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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

877.22.NIAMS (226.4267)

www.niams.nih.gov

Back Care

Back pain can be sharp, dull, acute, or chronic. It can be felt on one or both sides of the back.

Causes

Prevention

Back Exercises

Treatment for

Low Back Pain

Medical Care

Low Back Problems

Back pain occurs most often in the lower back. That is where the human body absorbs the most weight and stress. About half of working age adults have low back problems. Having an acute low back problem means lower back or back-related leg symptoms for less than 3 months. About 90 percent of persons with acute low back problems resume normal activity within a month with or without medical treatment. Often, acute low back pain goes away on its own in a few days or weeks.

Sprains and Strains

A sprain is an injury to a ligament (fibrous tissue that connects bones). A strain is an injury to a muscle or tendon (tissue that connects muscle to bone). Most backaches come from strained muscles in the lower back or from sprained ligaments that support the spine.

Poor Posture

People who slouch put strain on their backs. Poor posture can cause back pain and limit recovery efforts. The back has three natural curves: one at the neck, one at the middle back, and one at the lower back. A healthy spine and flexible muscles support the spine and keep the body in proper alignment. With good posture, all three curves are balanced and the ears, shoulders, and hips are aligned.

Lack of Exercise

Muscles that aren’t worked out regularly are more prone to injury. Do whole body exercises, such as swimming and/or walking. Do exercises that stretch and strengthen your back, too.

Excess Weight

Ten extra pounds of body weight puts 30 pounds of strain on the lower back. Being very overweight increases the weight on the spine, putting increased pressure on the discs in the spine. The discs allow the vertebrae to move more smoothly.

Image of women with back pain.

Stress

Stress can worsen back pain that already exists. Back spasms may even be caused by worries and fatigue. These exercises can help reduce stress:

•  Sit comfortably. Breathe deeply. Tighten and relax each muscle of your body from head to toe. Hold each muscle tight for five seconds and then relax.

•  Picture relaxing scenes and go there in your mind.

Other Causes of Back Pain

•  Arthritis

•  Back injury, such as from a fall or an accident

•  Fibromyalgia

•  Kidney stones

•  Infections (bladder, kidney, lung, etc.)

•  Osteoporosis

•  Ruptured disc or other mechnical problem in the spine

•  Sciatica. This is inflammation of the sciatic nerve. This nerve starts in the lower spine and goes down the back of the legs.

You can help improve a bad back, maintain a healthy back, and decrease your risk of back injury by exercising your back. Contact your doctor or health care provider before you start a new exercise program. Start slowly. Stop if pain increases.

 

Ask your health care provider about other back exercises. Ask, too, about an aerobic exercise program, such as walking, running, swimming, or biking.

 

Do back exercises for 15 minutes a day, 3 to 5 times a week.

Image of women doing back exercises.
  • Pelvic Tilt

    This strengthens front and back muscles and helps prevent swayback. Lie on your back with knees bent. Keep your feet flat on the floor. Breathe slowly and deeply. Rest your arms at your sides. Get comfortable and relaxed. Tighten your stomach muscles so the small of your back is flat on the floor. Next, begin to tighten the buttock muscles. Tilt the hips or pelvis upward, and relax. Hold for a count of 5. Repeat 5 times.

  • Knee-to-Chest Raise

    Image of women doing a knee-to-chest raise.

    This limbers up a stiff back. Lie on your back with knees bent, feet flat on the floor. Breathe deeply. Get comfortable and relaxed. Raise your right knee to your chest and grasp it with both arms. Hug your knee in order to feel a slight stretching in the lower back region. Hold for a count of 5. Do this  5 times. Repeat with your left leg. Repeat with both legs. Be careful not to arch your back. Don’t use your arms to lift your legs.

  • Spinal Stretch

    This increases flexibility of the spinal column. Stand erect and raise both hands over your head. Stretch towards the ceiling. Focus on your upper body. Use your arms, hands, and fingers to reach upward as though you were being pulled upward. Keep your feet flat on the floor. Hold for a count of 5.

    Image of women doing a spinal stretch.
  • Curl Up

    Image of women doing a curl up.

    This strengthens the lower back. Lie on your back while on a firm surface. Slowly bring both knees to your chest and bring your chin forward to your chest. Your arms should be extended straight at your sides. Hold for a count of 5. Gradually return to your starting position.

  • Elbow Props

    Image of women holding elbow.

    These strengthen low back muscles and help maintain the normal curve of the lower back. Lie on your stomach. Turn your head to one side. Relax your arms at your sides. Relax like this for 3 minutes. Prop up on your elbows with your head facing forward. Keep your lower back completely relaxed and flat. Hold this position for 2 minutes. Return to the starting position for 1 minute. Repeat 3 times.

  • Sitting Hamstring Stretch

    Image of a women doing a sitting hamstring stretch.

    This warms up and limbers the back muscles and stretches the hamstring muscles. Sitting on the floor, stretch your right leg out directly in front of you. Place your left foot under your right knee. The toes of your right leg should be pointed upward. Slowly reach forward to grasp the tips of your right toes. Be careful to bend over from the hip. Hold for a count of 10. Repeat 5 times. Then switch leg positions.

     

Continue your regular activities as much as you can. Back muscles can get weak if you don’t use them. Rest your back, if you must, but don’t rest in bed for more than 1 to 2 days, even if your back hurts a lot. Bed rest should only be used for persons with severe limitations (due mostly to leg pain).

{Note: Before you seek treatment for back pain on your own, check with your doctor or health care provider. Discuss the benefits and risks for treatments, such as spinal manipulation, different forms of massage, and herbal remedies.}

  • Medication

    •  Over-the-counter (OTC) pain relievers. Examples are acetaminophen, aspirin, ibuprofen, ketoprofen, and naproxen sodium. These relieve back pain, but only for a short time. All but acetaminophen also reduce swelling and are called NSAIDs†. This stands for nonsteroidal anti-inflammatory drugs.

    •  Prescribed NSAIDs† and other medicines, such as muscle relaxants.

    † NSAIDs can cause stomach upset, indigestion, and ulcers in the stomach and intestines. Discuss the benefits and risks of taking NSAIDs, as well as other medicines, with your doctor.

  • Cold Treatment

    Image of man holding a cold pack on lower back.

    Injury to the back can cause blood vessels to tear. This leaves a bruise. Cold inhibits bruising and swelling and numbs pain. Cold packs, like crushed ice wrapped in a towel, can help. Apply a cold pack for 5 to 10 minutes at a time, several times a day. For best results, lie on your back with your knees bent and place the ice pack under your lower back. Start right after a back strain. Do this for 10 minutes every 2 hours for the first 48 hours.

  • Heat Treatment

    Image of women in a hot tub.

    Unlike cold, heat increases blood flow to the affected area. This promotes healing. Wait at least 48 hours after back symptoms start to apply heat. If heat is  used sooner, the increased blood flow can add to the swelling. Heat can be applied with moist heating pads,  hot-water bottles, hot compresses, hot tubs, and hot baths or showers. Use heat for 10 minutes at a time. Do this several times a day.

  • Massage

    Image of a man getting a massage.

    Massage won’t cure a backache. It can increase blood flow to tight muscles and loosen them.

  • Braces or Corsets

    Braces and corsets support the back and keep you from moving it too much. They won’t make your back stronger, though.

This website is not meant to substitute for expert medical advice or treatment. Follow your doctor’s or health care provider’s advice if it differs from what is given in this guide.

 

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