Most back problems will get better on their own. The key is to
know when you need to seek medical help and when self-care measures
alone will allow you to get better.
Low back pain may be acute (short-term), lasting
less than one month, or chronic (long-term, continuous, ongoing),
lasting longer than three months. While getting acute back pain
more than once is common, continuous long-term pain is not.
Many people will feel better within one week after
the start of back pain. After another four to six weeks, the back
pain will likely be completely gone. To make sure you get better
quickly, it is important to take the right steps when you first
A common misconception about back pain is that you
need to rest and avoid activity for a long time. In fact, bed
rest is NOT recommended. If you have no indication of a serious
underlying cause for your back pain (like loss of bowel or bladder
control, weakness, weight loss, or fever), then you should stay
as active as possible. Reduce physical activity only for the first
couple of days and gradually resume your usual activities after
that. Here are some tips for how to handle pain and activity early
· Stop normal physical activity for the first
few days. This helps calm your symptoms and reduce any inflammation
in the area of the pain.
· Apply heat or ice to the painful area.
One good method is to use ice for the first 48 to 72 hours, then
use heat after that.
· Take over-the-counter pain relievers such
as ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol). If
you cannot take either of these for medical reasons, like a stomach
ulcer, stomach inflammation, or a liver disorder, then check with
your doctor for other pain relieving measures.
While sleeping, try lying in a curled-up, fetal
position with a pillow between your legs. If you usually sleep
on your back, place a pillow or rolled towel under your knees
to relieve pressure.
Do NOT perform activities that involve heavy lifting
or twisting of your back for the first six weeks after the pain
begins. AVOID exercise in the days immediately after the pain
begins. After two to three weeks, however, you should gradually
resume exercise (particularly with the guidance of a physical
therapist). And remember, getting back to every day activities
starts just after a few days.
When ready for exercise, begin with light cardiovascular training.
Walking, riding a stationary bicycle, and swimming are great examples
that you can start as soon as two weeks after your symptoms began.
Such aerobic activity can help blood flow to your back and promote
healing. They also strengthen muscles in your stomach and back.
Stretching and strengthening exercises are important in the long
run. However, starting with these types of exercises too soon
after an injury can make your pain worse. A physical therapist
can help you determine when to incorporate stretching and strengthening
exercises and how to do so.
AVOID the following exercises during initial recovery
unless your doctor or physical therapist says it is okay:
· Weight lifting
· Leg lifts when lying on your stomach
· Sit-ups with straight legs (rather than bent knees)
You should consult your doctor if the backache persist
or has the following symptoms:
· Unexplained fever along with your back pain.
· Your back pain started after a severe blow or fall.
· There is redness or swelling on the back or spine.
· The pain travels down your legs below the knee.
· You have weakness or numbness in your buttocks, thigh,
leg, or pelvis.
· You have burning with urination or blood in your urine.
· You have been losing weight unintentionally.
· You use steroids or intravenous drugs.
· Your pain is worse when you lie down or pain awakens
you at night.
· Your pain is very sharp.
· You have never had or been evaluated for back pain before.
· You have had back pain before but this episode is distinctly
· This episode of back pain has lasted longer than four
If any of these symptoms are present, your doctor
will carefully check for any sign of infection (like meningitis,
abscess, or urinary tract infection), ruptured disk, spinal stenosis,
hernia, cancer, kidney stone, twisted testicle, or other serious
Taking care of your back
Exercise is important for avoiding repeat episodes
of back pain and avoiding back pain in the first place. If you
have had back pain at some point, it is helpful to work with a
physical therapist when learning how to exercise safely. Through
exercise you can:
· Improve your posture
· Strengthen your back and improve flexibility
· Lose weight
· Avoid falls
A complete exercise program should include aerobic
activity (like walking, swimming, or riding a stationary bicycle)
as well as stretching and strength training. To prevent back pain,
it is also very important to learn to lift and bend properly.
Follow these tips:
· If an object is too heavy or awkward, get
· Spread your feet apart to give a wide base of support.
· Stand as close to the object you are lifting as possible.
· Bend at your knees, not at your waist.
· Tighten your stomach muscles as you lift the object up
or lower it down.
· Hold the object as close to your body as you can.
· Lift using your leg muscles.
· As you stand up with the object, DO NOT bend forward.
· DO NOT twist while you are bending for the object, lifting
it up, or carrying it.
Other measures to take to prevent back pain include:
· AVOID standing for long periods of time.
If you must for your work, try using a stool. Alternate resting
each foot on it.
· DO NOT wear high heels. Use cushioned soles when walking.
· When sitting for work, especially if using a computer,
make sure that your chair has a straight back with adjustable
seat and back, armrests, and a swivel seat.
· Use a stool under your feet while sitting so that your
knees are higher than your hips.
· Place a small pillow or rolled towel behind your lower
back while sitting or driving for long periods of time.
· If you drive long distance for work (like truck driving),
stop and walk around every hour, bring your seat as far forward
as possible to avoid bending. DO NOT lift heavy objects just after
· Quit smoking.
· Lose weight.
· Learn to relax. Try methods like yoga, tai chi, or massage.