Most people will have a minor
back problem at one time or another. Our body movements usually do not cause
problems, but it's not surprising that symptoms develop from everyday wear and
tear, overuse, or injury. Back problems and injuries often occur during sports
or recreational activities, work-related tasks, or home projects.
Back pain can cause problems anywhere from the neck to the
tailbone (coccyx). The back includes:
discs that separate the vertebrae and absorb shock as
The muscles and
ligaments that hold the spine together.
Back injuries are the most common cause of back pain.
Injuries frequently occur when you use your back muscles in activities that you
do not do very often, such as lifting a heavy object or doing yard work. Minor
injuries also may occur from tripping, falling a short distance, or excessive
twisting of the spine. Severe back injuries may result from car accidents,
falls from significant heights, direct blows to the back or the top of the
head, a high-energy fall onto the buttocks, or a penetrating injury such as a
Although back pain is often caused by an injury to one
or more of the structures of the back, it may have another cause. Some people
are more likely to develop back pain than others.
Things that increase your risk for back pain and
injury include getting older, having a family history of back pain, sitting for
long periods, lifting or pulling heavy objects, and having a degenerative
disease such as
Low back pain may occur in
children and teenagers, but children and teens are
less likely to see a doctor for low back pain. Although most back problems
occur in adults ages 20 to 50, back problems in
children younger than 20 and adults older than 50 are more
likely to have a serious cause.
Sudden (acute) injuries
Pain from an injury may be
sudden and severe. Bruising and swelling may develop soon after the injury.
Pain from an acute injury usually does not last longer than 6 weeks. Acute
An injury to the ligaments or muscles in the
back, such as a
sprain or a
A fracture or dislocation of the
spine. This can cause a spinal cord injury that may lead to permanent
paralysis. It is important to immobilize and transport the injured person
correctly to reduce the risk of permanent paralysis.
A torn or
ruptured disc. If the tear is large enough, the jellylike material inside the
disc may leak out (herniate) and press against a nerve. See a picture of a
You may not remember a specific injury,
especially if your symptoms began gradually or during everyday activities.
These injuries occur most often from improper movement or posture while
lifting, standing, walking, or sitting, or even while
sleeping. Symptoms can include pain, muscle spasms,
and stiffness. The pain often goes away within 4 weeks without any
Conditions that may cause back problems
Back pain or problems
may not be related to an injury.
medical conditions can cause pain to spread to the
back from other parts of the body (referred pain). Many health problems that
can cause back pain have nothing to do with the bones, joints, muscles, or
ligaments of the back.
Chronic pain syndrome caused by a previous injury or
degenerative disease with aging can cause back pain.
Most back pain will get better and go away
by itself in 1 to 4 weeks. Home treatment will often help relieve back pain
that is caused by minor injuries. It is usually a good idea to continue your
regular activities while your back is healing. Avoid heavy lifting and
activities that seem to make your back problems worse.
treatments for a back problem or injury may include first aid measures,
physical therapy, manipulative therapy (such as chiropractic), medicine, and in
some cases, surgery. Treatment depends on:
The location, type, and severity of the
Your age, health condition, and activities (such as work,
sports, or hobbies).
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Home treatment may help relieve
pain, swelling, and stiffness related to a back problem.
Return to your normal daily activities and work
as soon as you can, although you may need to modify or limit some work
Avoid bed rest. Bed rest is not an effective treatment for
back pain and may cause you to heal more slowly.
ice or cold pack to the injured area for the first 48 to 72 hours. Apply
cold packs or ice for 15 to 20 minutes, 3 to 4 times a day or up to once an
hour. Cold decreases swelling and pain. Keep a towel between your skin and the
ice to prevent
frostbite. Do not fall asleep with the ice on your
Change position every 30 minutes. Gently massage or rub the
area to relieve pain and encourage blood flow. Do not massage the injured area
if it causes pain.
For the first 48 hours after an injury, avoid
things that might increase swelling, such as hot showers, hot tubs, hot packs,
or alcoholic beverages.
After 48 to 72 hours, if swelling is gone,
heat. Use a warm pack or heating pad set on low. Some
experts recommend switching back and forth between heat and cold treatments.
You can also begin
gentle exercise with the aid of moist heat to help
restore and maintain flexibility.
Avoid sitting up in bed, sitting
on soft couches, and twisting or sitting in other positions that make your
Try one of the following
sleep positions if you have trouble sleeping at night:
Lie on your back with your knees bent and
supported by large pillows, or lie on the floor with your legs on the seat of a
sofa or chair.
Lie on your side with your knees and hips bent and a
pillow between your legs.
Lie on your stomach if it does not
increase your pain.
Begin moderate aerobic exercise. Take short walks
(3 to 5 minutes every 3 hours) on level surfaces as soon as you can to help
keep your muscles strong. Avoid hills and stairs. Walk only distances that you
can manage without pain, especially pain in your legs. Add to your exercise
program every week to continue your progress.
Do pelvic tilt
exercises to gently move the spine and stretch the lower back. Lie on your back
with your knees bent and feet flat on the floor. Slowly tighten your stomach
muscles and press your lower back against the floor. Hold the position for 10
seconds. Do not hold your breath. Slowly relax.
More home treatment for a tailbone (coccyx) injury
sitz bath for 20 minutes, 3 to 4 times per day after
the first 48 to 72 hours, can be soothing to the tailbone area. Sitting in a
hot tub or warm bath may also feel good, as long as you are not sitting
directly on your tailbone.
Do not sit on hard, unpadded
Sit on a C-shaped pillow with the open space under your tailbone to take pressure off the
Avoid constipation. Straining to have a bowel
movement will increase tailbone pain. For more information, see the topic
Constipation, Age 12 and Older.
Do not smoke. Smoking slows healing because it decreases
blood supply and delays tissue repair. For more information, see the topic
Medicine you can buy without a prescription
Try a nonprescription
medicine to help treat your fever or pain:
Aspirin (also a nonsteroidal
anti-inflammatory drug), such as Bayer or Bufferin
Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine.
Be sure to follow these
safety tips when you use a nonprescription medicine:
Carefully read and follow all directions
on the medicine bottle and box.
Back pain often gets better when you gradually increase
your physical activity. Try to get back to your normal routines and activities
as soon as possible. Resting and not doing anything may actually increase back
pain or make it last longer.
There is no clear evidence that you can
back pain. But there are some things you can do that may help prevent it. And they can prepare you for faster recovery if you
do have back pain.
Exercise to keep your back healthy and strong.
Exercise programs that include aerobic conditioning and strengthening exercises
can help keep low back pain from coming back. For more information, see
Pelvic Tilt Exercise.
Protect your back while sitting.
Standing posture is also important. For most people, good posture means that when you stand, your ears, shoulders, hips,
and knees should be in line with one another.
Try different sleeping positions that protect your back. If you sleep on your side, try putting
a pillow between your knees. If you sleep on your back, use a pillow under your
knees. You can also try rolling up a small towel and using it to support your
Stay at a healthy
weight to avoid excess strain on your lower back. For more information, see the
If you're a smoker,
quit. Smoking increases your risk of bone loss (osteoporosis)
and increases your sensitivity to pain. Smoking also interferes with blood
circulation by tightening the arteries, which makes it harder for blood to
flow, and by decreasing the amount of oxygen the red blood cells can carry.
Spinal discs don't have their own blood supply, but they receive nutrition in part
from the blood supply to the vertebral bones above and below them. Decreased
circulation may increase the speed of degeneration and/or slow the healing of
the discs. For more information on how to quit, see the topic
Some exercises actually increase
the chances of causing of low back pain. Avoid:
sit-ups during acute back pain (may be safe if back is kept in neutral
Leg lifts (lifting both legs while lying on your
Lifting heavy weights above the waist (military press or
biceps curls while standing).
Any stretching done while sitting
with the legs in a V position.
Toe touches while standing.
Work comfort and design
Most back problems that occur
in the workplace are caused by physical stress, such as being in an awkward
position for a long time, making the same motions over and over, and simply
using your back too much. These injuries can cause stress and strain on
muscles, nerves, tendons, joints, blood vessels, or spinal discs.
Arrange your work to help prevent work-related injuries. It is important
to position yourself so that you can sit comfortably and minimize stress on any
one area of your body. Change your positions and tasks as often as possible,
and match tools to your size and preferences. If you are doing a job or task
that requires you to sit for long periods, get up and stretch and move around
at least once an hour.
How this information was developed to help you make better health decisions.