That aching back: What helps, what harms

The standard treatment for back pain used to be bed rest and pain relievers.  Today, back specialists advise doing physical activity as soon as your pain and back condition allow. When you don’t move, you lose flexibility, strength and endurance.  Physical activity can reduce pain and help speed recovery.

  • Guidelines for treatment of new acute back pain include:
  • Apply ice for severe pain to reduce inflammation, for 10 minutes every hour for up to 3 days, and then less frequently until the inflammation subsides
  • You can then switch to heat to soothe strained muscles, or alternate heat with icing
  • You may take over-the-counter pain relievers, such as acetaminophen or ibuprofen, following the recommended daily dose
  • If new acute back pain doesn’t improve in 3 days, contact your physician

If are you receiving treatment for chronic back pain be sure to consult your health provider before becoming more active. Depending on your condition, you can start with gentle exercise, such as short walks, within two weeks after pain begins, then progress to more vigorous exercise–brisk walking, swimming or biking. Inactivity and prolonged sitting are major causes of back pain and can make it worse.  But it’s important not to do activities that strain your back.

Having a back problem is an opportunity to improve your habits and develop a healthier lifestyle.  Here are some actions you can take, and things to avoid that can reduce chronic back pain and promote good back health:


  • Improve your fitness–regular exercise tones your body and keeps it healthy.  You can start by doing 30 minutes of low-impact activities, such as walking, swimming or riding a stationary bike, preferably five days a week.  Make exercise part of your daily routine by walking instead of driving and taking stairs rather than elevators.
  • Stretch–before exercising and when you’ve been sitting for a while.  Stretching increases flexibility and helps to loosen tighten muscles that can stress the spine.
  • Strengthen your back–exercises that strengthen the muscles that support the spine–abdominal, back and side muscles–reduce pain and protect your back from injury.
  • Practice good posture–don’t slouch when standing or sitting.  Keeping your weight balanced on your feet keeps your back in alignment.
  • Maintain a healthy body weight–excess weight, especially around the waistline, taxes lower back muscles.  If you are overweight, regular exercise and good nutrition will help you shed pounds.
  • Eat foods that contain nutrients–calcium, phosphorus, vitamin D–that promote new bone growth.     Wear comfortable, low-heeled shoes
  • Sit in a comfortable chair with good lumbar support adjusted to the right height and position for your desk.  Place a pillow or rolled-up towel behind your back for added support.
  •  Use proper lifting techniques–plan how to position your body before lifting heavy objects.  Keep your upper body straight with your head aligned with your back and squat down.  Avoid bending forward directly.  Hold the object close to your body and don’t twist when lifting.
  • Find a mattress and pillow that are comfortable and support your back and neck.
  • Participate in social activities as long as they don’t strain your back.
  • Ask others for help–let family and friends help with everyday activities and do the “heavy lifting” while you heal and get stronger.
  • Keep a positive outlook–it will help you get back in action.



  • Avoid moving unless you are directed to do this by your doctor.
  • Participate in high-injury sports such as long-distance running, football, soccer, downhill skiing, diving.
  • Lift objects over three pounds or bend your back when lifting.
  • Twist your back
  • Stand for long periods of time
  • Sit for long periods of time–take frequent breaks to walk around your office and stretch
  • Take pain medications longer than needed to treat your pain, or in a way other than how they are prescribed.
  • Smoke–it reduces blood flow to the lower spine and causes spinal discs to degenerate.  If you do smoke, consider quitting or cutting back.
  • Carry large and/or heavy objects.
  •  Isolate yourself at home–getting out and being with others will lift your spirits and distract you from your pain.


Caudill, M.A. (2002). Managing Chronic Pain Before it Manages You (Revised Version). New York, NY. The Guilford Press.

Moore, J, Lorig, K, et. al. (1999). The Back Pain Helpbook. New York, NY: Perseus Books.

Sinel, M.S. & Deardorff, W.W. (1999). Back Pain Remedies for Dummies. New York, NY: Wiley Publishing.

Turk, D.C., Frits, W. (2005). The Pain Survival Guide: How to Reclaim Your Life. Washington, D.C.: American Psychological Association.