Once you have had low back pain, you are likely to have it again. To help keep your back healthy and avoid further pain:

• Practice good posture when you sit, stand, and walk.
• Get regular, low-impact exercise. Walk, swim, or ride a stationary bike. Stretch before you exercise.
• Wear low-heeled shoes with good support.
• Sleep on your side. A medium-firm mattress may be easiest on your back.
• Watch your weight. Being too heavy, especially around your waist, puts extra stress on your back.
• Don’t try to lift things that are too heavy for you. When you must lift, bend your knees and keep your back straight, keep the object you are lifting close to your belly button, and avoid lifting and twisting at the same time.

If you sit or stand for long periods at work:

• Pay attention to your posture. Sit or stand up straight, with your shoulders back.
• Make sure your chair has good back support.
• Take regular breaks to walk around.

If your work involves a lot of bending, reaching, or lifting:

• Talk to your human resources department to see if there are other ways you can do your work.
• Don’t depend on a “back belt” to protect your back. Studies have not shown these belts to be effective in reducing back injuries. The most they can do is to help remind you to use good techniques for lifting.

Welcome

Most low back pain will improve with the following treatment:

• Apply ice for the first 2 or 3 days after you hurt your back, then switch to heat. Use an ice pack for 5 to 15 minutes every 2 or 3 hours. After a couple of days, use a heating pad or take a hot shower for 15 to 20 minutes every 2 or 3 hours.
• Take over-the-counter pain medicine, such as acetaminophen or an anti-inflammatory drug such as aspirin or ibuprofen. These medicines usually work best if you take them on a regular schedule instead of waiting until the pain is severe.
• For the first day or two, rest in a comfortable position . Try lying on your side with a pillow between your knees. Or lie on your back on the floor with a pillow under your knees.
• As soon as possible, get back to your normal activities. Staying in bed for more than 1 or 2 days can weaken your muscles and make the problem worse.

Walking is the simplest and maybe the best exercise for the lower back. It gets your blood moving and helps your muscles stay strong. Start with easy walks of 5 to 10 minutes a day, and gradually increase your time. Walking in water up to your waist or chest is also good exercise.

Some people get relief from pain by using treatments such as massage, chiropractic, or acupuncture. Certain treatments work for some people but not for others. You may need to try different things to see which work best for you.

Only a few people with low back pain need surgery. Surgery may help if you have a herniated disc or back pain along with symptoms of nerve damage, such as numbness in your legs. Even in these cases, most people will improve without surgery. Having surgery does not guarantee that all your pain will go away. Before you have surgery, it is a good idea to get a second opinion.

In 2004, the most recent year statistics are available, almost 15,000 people 65 and older died from falls and about 1.9 million were treated for injuries in emergency rooms, said Judy Stevens, an epidemiologist with the Centers for Disease Control and Prevention.

“I think the magnitude of the problem is something that people don’t recognize,” Stevens said. “It really is a serious issue for older adults.”

Making sure that people over the age of 65 know how to avoid falling or being injured by a fall is the goal of a campaign launched this month by the National Athletic Trainers’ Association and American Academy of Orthopaedic Surgeons.

The organizations say in addition to exercise, older people can make their homes safer by installing night lights, bathroom grab bars and slip- resistant floors.

“If we continue to exercise, especially strength training, we decrease the loss of bone density. Just by working on strength training, you’re working your muscles to keep strong,” said Joe Scott, a NATA member who is outpatient orthopedic team leader for Southcoast Hospitals Group in New Bedford, Mass.
Scott said that as people get older, they’re less active so they lose strength. Also, sight and balance problems can creep in.

Stevens also said it’s a good idea for older people to have a doctor review their medicines each year to look for things like drug interactions that could lead to dizziness.

Experts say certain exercises — yoga, tai chi, and trying to balance on one leg with your eyes closed — can help improve balance.

If a younger person slips, they’ll usually catch themselves, but older people often have less strength and slower reaction times, experts say.

Injuries from falls in the elderly can include broken wrists, elbows, arms and hips, said Dr. Jay Mabrey, chief of orthopedics at Baylor University Medical Center in Dallas.

Low back pain can affect the back anywhere below the ribs and above the legs. The lower back is the connection between the upper and lower body, and it bears most of the body’s weight. Because of these roles, it is easily injured when you lift, reach, or twist.

Almost everyone has low back pain at one time or another. The good news is that most low back pain will go away in a few weeks with some basic self-care. But if your pain is severe or lasts more than a couple of weeks, see your doctor.

Low back pain is often caused by overuse, strain, or injury. For instance, people often hurt their backs playing sports or working in the yard, being jolted in a car accident, or lifting something too heavy. It is more likely to become long-lasting (chronic) if you are under stress or depressed.

Depending on the cause, low back pain can cause a range of symptoms. It may:

• Be dull, burning, or sharp.
• Be felt at a single point or over a broad area.
• Come on gradually or suddenly.
• Occur with muscle spasms or stiffness.
• Cause leg symptoms, such as pain, numbness, or tingling, often extending below the knee. These symptoms can occur on their own or along with low back pain. Leg symptoms are often caused by lower spine problems that place pressure on a nerve that leads to the leg.

A rare but serious problem called cauda equina syndrome can occur if the nerves at the end of the spinal cord are squeezed. Seek emergency treatment if you have weakness or numbness in both legs, along with loss of bladder or bowel control.

Doctors say back pain is:

• Acute if a spell (or episode) of pain lasts less than 3 months. Most back pain is acute and goes away with 4 to 6 weeks of home treatment.
• Recurrent if acute symptoms come back. Most people have at least one episode of recurrent low back pain.
• Chronic if your back bothers you most of the time for longer than 3 months.