How to avoid letting back pain knock you flat

Is your back hurting? You’re in good company. In any three-month period, about 1 in 4 adults in the US has at least one day of back pain, mostly in the lower back.

woman with back pain

Back pain is common but sometimes complicated

The back is a complicated structure. Its center is the spine, which is made up of 33 bones — vertebrae — stacked in a column. The nerves of the spinal cord run in a tunnel through the middle of those bones, then spongy discs between the vertebrae act as cushions, while ligaments and tendons hold everything together.

A lot of things can go wrong with your back. A strained muscle or a problem with a disc or a bone can cause pain, and back pain might also arise from a fracture or tumor. Much of the time, though, it’s impossible to tell what’s making your back hurt.

“We rarely find out exactly what it is,” says Dr Gunnar Andersson, an orthopedic surgeon at Rush University Medical Center in Chicago. “As long as it stays as back pain, we are typically not that concerned.”

Tips to help with lower back pain

“Many people with lower backaches say symptoms disrupt their daily routines; however, everyday habits may be the factors causing the pain,” says orthopaedic spine surgeon and American Academy of Orthopaedic Surgeons (AAOS) spokesperson Dr Michael Gleiber. “It’s important to identify some of those behaviors, avoid them and adapt healthy ones.”

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The AAOS offers these tips on how to protect your back and reduce the risk for pain and injuries.

Consider these five tips from the AAOS:

  1. Exercise regularly to strengthen your back and core muscles: If you already have acute back pain, hold off on strenuous exercise, but continue to get up and move around. Prolonged bed rest and inactivity could worsen symptoms. Specific exercises are available in the AAOS low back pain exercise guide.
  2. Use proper lifting techniques: Avoid lifting heavy items if possible, but if you must lift, be sure to use proper technique. Bend with your legs, not your back. Do not bend over to pick something up. Keep your back straight and always bend at your knees.
  3. Maintain a healthy weight: Excess weight on your body puts added stress on your lower back.
  4. Practice using proper posture: Good posture is important to help avoid future back problems.
    • Spine: Ears should be in line with tops of shoulders, and shoulders in line with hips.
    • Shoulders: Upper arms should hang relaxed and close to the body.
    • Wrists: Hands should be in line with lower arms.
  5. Avoid smoking: Both cigarette/cigar smoke and nicotine cause your spine to age faster than normal.
How your back changes as you age

Your back naturally changes as you get older. Discs degenerate and arthritis may develop in the small joints of the back, and these changes may show up on an MRI or other types of imaging scans. But because such changes to the back are also seen in a lot of people who don’t have back pain, it’s hard to know if the changes are actually what’s causing the pain.

We do know that — in addition to the above — back pain is more common in people who don’t exercise much, or in people who are mostly inactive but have occasional bursts of exercise.

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The good news is that most back pain goes away by itself. For a new pain in the back, Andersson says he usually advises taking over-the-counter medications for the pain and staying away from activity that is hard on the back — lifting, carrying, bending, and twisting. “Then, wait for the problem to disappear, which it will in the great majority of people over a few weeks,” he says.

What if back pain persists?

But for some people, the pain continues. If your back hurts most of the time for more than three months, you have what’s termed chronic back pain.

What doctors do about chronic pain depends on the source of the pain. Some chronic back pain requires prolonged medical attention. If the pain comes from a fracture or tumor, those problems can be treated. Surgery can help if the pain is caused by a ruptured (herniated) disc or certain other conditions like spinal stenosis (narrowing of the spinal column, which can put pressure on the nerves) or degenerative spondylolisthesis (when one vertebra slips over another). But, as with all things, surgery isn’t the right choice for everyone.

There are, however, many treatment options for back pain, so be sure to talk to your health care provider about which approach is right for you. For most people, even chronic pain eventually clears up without surgery.

The most important thing, Andersson says, is not to let the pain take over. Research has shown that patients who stay active are better off — just be sure to avoid activities that might strain the back.

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“It’s important not to succumb to the pain and become afraid of moving,” Andersson says. “It doesn’t seem to make much difference what you do, as long as you stay active.”

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