Back Pain - Treating Backache

Maybe you lifted something heavy or swung a golf club a little too enthusiastically. Or maybe you’ve been sitting in an uncomfortable desk chair for two weeks, sweating over a deadline. Whatever the reason, now you’re flat on your back, wishing for something-any thing­that will put an end to the agony.

Take heart-you’re not alone. Almost every American suffers from back pain at some point in his or her life. The bad news is that unless you have a major injury or disc problem, your doctor may not be able to do much for you other than prescribe some pain medication and advise you to rest. The good news is that by following some simple steps, you can be on your feet again in just a few days. Even better, you can avoid having to endure similar discomfort in the future.

Easing the Pain

The following remedies are appropriate for anyone who is suffering from back pain as a result of tight, aching muscles or a strain. However, if you are experiencing pain, weakness, or numbness in the legs or a loss of bowel or bladder control, see a doctor without delay.

Go to bed. “Bed rest is a way of removing the strain from the muscles,” says Daniel S. J. Choy, M.D., director of the Laser Laboratory at St. Luke’s-Roosevelt Hospital Center and an assistant clinical professor of medicine at Columbia University College of Physicians and Surgeons in New York. “The back muscles’ job is to hold you erect. If you lie down, it takes the stress off of the muscles.” The best way to lie is flat on your back with two pillows underneath your knees. Never lie facedown, Choy says, since this position forces you to twist your head to breathe and may cause neck pain. Make an effort to get up and start moving around after three days, since longer periods of bed rest may make the muscles weaker and more prone to strain, he adds.

Ice it. Applying an ice pack to the painful area within 24 hours of the injury can help keep inflammation and discomfort to a minimum, according to Willi bald Nagler, M.D., Anne and Jerome Fisher Physiatrist-in-Chief and chairman of the Department of Rehabilitation Medicine at The New York Hospital-Cornell Medical Center in New York. “Ice does one thing-it decreases the nerve’s ability to conduct a painful stimulus,” he says. Nagler suggests wrapping ice cubes in a plastic bag, then applying the bag on top of a thin towel that has been placed on the skin. Leave the ice pack on for 20 minutes, take it off for 30 minutes, then replace it for another 20 minutes, he says.

Take a hot bath. If more than 24 hours have passed since the injury occurred, ice will not help reduce pain or inflammation. After that time, heat may help increase the elasticity of the muscles by about ten percent, Nagler says. Jerold Lancourt, M.D., an orthopedic surgeon at North Dallas Orthopedics & Rehabilitation, P.A., in Dallas, tells his patients to soak in a hot bath for 20 minutes or more. Pregnant women, however, should not sit in a hot bath for too long, since raising the body temperature over 100 degrees Fahrenheit for long periods may cause birth defects or miscarriage.

Invest in a new mattress. A soft, sagging mattress may contribute to the development of back problems or worsen an existing problem, according to Henry 1. Bienert, Jr., M.D., an orthopedic surgeon at Tulane University School of Medicine in New Orleans. If a new mattress is not in your budget, however, a three-quarter-inch-thick piece 36 of plywood placed between the mattress and box spring may help somewhat. “The verdict’s not back yet on water beds,” he adds. In any case, try to sleep on your back with two pillows underneath your knees.

Get a massage. If you’re lucky enough to have an accommodating spouse, friend, or roommate, ask him or her to give you a rubdown. “Lie face-down and have someone knead the muscles,” Choy says. Local massage therapists may also make house calls. You can check the yellow pages for listings or ask a friend for a referral.

Relax. Much back pain is the result of muscles made tight by emotional tension, Lancourt says. He recommends that his patients practice relaxation and deep-breathing exercises, such as closing their eyes, breathing deeply, and counting backward from 100.

Take two aspirin. Taking an over-the-counter analgesic such as aspirin, acetaminophen, or ibuprofen may help relieve your pain. However, be aware that not all medications-not even nonprescription ones-are for everyone. Pregnant women, for example, should not take any medication without first checking with their doctor. And people with ulcers should stay away from analgesics containing aspirin, according to Lancourt. “Any medicine should be taken with knowledge of its side effects,” he says. “Make sure to get the advice of your doctor.”

Preventing Future Pain

Many of the activities you engage in each day­sitting, lifting, bending, carrying-can put a strain on your back. By learning new ways of going about these activities, you can help prevent back pain and ensure the health of your back for years to come. The tips that follow can help.

Put your arm behind your back. If you have to sit for long periods in a chair that doesn’t support your lower back and you don’t have a cushion, try rolling up a towel or sweater so that it has about the same circumference as your forearm. Then slide the rolled-up cloth between your lower back and the chair, recommends Billy Glisan, M.S., an exercise physiologist and the director of injury prevention programs for the Texas Back Institute in Dallas. In a pinch, you can simply slide your forearm between your lower back and the back of the chair to ease the strain on your back. Even with the best back support, however, sitting is still stressful on your back, so try to make small adjustments in the curvature of your lower back every few minutes or so, advises Glisan.

Use a cushion. “The seats of most cars and trucks are not well designed,” Choy says. They should support the small of your back.” If your seat doesn’t, Choy suggests that you buy a small cushion that can be fitted to provide the missing support. He adds that the most desirable sitting position is not one in which your back is straight up and down. It’s better to be leaning back at an angle of about 110 degrees. If you sit for long hours, Choy also recommends that you periodically get up and walk around.

Swim. Swimming is the best aerobic exercise for a bad back, according to Choy. Doing laps in the pool can help tone and tighten the muscles of the back and abdomen. Walking is second best, he says. You can also try the “Back-Saving Exercises.”

Lift with your knees bent. The large muscles of your legs and buttocks are better equipped to bear heavy weights than your back muscles are, according to Bienert. “Pretend you have a goldfish bowl filled with water on the top of your head,” he says. “When you squat down to pick something up, don’t spill a drop.” Bienert also recommends strengthening leg and buttock muscles to facilitate squatting.

Carry objects close to your body. When picking up and carrying heavy objects, pull in your elbows and hold the object close to your body, Choy recommends. “If you have to reach something on a shelf, get right under it and rest it on your head,” he says. “Then, the weight is carried by the erect spine, and you don’t ask as much of your muscles.”

Stay alert. Careless activity is the number-one cause of back injury, according to Lancourt. “If you have had previous back pain, be very careful,” he says. “Avoid bending and twisting and lifting. Avoid being caught off guard. Sometimes it’s better to hire somebody to do things, such as yard work or carrying heavy suitcases, than to hurt yourself and miss three months of work.”

Watch your weight. Maintaining your ideal weight may help take the strain off the back muscles, according to Bienert. “The less you have to carry, the less load you have,” he says. “Secondly, when you gain weight in your abdomen, you may become sway-backed, which can accentuate back.”

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Filed under: Musculoskeletal Problems