Back Pain

Definition

  • Upper, mid or lower back pain that occurs mainly in the midline
  • Not due to a known major (e.g., auto accident, fall) back injury

General Information

Lower back pain is a cause of countless visits to doctors' offices and emergency rooms. It is the second most common cause of lost work days, after cold and flu symptoms. Over 80% of people at some point in their lives have back pain. In most cases, the cause of lower back pain is not serious, and the pain usually subsides within 4-6 weeks, without special treatment.

Lumbar Strain

New lower back pain in the 18-50 year old age group is usually from straining some of the 200 muscles in the back. Often the triggering event is carrying something too heavy, lifting from an awkward position, or bending too far backward or sideways. Individuals with strained back muscles often note that the pain is increased by bending or twisting movements. They also note that the pain can be reduced by assuming certain positions and that the back muscles are tender to touch.

Bed Rest

Complete bed rest is inconvenient and unnecessary in the most patients with back pain. Research has shown that continuing ordinary activities within the limits permitted by pain results in a speedier recovery than rest.

Treatments

Reassurance: Heavy lifting or excessive twisting can cause lower back pain. With treatment, the pain usually goes away in 1 to 2 weeks.

Local Cold or Heat: During the first 2 days after a mild injury, apply a cold pack or ice bag (wrapped in a moist towel) to the sore muscles for 20 minutes four times a day. Wrap the cold pack in a towel to prevent frostbite. After 2 days, apply a heating pad or hot water bottle to the most painful area for 20 minutes whenever the pain flares up. Wrap hot water bottles or heating pads in a towel to avoid burns.

Sleep: Sleep on your side with a pillow between your knees. If you sleep on your back, place a pillow under your knees to reduce stress on your lower back. Avoid sleeping on your abdomen. The mattress should be firm or reinforced with a board. Avoid waterbeds.

Activity: Continue ordinary activities as much as your pain permits. Continued activity is more healing for the back than rest. Avoid any activities that significantly increase the pain. Avoid heavy lifting, twisting, and strenuous exercise until completely well (Note: complete bed rest is unnecessary).

Pain Medicines: For pain relief, take acetaminophen, ibuprofen, or naproxen.

  • Acetaminophen (e.g., Tylenol):
    • Take 650 mg by mouth every 4-6 hours. Each Regular Strength Tylenol pill has 325 mg of acetaminophen. 
    • Another choice is to take 1,000 mg every 8 hours. Each Extra Strength Tylenol pill has 500 mg of acetaminophen. 
    • The most you should take each day is 3,000 mg.
  • Ibuprofen (e.g., Motrin, Advil):
    • Take 400 mg by mouth every 6 hours.
    • Another choice is to take 600 mg by mouth every 8 hours.
    • Use the lowest amount that makes your pain feel better.
  • Naproxen (e.g., Aleve):
    • Take 250-500 mg by mouth every 12 hours.
    • Use the lowest amount that makes your pain feel better.


Extra Notes:
Acetaminophen is thought to be safer than ibuprofen or naproxen in people over 65 years old. Acetaminophen is in many OTC and prescription medicines. It might be in more than one medicine that you are taking. You need to be careful and not take an overdose. An acetaminophen overdose can hurt the liver.

Caution: Do not take acetaminophen if you have liver disease.

Caution: Do not take ibuprofen or naproxen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of medicine. Do not take ibuprofen or naproxen for more than 7 days without consulting your doctor.

Before taking any medicine, read all the instructions on the package


Prevention:

  • The only way to prevent future backaches is to keep your back muscles in excellent physical condition.
  • A sedentary lifestyle (lack of exercise) is a risk factor for developing back pain.
  • Walking, stationary biking, and swimming provide good aerobic conditioning as well as exercise for your back.
  • Being overweight puts more weight on the spine and thus increases the risk of back pain. If you are overweight, work with your doctor to develop a weight-loss program.


Good Body Mechanics:

  • Lifting: Stand close to the object to be lifted. Keep your back straight and lift by bending your legs. Ask for lifting help if needed.
  • Sleeping: Sleep on a firm mattress.
  • Sitting: Avoid sitting for long periods of time without a break. Avoid slouching. Place a pillow or towel behind your lower back for support.
  • Posture: Maintain good posture.


Strengthening Exercises:

During the first couple days after an injury, strengthening exercises should be avoided. The following exercises can help strengthen the back. Perform the following exercises 3-10 times each day, for 5-10 seconds each time.

  • Bent knee sit-ups: Lay on back, curl forward lifting shoulders about 6 inches (15 cm) off the floor.
  • Leg lifts: Lay on back, lift foot 6 inches off floor (one leg at a time).
  • Pelvic tilt: Lay on back with knees bent, push lower back against floor.
  • Chest lift: Lie face down on ground, place arms by your sides, lift shoulders off the floor.


Call Your Doctor If:

  • Numbness or weakness occur
  • Bowel/bladder problems occur
  • Pain persists for more than 2 weeks
  • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.

See All Treatments

Symptoms and Screenings for Back Pain

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Causes and Preventions for Back Pain

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Education and Resources for Back Pain

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Support groups for Back Pain

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