Your back covers the area from below the neck to the tailbone. It includes the bones of the spine (vertebrae),
the joints that guide the direction of the movement of the spine, the discs that separate the bones of the
spine and absorb shock as you move, and the muscles and ligaments that hold them all together. One or more of
these structures can be injured.
Back injuries are a common cause of back pain, such as:
Strain or sprain of the ligaments or muscles from sudden or improper movement or by overuse. Symptoms can
include pain, muscle spasms, and stiffness. This type of injury accounts for 80% of back pain. The majority
of pain often goes away within 4 weeks without any treatment. Home treatment can help speed healing, relieve
pain, and prevent re-injury. Some factors may increase your risk for back pain and injury. Damage to discs so
that they tear, stretch, or rupture. If the tear is large enough, the jelly-like material inside the disc may
leak out and press against a nerve. Shooting pain, tingling, or numbness may be felt in the low back, in the
buttock, or down one leg (sciatica). The muscles controlled by the compressed nerve may become weak.
Fracture of the spine may occur from an injury, such as a car accident, a fall from a high place, a direct
blow to the back, a blow to the top of the head, or a fall onto the buttock.
Injury is not the only cause of back pain. Back pain can be a symptom of other
health problems, such as:
Diseases that affect the spine. The spine can be worn or weakened by diseases such as arthritis, osteoporosis,
or Paget's disease. These diseases are more common in older adults. In rare cases, tumors or infections in or
around the spine can cause pain. Medical conditions can cause pain to spread to the back from other parts of
the body. Many health problems that can cause back pain have nothing to do with the bones, joints, muscles,
or ligaments of the back.
Immediately after an injury and for the next few days, try home treatment to relieve your symptoms.
For a Tailbone Injury:
Apply ice or a cold pack to the tailbone area for 15 to 20 minutes, 3 to 4 times a day, for the first 24 to 48
hours. Cold decreases inflammation, swelling, and pain. A warm sitz bath for 20 minutes, 3 to 4 times per day,
after the first 24 to 48 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 the tailbone. Avoid slumping posture or sitting
on hard surfaces. Consider using a doughnut-shaped pillow to take pressure off the tailbone area. Avoid
constipation, as straining to have a bowel movement increases tailbone pain.
For a Back Injury:
Get in a comfortable position and apply ice or a cold pack to the injured area. Apply cold packs or ice for 15
to 20 minutes, 3 to 4 times a day, or up to once an hour for at least the first 3 days. Cold decreases
inflammation, swelling, and pain. Sit or lie in positions that are most comfortable and reduce your pain,
especially any leg pain. Do not sit up in bed and avoid soft couches and twisted positions. Avoid positions
that make your symptoms worse, such as sitting for long periods of time.
Bed rest can help relieve back pain but may not speed healing. Unless you have severe leg pain, it is probably
best to try to continue with your usual daily activities. If any activity makes your pain worse, modify it or
avoid it altogether. If you have difficulty sleeping at night, try one of the following positions:
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. Take aspirin, ibuprofen (such as Advil), or naproxen
sodium (such as Aleve) regularly as directed. Check with Lynne Carr Columbus, D.O. if you've been told to avoid
anti-inflammatory medications. Acetaminophen may also be used. Take these medications sensibly and follow
the directions on the bottle. The maximum recommended dose will reduce the pain. Masking the pain completely
might allow movement that could lead to reinjury. Do not give aspirin to anyone under the age of 20. Take short
walks (3 to 5 minutes every 3 hours) on level surfaces (no inclines) as soon as you can to help keep your
muscles strong. Walk only distances that you can manage without pain, especially leg pain.
Relax your muscles. Gentle massage can relax and soothe painful muscles.
After 2 to 3 days of Home Treatment:
Continue daily walks (increase to 5 to 10 minutes 3 to 4 times a day) and the exercises above. Try swimming, which is good for your back. It may be painful immediately after a back injury, but lap swimming or kicking with swim fins is often helpful to prevent back pain from
recurring. Begin easy exercises that do not increase your pain as soon as your pain has improved. One or two of the exercises in the Prevention section may be helpful. Start with 5 repetitions twice a day and increase to 10 repetitions as you are able.
Symptoms to Watch for During Home Treatment
If one or more of the following symptoms occur during home treatment, contact Lynne Carr Columbus, D.O. immediately:
Weakness or numbness in the legs
Loss of bowel or bladder control
Back pain worsening or not better after 1 to 2 weeks
Prevention of Future Back Pain
The frequency of back pain has increased dramatically in all developed countries. The more time we spend
sitting at desks, in cars, or in front of the TV, the more we must do to prevent back pain. Good posture and
body mechanics will reduce the stress on your back. Exercise (stretching, strengthening, and aerobic exercise)
will help maintain your flexibility, strengthen the muscles that support your spine, and maintain your overall
fitness. Maintaining an ideal body weight also reduces the load on your lower back.
Exercises to prevent back pain
The exercises below and general aerobic exercise (such as walking, swimming, cycling) are important to prevent
back injury and pain. They will also speed your recovery from injuries and decrease chronic pain.