Low back pain is one of the most common and debilitating health conditions in the United States, making millions of people unable to work or enjoy everyday activities.
Back pain is also the third most common reason people visit their doctor, according to the American Chiropractic Association, and in many cases, that’s a wise move.
If you’re not sure about the severity of your back pain, you’ve had pain for more than a month, your pain is worsening over time, or you’re developing new neurologic symptoms such as numbness or weakness in any part of your body, it is best to see your healthcare professional.
A doctor or physical therapist can sometimes detect certain patterns that are causing or contributing to the pain, says Ian Stephens, a physical therapist at the Cleveland Clinic in Ohio. “Sometimes we can identify a theme in certain tasks, postures, or positions that consistently flare up a person’s symptoms. If we find that, we can help them to modify it to reduce the likelihood of experiencing back pain,” he says.
The good news is that “even though it can be very painful, back pain isn’t usually cause for alarm — most people will experience it at some point in their lifetime,” says Stephens. Most of the time, the pain resolves, and the person returns to normal pursuits, he notes. “If back pain happens, try not to fear it and continue to try to function despite it,” he says.
Whether you choose to seek out a healthcare professional, there are things you can do at home to relieve back pain and help reduce the chance of it happening again. Here are some tips on dealing with lower back pain.
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Ergonomics: Set Yourself Up for Success
“The modern workplace often requires a lot of sustained static loading, particularly in sitting,” says Stephens. Sustained static load is a scientific way of describing gravity, he says.
“Throughout the day, the force of gravity is compressing us a little bit; all day long our muscles have to push back up against gravity to maintain that verticality. When we’re in one position for a long time, we’re going to rely on that specific muscle group, and at some point, those muscles will start to fatigue,” says Stephens.
Ergonomics is the science of arranging your workspace or the things you use in daily life to fit your needs and body, thereby making you more efficient and reducing discomfort.
Even though the ideal posture can be different for different people, there are some basic ergonomic principles that generally apply to everyone, says Stephens. “There are strategies to assist you so that you don’t have to fight gravity with just your muscles,” he says.
Stephens offers a few tips on how to work or sit in a way that may help reduce back pain:
- Make sure you’re sitting deep enough in your chair so that your back can be supported by the back of the chair.
- Your chair should be low enough to the ground so that you can rest your feet comfortably on the ground, but not so low that your knees are higher than your hips.
- Set your computer monitor at eye level so that you aren’t slumping to get your gaze in line with your screen.
- Your forearms should be well supported on the armrests of the workstation and the armrests raised high enough that you can rest your elbows on them comfortably.
Take Breaks to Change Your Position
Stephens recommends getting up to walk around for a couple of minutes every 30 minutes, or if that’s not possible, every hour.
“Simple movement and change of position can be helpful. It helps to set a reminder on your phone or desktop calendar that reminds you,” he says.
Sleep Is Good Medicine for Back Pain
Many studies have shown the connection between sleep and pain, including one published in August 2015 in Pain that showed that sleep problems significantly increase the risk for reduced pain tolerance.
There’s no one right way to sleep, says Stephens. “For some people it might be great to lie on their stomach, whereas other people might do much better on their back with a pillow under their knees,” he says. If you think your sleeping position is causing you back pain, you may want to try another position or consult a healthcare professional, he says.
“No matter what your sleep position, it’s important that you’re able to achieve some form of restorative sleep. We know that if you’re not sleeping well, it’s hard to feel better, because sleep is when the body is really actively recharging the batteries. If you can’t do that, you’re going to be predisposed to pain,” says Stephens.
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Exercise and Movement Can Prevent and Help Relieve Back Pain
“In my experience, people who tend to move more often throughout the day tend to experience less frequent episodes of back pain and often less intense back pain,” says Stephens. However, this rule may not apply to people who have more physically demanding jobs that require a lot of lifting, he notes.
“Generally, most types of physical activity are somewhat protective in terms of the likelihood of developing back pain and also the prognosis. If someone is habitually physically active, that seems to have some preventive benefit, and if back pain occurs, it helps someone get through it faster,” says Stephens.
What kinds of exercise are good for back pain? According to Stephens, all types are good. “For a large percentage of people, that could be something as simple as walking daily,” he says.
A study published in October 2017 in the Annals of Rehabilitation Medicine looked at the walking habits of 5,982 people age 50 and older, 26 percent of whom reported experiencing lower back pain. Investigators found that the people who walked the most (the top quartile) were the least likely to experience back pain.
Whether a person will benefit from specific strengthening exercises for their back depends on the person and the back pain, says Stephens. Check with a physical therapist or your doctor before you begin any new exercise routine, he advises.
The expression “start low and go slow” applies when starting a new exercise, says Stephens. “Your body has to adjust to that new movement. The first few times you do an exercise, you’re likely to experience some soreness and pains that you didn’t have before,” he says. The majority of the time, those feelings are transient and will subside once your body gets used to that new activity, he adds.
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Temporary Pain Relief: Ice, Heat, or Both?
Heat and ice both have a place in temporarily relieving back pain, says Stephens. “They’re both going to help calm down that pain signal and help relax the nervous system a little bit,” he says.
“Normally, with most injuries, we would counsel ice early on during the acute phase of the injury,” he says.
As a general recommendation, ice the painful area with a frozen wet towel or an ice pack — keeping a towel or other cloth between your skin and the cold pack to protect your skin — at least three times a day. Don’t apply ice for longer than 15 to 20 minutes at a time.
“After a couple weeks, we would transition to using a heating agent,” says Stephens. “There is some research that suggests that moist heat during acute low back pain can be a useful adjunct to exercise and other interventions,” he says.
Stretching and Foam Rollers May Improve Back Pain
“If the primary issue causing back pain was limited motion and stiffness, it’s likely that I would prescribe some stretching exercises,” says Stephens. These could be done with a therapist or independently at home, he says.
“Foam rollers can sometimes be helpful in relaxing a tight muscle, but it can be difficult to access the right spot with lower back pain if you’re trying to do it on your own,” he says.
Maintaining a Healthy Weight Can Help Reduce Back Pain
“If you’re at a healthy weight, your muscles don’t have to work as hard to support you against gravity. The muscles won’t fatigue as quickly, and that would be helpful with pain,” says Stephens. There’s also less pressure on your back and other joints, he adds.
A meta-analysis of 33 studies published in the American Journal of Epidemiology examined the association between overweight and obesity and low back pain, and found that both conditions increased the risk for low back pain.
RELATED: Healthy Weight and BMI Calculator Chart for Adult Men and Women
Check With Your Doctor About Over-the-Counter Medications
Stephens recommends that people with back pain reach out to their primary care physician to discuss how to safely take NSAID (nonsteroidal anti-inflammatory) medications such as ibuprofen (Advil, Motrin) or naproxen (Aleve) to relieve back pain.
“We’re very aware of some of the long-term health risks associated with excessive use of NSAIDs. They have a place when it comes to helping manage pain, but a patient needs to follow the advice of their doctor to minimize any negative effects of that medication,” says Stephens.
NSAID use can increase the risk for severe or life-threatening gastrointestinal bleeding and ulcers in some people, and taking too much of these drugs can also lead to liver or kidney injury or failure.
Address Back Pain Sooner, Not Later
If you have tried adaptations such as improving your work setup or adjusting your posture and don’t have any improvement in pain within two to four weeks, you may want to seek a formal consultation with a healthcare provider or physical therapist, says Stephens.
“It’s not a good idea to live with pain too long; physical therapists can usually be of more help if you come earlier in your pain episode,” he says.
In the past, many doctors recommended bed rest for back pain, but that’s no longer thought to be a good solution, says Stephens. “We’re pretty sure that doesn’t help you get through an episode of low back pain any faster or end up with a better result,” he says.
“There’s nothing wrong with taking it easy for a day or two, but that’s really the most that someone should be following any type of bed rest. After that, they need to try to introduce movement, because that’s so important in helping tissue heal,” says Stephens.