuous tasks. If you do have to lift something, keep the item close to your belly button. When you lift a milk carton at arm's length, you put as much stress on your back as if you lifted 30 pounds close to the body. Also, when you lift, avoid bending forward, twisting, or reaching.

Should I Exercise When My Back Hurts?

It's a good idea to ease back into your exercise routine after back problems set in. Gentle walking or stretching exercises may help right away. But wait a week or two to do more intense exercise.

Once the pain subsides, make a commitment to do aerobic exercises several times a week. Studies show that regular exercise can prevent future back pain. Activities that minimally stress the back include brisk walking, biking, and swimming.

Then, add strength-training and stretching exercises to your routine. Be sure to include exercises that strengthen the back as well as the abdomen, which supports the back.

People who have chronic back pain (or pain that continues longer than four weeks) should talk to their doctor about the benefits of exercising—despite their pain. Studies show that chronic back pain sufferers who exercise on a regular basis report less pain than those who are inactive.

What Can Help Relieve My Pain?

Over-the-counter pain relievers can help. Using cold packs for five to 10 minutes at a time may help as well. A bag of ice or frozen peas wrapped in a towel also works. If the pain lingers after 24 hours, switch to heat. Use a heating pad, or try a hot shower or bath.

Another tip: Spend less time sitting, which can be uncomfortable. When you do sit, use a towel or pillow to support your lower back. Or sit in a rocking chair or a chair that reclines slightly.

Can Prescription Medicines Help?

Aspirin, ibuprofen, acetaminophen, and other over-the-counter (OTC) pain relievers are usually just as effective against back pain as prescription painkillers or muscle relaxants. Acetaminophen is less likely to cause stomach upset and other side effects than aspirin and other OTC pain relievers.

When Should I Call a Doctor?

Generally, back pain gets better in two to four weeks with what doctors call conservative therapy. This usually includes:

gradually returning to normal activities
using over-the-counter pain relievers as needed
applying ice and heat appropriately.

However, call your doctor if back pain is severe, worsens, or fails to get better. You should also contact a doctor if you have back pain plus other serious conditions. These include:

fever
unexplained weight loss
bladder or bowel problems
leg weakness
a history of cancer.

Is Back Pain Inevitable with Age?

The spine begins to show signs of wear and tear as early as age 35. As the back becomes less strong and flexible, muscle strains and sprains are more likely.

However, people can strain their back at any age. It often occurs when people lift objects that are too heavy or use improper form when lifting, twisting, bending, or doing other activities. Construction workers, nurses, and others with jobs that involve a lot of heavy work are more likely to develop back pain than those whose jobs are less strenuous.

Various health problems also can cause back pain. These include osteoarthritis, osteoporosis, sciatica, and kidney infections.

Experts admit that there's still a lot to be learned about what causes back pain. Up to 85% of patients never find out the exact cause of their back pain. That's because X-rays and other technology cannot always detect what is causing the pain.

How Can I Prevent Low Back Pain?

Here are some ways to prevent back problems from recurring—or ever occurring in the first place:

Exercise to keep back muscles strong and flexible. Experts recommend regular aerobic exercise, such as brisk walking, cycling, or swimming. Also important: stretching and strengthening exercises.
Maintain proper weight. Being overweight puts a strain on back muscles.
Practice correct posture. Avoid slouching while standing and sitting. Keep a slight natural arch in the lower back when you sit, and keep your knees even with or lower than your hips. Use chairs that provide back support or use a pillow or rolled up towel to support your lower back. Set up your work area so you can reach things without twisting.
Sleep in a back-friendly position. Make sure your mattress is firm. If not, put a board under it. Avoid sleeping on your stomach. Instead, lie flat on your back with a pillow under your knees. Or sleep on your side with knees slightly bent and a pillow between your legs.
Lift properly. Let your legs do the lifting. Squat with your back straight and your knees bent. Carry heavy objects close to your body at waist level.
Avoid standing or sitting in one position for too long. If you have to, put one foot on top of a box or stool. Also good: Frequent stretching breaks.
Choose comfortable shoes. Ones with one-inch heels are typically good for the back.
Travel light. Avoid carrying an overloaded backpack, briefcase, or purse.
Find ways to release emotional stress. Exercise is a proven stress buster. Other options include relaxation techniques or creative outlets, such as painting or playing an instrument.

What Exercises Are Good for My Back?

Here are two good exercises for the back. Your doctor may be able to recommend others.

Cat Curl

This exercise is good for stretching the back.

1.Begin on your hands and knees, with your palms on the floor.

2.Lift your head and look forward, keeping your back straight.

3.Slowly begin arching your back like a cat. Take several seconds to do this, inhaling as you move. Your chin should slowly drop to your chest at the same time.

4.Exhaling, slowly revert back to the original position. You should end up looking straight ahead with your back flat.

5.Repeat several times.

Stomach Crunch

This partial sit-up is great for tightening the abdominal muscles, which support the back.

1.Lie on your back. Your knees should be bent and your feet about a foot apart.

2.Cross your hands across your chest. Or place your hands behind your head, but don't let your hands touch. This forces you to use your abdominal muscles—not your neck and back muscles.

3.Tuck your chin in slightly and lift your shoulders only about three to six inches off the ground. Your lower back should remain on the floor.

4.Hold for a second, and then slowly lower yourself to the floor.

5.Repeat 10 times, rest, and then repeat another 10 times.