What can I do when my back hurts?

hi.  what can I do when my back hurts?  thanx.  penny


Greetings Penny,

Well you didn’t give me much to work with, did you, Penny?  Usually I try to provide several specific ideas and information about your back pain that might be helpful to your unique situation.  Because your question is so brief and non-specific I will have to give you some very general ideas to work with that will apply to many back pain problems, whether it is in the low back or upper back.

       Cool it.  This suggestion is listed first because it should be the first thing you do for your back when pain starts. Cold packs or a good old fashioned ice bag is your best friend immediately after an injury or aggravation of an old problem.  While some advise that cold is best applied during the first 24 to 48 hours after injury to reduce inflammation, I have another way to look at it that makes a lot of sense. My rule of thumb is that ice should be used whenever there is significant pain or limited movement due to swelling of an area – regardless of how long it started.   An injured area can stay in the acute state for a long time – certainly longer than 48 hours.  As long as the painful area feels and acts as bad as an acute I suggest to treat like it was an acute injury by resting, elevating and chilling the area; if it hurts like an acute injury, treat it like an acute injury.  Everyone likes the way heat feels on a painful area, but when acute pain is present it is best to meet it with rest, ice, compression and elevation.

       Stay active.   Immediately after the initial flare up of pain to any injured area of the spine it is effective to rest the area – usually this means staying flat and resting the back.  But as soon as the pain subsides and small or brief movement is tolerated it is best to keep the back moving.  Continue with all your usual daily activities that make sense for the current condition you are in.  On one hand try to not baby yourself, but on the other hand you must use good judgment to not reinjure the back while you trying to help yourself.  

        Stay limber.  Do your best to not sit very long, whether you must get up away from your desk or the television set or by pulling off the road while on a long car trip to walk around and stretch a bit.  Stretching every 20 minutes or so always feels good.  A good place to start is with hamstring stretches for back pain. In addition, make part of your daily back routine a few spinal stretches that target the area of your greatest problem.

        Get stronger.  Do not exercise during an acute back pain episode.  But as soon as your pain becomes mild you will accelerate your recovery and avert future back pain episodes by getting busy with a regular routine of strengthening spinal exercises and spinal stretches.  Your emphasis should be on that area of the back where you have experienced most problems in the past.  No matter where your problem is in the spine it is always a good idea to strengthen the core (spine, hip, pelvic, and abdominal) muscles.

        No or low heels.  Wear comfortable shoes that support your feet.  Avoid high heels and shoes with little arch support.  Shoes with a rigid sole tend to be better for most feet and better than overly soft and flexible soles.

       Watch your posture.  Stand tall with the chest lifted.  Keep your head balanced over the center of your body so that you do not slump.  Lift with the legs, not the back, while keeping the object you are lifting close to your body and your spine is held vertically.   

       Know and respect your limits.   Any time you lift or move an object, whether it is down at your feet or up above your head, any area of your back can be injured.  Lifting can be especially harmful to all parts of the back.  One critical factor that makes a lifting activity potentially harmful and determines if you might aggravate your back is the size of the load you will move.  No matter how big and strong you might be, everyone has limits.  When possible keep the size of the load you are handling within your limits.   If you can work within your reasonable range of weight limitation you are more likely to not injure yourself.  Statistics say that one in four Americans have recently had a back pain episode, and it is a rare person who does not experience at least one major bout of back pain their lifetime.  Sounds like a lot of people do not respect their limits.

       Lighten the load.   Diet and exercise maintain body weight in a healthy range.  Added body weight places excess stress on the spine and knees.  Knee problems lead to back pain because they are an unstable foundation for the back.   

       Fit your space.   Look at the place at home and at work where spend most of your time. Change whatever you can from an ergonomic standpoint so you and your environment work together with the least stress possible.  Look for ways to avoid unnecessary reaching, stretching, twisting, hunching, squinting, forward and backward bending, slouching, lifting and anything you do repeatedly that stresses your back.  

       Clear the air.  Nicotine from cigarette smoke destroys collagen and is the reason smokers have more lines and wrinkles on their face; the skin lacks the internal support of healthy collagen and so it sags and folds into wrinkles.  A lack of collagen also allows lung, brain, liver, kidney, bone and all other tissue from being healthy; this is one of the fundamental reasons that tobacco smokers have so many health problems.  Smoking can lead to the pain of spinal osteoporosis of the spine, as well as compression fractures of the spine.  Smokers experience three times more low back pain than non-smokers.

        OTC if needed.   Over-the counter anti-inflammatory drugs (aspirin, Advil, Motrin, Nuprin,  Aleve, Anaprox and Naprosyn) when used occasionally and with caution can help reduce back pain.  Acetaminophen (Tylenol, Actamin, Panadol) is another over-the-counter option for pain management. Overuse and dependence will lead to possible side-effects that reduce overall health but it will also reduce effectiveness because the tissue can acclimate to the chemical reaction of these drugs. Check with your pharmacist or doctor about possible drug interactions with medications you are taking currently.

Next time please give me a few details and perhaps I can offer a few ideas to you.  DL