Management of Back Pain

Back pain in the lower back is a common concern affecting up to 90% of Americans at some point in their lifetime.

Up to 50% will have more than one episode occurring from a variety of reasons with almost 85% of the people suffering, even after a medical exam, causes undetermined.

Lower back problems is one of the most common reasons people go to the doctor or miss work and can be prevented in most cases.

If prevention fails, simple home treatment and proper body mechanics will often heal your back within a few weeks and keep it functioning for the long haul.


Back pain is a symptom suggesting a problem with your body's intricate structure of bones, muscles, ligaments, tendons, disks, and even internal organs.

Some causes include:

  • Strains: Strained muscles and ligaments from improper lifting techniques or after a sudden awkward movement.
  • Structural problems: Structural problems such as bulging, ruptured, or herniated discs. Discs act as cushions between the vertebrae in your spine. Sometimes the soft material inside a disk may bulge out of place or rupture and press on a nerve causing the pain.
  • Sciatica: If a bulging or herniated disc presses on the main nerve traveling down your leg it can cause sciatica - a sharp shooting pain through the buttock and back of the leg.
  • Arthritis: The joints most commonly affected by osteoarthritis are the hips, hands, knees and lower back. In some cases arthritis in the spine can lead to a narrowing of the space around the spinal cord, a condition called stenosis.
  • Skeletal irregularities: Irregular curvature of your spine such as scoliosis can lead to pain.
  • Compression fractures: Fractures of your spine's vertebrae can occur if your bones become porous or brittle as with osteoporosis.
  • Rare Conditions: Neurological problems such as Cauda equina syndrome, cancer of the spine, or infection of the spine.
  • Musculoskeletal pain syndromes: Including myofascial pain syndromes and fibromyalgia.


There are several risk factors that can increase your risk of developing lower back pain.

  • Smoking
  • Obesity
  • Older age
  • Female gender
  • Physically strenuous work
  • Sedentary work
  • Stressful job
  • Anxiety
  • Depression

Most back problems gradually improves with home treatment and self-care. Although the pain may take several weeks to disappear completely, you should notice some improvement within the first 72 hours of self-care.

See a doctor immediately if your pain:

  • Is constant or intense, especially at night when you lie down.
  • Spreads down one or both legs, especially if the pain extends below the knee.
  • Causes weakness, numbness or tingling in one or both legs.
  • Is associated with pain or pulsation (throbbing) in the abdomen, or fever.
  • Follows a fall, blow to your back or other injury.
  • Is accompanied by unexplained weight loss.


You may be able to avoid back pain by improving your physical condition and learning and practicing proper body mechanics.

To keep your back healthy and strong:

  • Exercise: Regular low-impact aerobic activities can increase strength and endurance in your back and allow your muscles to function better. Walking and swimming are good choices.
  • Build muscle strength and flexibility: Abdominal and back muscle exercises help condition these muscle so that they work together like a natural corset for your back. Flexibility in your hips and upper legs aligns pelvic bones to improve how your back feels.
  • Quit smoking: Smokers have diminished oxygen levels in their spinal tissues which can hinder the healing process.
  • Maintain a healthy weight: Being overweight puts a strain on your back muscles.
  • Use proper body mechanics: Stand smart-maintaining a neutral pelvic position. Sit smart-choose a seat with good lower back support, arm rest and a swivel base. Lift smart-let your legs do the work. Move straight up and down keeping your back straight and bend only at the knees. Hold the load close to your body and avoid lifting and twisting simultaneously.

A regular schedule of over-the-counter pain relievers may be all that you need to improve your back pain and short periods of bed rest is okay, but more than a couple of days actually can do more harm than good.

Of course doctors can prescribe stronger medications, cortisone injections, physical therapy or even surgery.

But many people chose hands-on therapies such as:

  • Chiropractic care: back problems are one of the most common reasons that people see a chiropractor.
  • Acupuncture: Some people report that acupuncture helps relieve their symptoms. The National Institutes of Health has found that acupuncture can be an effective treatment for some types of chronic pain.
  • Massage: If your pain is caused by tense or overworked muscles massage therapy may help loosen knotted muscles and promote relaxation.

Whatever the cause or reason for your back pain it is always recommended to seek professional advice from your health care provider. After an x-ray and medical exam various safe options can be considered and chosen to minimize your pain and rehabilitation.

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