Most backaches come from strained muscles or ligaments in the lower back. Other causes include back injuries such as a slipped or herniated disc, arthritis (see Arthritis), osteoporosis (see Osteoporosis), and urinary tract infections (see Urinary Tract Infections).
Treatment
Most backaches caused by strained muscles and ligaments can be treated with
self-care. (See Self-Care Tips below.) Other causes need a
medical evaluation and treatment specific to the problem. For example, surgery to repair a
herniated disk may be needed if other non-surgical measures don't bring relief.
The goals of treatment are to treat the cause of the backache, relieve the pain, promote healing, and avoid reinjury.
Prevention
Improper lifting causes a lot of backaches. Here are some lifting "dos
and don'ts" to help you avoid straining your back.
Dos
Wear good shoes with
low heels, not sandals or high heels.
Stand close to the thing you want to lift.
Plant your feet squarely, shoulder width
apart.
Bend at the knees, not at the waist. Keep
your knees bent as you lift.
Pull in your stomach and rear end. Keep
your back as straight as you can.
Hold the object close to your body.
Lift slowly. Let your legs carry the
weight.
Get help or use a dolly to move something
that is too big or very heavy..
Don'ts
Don't lift if your
back hurts.
Don't lift if you have a history of back
trouble.
Don't lift something that's too heavy.
Don't lift heavy things over your head.
Don't lift anything heavy if you're not
steady on your feet.
Don't bend at the waist to pick something
up.
Don't arch your back when you lift or
carry.
Don't lift too fast or with a jerk.
Don't twist your back when you are holding
something. Turn your whole body, from head to toe.
Don't lift something heavy with one hand
and something light with the other. Balance the load.
Don't try to lift one thing while you hold
something else. For example, don't try to pick up a child while you are holding a grocery
bag. Put the bag down, or lift the bag and the child at the same time.
Is the back pain extreme and felt across the upper back
(not just on one side) and did it come on suddenly (within about 15 minutes) with no
apparent reason such as an injury or back strain? {Note:
These may be symptoms of a dissecting aortic aneurysm.} |
 |
| Did the back pain start inside your chest and move to the upper
back? {Note: You may be having a heart attack. The pain
may be dull and you may not feel it in the chest at all.} |
|
| Was the back pain sudden with a cracking sound? |
|
| Did the pain come after a recent fall, injury, or violent movement
to the back and are you having a hard time moving your arm or leg? Do you also have
numbness or tingling in your legs, feet, toes, arms, or hands and/or loss of bladder or
bowel control? |
|
| Did the pain come on all of a sudden after being in a wheelchair
or a long stay in bed, or are you over 60 years old? |
 |
| Is the pain severe (but not a result from a fall or injury to the
back), and has it lasted for more than 5-7 days or is there also a sense of weakness,
numbness or tingling in the feet or toes? |
|
| Does the pain travel down the leg(s) below the knee? |
|
| Does it hurt more when you move, cough, sneeze, lift, or strain?
Or, have you lost control of your bladder or bowel movements? |
|
Are any of the following also present? Pain, burning or itching when you
urinate Increased urge to urinate or urinating often Foul-smelling urine or blood in the urine Abdominal pain |
|
| Is the pain felt on one side of the small of your back, just above
your waist, and do you feel sick and have a fever of 101o F or higher? |
|
| Do you also have any of the following? Joint stiffness and pain Redness, heat, or swelling in affected
joints Cracking or grating sounds with joint
movement |
|
Relieve the Pain
Take an over-the-counter
medicine for pain. Acetaminophen will help with pain, but not with swelling. {Note:
See Pain relievers in "Your Home
Pharmacy".}
Don't "overdo it" after taking a
painkiller. You can hurt your back more, and then it will take longer to heal.
Activity
Continue your regular activities as much as you can. Rest the back if you
must, but don't rest in bed more than 2-3 days, even if your back hurts a lot. Your back
muscles can get weak if you don't use them or if you stay in bed longer than 3 days. Bed
rest should only be used for persons with severe limitations (due mostly to leg pain). Other
tips:
Get comfortable when you are lying,
standing, and sitting. For example, when you lie on your back, keep your upper back flat,
but your hips and knees bent. Keep your feet flat on the bed. Tip your hips down and up
until you find the best spot.
Put a pillow under your knees or lie on
your side with your knees bent. This will take pressure off your lower back.
When you get up from bed, move slowly, roll
on your side, and swing your legs to the floor. Push off the bed with your arms.
Cold Treatment
Cold helps with bruises and swelling. For the first 48 hours after back
symptoms start, apply a cold pack (or bag of ice) to the painful area. Lie on your back
with your knees bent, and put the cold pack under your lower back. Do this for 5-10
minutes at a time, several times a day.
Heat Treatment
Heat makes blood flow, which helps healing. But don't use heat on a back
strain until 48 or more hours after back symptoms start. Use cold treatment first (see
"Cold Treatment" above). If used sooner, heat can make the pain and swelling
worse. Use a moist heating pad, a hot-water bottle, hot compresses, a hot tub, hot baths,
or hot showers. Use heat for 10 minutes at a time. Do this several times a day. Be careful
not to burn yourself.
Massage
Massage won't cure a backache, but it can loosen tight muscles.
Braces or Corsets
Braces and corsets support your back and keep you from moving it too much.
They do what strong back muscles do, but they won't make your back stronger.
Spinal Manipulation
This treatment, done by a professional such as chiropractor or physical
therapist, uses the hands to apply force to "adjust" the spine. This can be
helpful for some people in the first month of low back symptoms.
Check with your doctor about spinal manipulations. You may need a referral from your doctor to see a professional who does this form of treatment.
More Tips
Try some mild stretching exercises
(in the morning and afternoon) to make your stomach and back muscles stronger. Ask your
doctor for his or her advice on exercising.
Don't sit in one place longer than you need
to. It strains your lower back.
Sleep on a firm mattress.
Never sleep on your stomach. Sleep on your
back or side, with your knees bent.
If your back pain is chronic or doesn't get
better on its own, see your doctor. He or she can evaluate your needs. Your doctor may
refer you to a chiropractor, physical therapist, or physiatrist (a physical therapy
doctor).
Sciatica
Sciatica is inflammation of the sciatic nerve, which starts in the lower
spine and goes down the back of the legs. Pressure on the nerve (from tight muscles,
herniated disk, etc.) causes a sharp pain that can be felt in the buttock and may extend
to the thigh, knee, or foot. To prevent sciatica:
Don't strain the muscles in your lower
back. (See the "Dos and Don'ts" under "Prevention".)
Do exercises to strengthen your stomach
muscles. These exercises help make your back stronger.
Treatment for mild sciatica is rest, heat and over-the-counter medicine for pain. Physical
therapy may be helpful. In some cases, surgery to repair a herniated disk may be needed.
HEALTH AT HOME - Your Complete Guide to Symptoms, Solutions, and Self-Care © 1999 by Don R. Powell. American Institute for Preventive Medicine.
Date updated 02/01/99