[{"@context":"https:\/\/schema.org\/","@type":"Article","@id":"https:\/\/share-dev.upmc.com\/2022\/02\/preventing-back-pain\/#Article","mainEntityOfPage":"https:\/\/share-dev.upmc.com\/2022\/02\/preventing-back-pain\/","headline":"Treating and Preventing Back Pain: What You Need to Know","name":"Treating and Preventing Back Pain: What You Need to Know","description":"Back pain is a common condition that may be prevented or managed. UPMC offers surgical and non-surgical treatment options for back pain.","datePublished":"2022-02-07","dateModified":"2024-01-04","author":{"@type":"Organization","@id":"https:\/\/www.upmc.com\/","name":"UPMC","url":"https:\/\/www.upmc.com\/","sameAs":"https:\/\/share-dev.upmc.com\/upmc\/","parentOrganization":"UPMC"},"publisher":{"@type":"Organization","name":"UPMC HealthBeat","logo":{"@type":"ImageObject","@id":"https:\/\/share-dev.upmc.com\/wp-content\/uploads\/2019\/04\/UPMC-HealthBeat-Logo.png","url":"https:\/\/share-dev.upmc.com\/wp-content\/uploads\/2019\/04\/UPMC-HealthBeat-Logo.png","width":600,"height":60}},"image":{"@type":"ImageObject","@id":"https:\/\/share-dev.upmc.com\/wp-content\/uploads\/2021\/07\/GettyImages-1138353899.jpg","url":"https:\/\/share-dev.upmc.com\/wp-content\/uploads\/2021\/07\/GettyImages-1138353899.jpg","height":325,"width":754},"url":"https:\/\/share-dev.upmc.com\/2022\/02\/preventing-back-pain\/","about":["Health Topics A-Z","New Here","Spine Health"],"wordCount":2288,"articleBody":"Eight out of 10 Americans will experience back pain at least once or more in their lifetimes. In fact, a third of people ages 18 to 29 already have back problems, while nearly half of those ages 65 and older do. And women are slightly more likely to experience back pain than men.Learn more about treating and preventing lower back pain.Types of Back PainBack pain is usually categorized by the area where you feel the pain. The most common type of back pain is in the lower back.Lower back painLower back\u00a0pain can happen anywhere below the ribs and above the legs. You can hurt your lower back when you lift, reach, or twist. In fact, almost everyone has low back pain at one time or another.Depending on the cause, low back pain can have a range of symptoms. The pain may be dull or sharp. It may be in one small area or over a broad area. You may have muscle spasms.Low back pain also can cause leg pain, numbness, or tingling, often extending below the knee.Seek emergency treatment if you have weakness or numbness in both legs or if you lose bladder or bowel control.Upper and middle back painUpper and middle back pain are less common because the bones in this area of the back don’t flex or move as much as the bones in your lower back or neck.Upper and middle back pain can occur anywhere from the base of your neck to the bottom of your rib cage. If a nerve in this area is pinched, irritated, or injured, you also may feel pain in other places where the nerve travels, including your arms, legs, chest, and belly.What Causes Back Pain?\u201cThe most common causes of occasional back pain include overuse, strain, or injury to the muscles, ligaments, and discs that support your spine,” says UPMC spine surgeon\u00a0Sheela Vivekanandan.\u201cFast movement, repetitive lifting, an awkward bend, or an attempt to lift something beyond your capabilities can cause pain. If you routinely lift and bend, repetitive stress on your lower back can trigger painful muscle spasms.”Dr. Vivekanandan says the main cause of back pain usually is years of weight gain and inactivity. \u201cBack pain is the result of years of strain on the body,” she says. \u201cThe spine is the last level of support for the rest of the body.”Additionally, if you’re spending hours at a computer each day \u2014 whether at the workplace or at home \u2014 poor posture and\u00a0ergonomics\u00a0(how your desk is set up) can lead to chronic back pain.Other common causes include:Arthritis.Compression fractures.Pressure on the\u00a0spinal nerves\u00a0from certain problems, such as a\u00a0herniated disc.Osteoarthritis\u00a0caused by the breakdown of\u00a0cartilage\u00a0that cushions the small\u00a0facet joints\u00a0in the spine.Myofascial pain\u00a0that affects the connective tissue of a muscle or group of muscles.In rare cases, pain may be caused by other problems, such as\u00a0gallbladder\u00a0disease, cancer, or an infection. Often, doctors don’t know what causes low back pain. About 90% of the time there is no clear cause.How Can I Reduce Back Pain at Home?Most low back pain will improve with conservative treatment you can do at home. Dr. Vivekanandan also recommends that you:Try to keep moving. Continue light activity, like walking. If your back hurts a lot, take a break. But try not to let too much time pass before you get moving again. Instead, return to activities slowly. Walking is perhaps the simplest and best exercise for the lower back. It gets your blood moving and helps your muscles stay strong.Try aqua therapy.\u00a0If land-based exercise is difficult, try moving in a warm pool. The reduced gravity of the water can help build more range of motion in your spine.Use over-the-counter pain medicines.\u00a0Nonsteroidal anti-inflammatory drugs\u00a0(NSAIDs) such as ibuprofen and naproxen seem to work best for low back pain. Be safe with medicines. Read and follow all instructions on the label.Use a heating pad or ice pack.\u00a0Heat can reduce pain and stiffness. Ice can help reduce pain and swelling. There is no rule about using\u00a0heat or ice for back pain. Try each to see which works best for you.Try a gentle yoga\/stretch class.\u00a0Slow, deliberate movement and stretching can build core strength and increase flexibility.Try chiropractic care but avoid any sudden repositioning or snapping of the back or neck.\u00a0Chiropractic can relieve pain, but request that they not adjust your back or neck abruptly.Try acupuncture.\u00a0Research shows that many people find relief of muscle spasms and back pain with this Eastern medicine practice which uses strategically placed needles to treat pain. A qualified, well-trained professional can provide safe treatment.Try manual therapy.\u00a0Manual therapy is a general term for treatment performed mostly with the hands, including massage, mobilization, and manipulation. The goals of manual therapy include relaxation, decreased pain, and increased flexibility.Get regular aerobic exercise. During aerobic exercise, you move your large muscle groups. That gets your blood pumping throughout your body and you begin to take in more oxygen as your breathing rate picks up. Aerobic exercise builds whole body fitness, which helps with back pain and all aspects of life.Do some simple\u00a0core-strengthening exercises. Good posture depends on strong abdominal muscles \u2013 the opposing muscle group to the low back. Strengthening the core can relieve low back pain. Your doctor or physical therapist can recommend more specific exercises to help your\u00a0back muscles get stronger. These may include a series of simple exercises for\u00a0core stabilization. Strengthening the muscles in your trunk or torso can improve your posture, keep your body in better balance, and lower your chance of injury.Ask for help if you are depressed or anxious.\u00a0Having ongoing (chronic) back pain can make you depressed. In turn, depression can have an effect on your level of pain and whether your back gets better. People with depression and chronic pain often benefit from both antidepressant medicines and counseling. Counseling can help you learn stress management and pain control skills. More than half of people with chronic pain can have depression. It doesn’t matter which one came first \u2013 the depression or the pain.If your symptoms are severe or you still have symptoms after two weeks of self-care, see your primary care provider. You may need stronger pain medicines.Your provider will perform a physical exam and possibly tests, such as an x-ray, MRI, or CT scan to help make a diagnosis. After that, you and your provider can work together to find the most effective treatment plan that is tailored to you.When Should I See a Spine Specialist for Back Pain?Time is your friend when dealing with low back pain, says Dr. Vivekanandan, but if your pain does not subside within six weeks of treatment, including taking NSAIDs and trying pain relief methods at home, your PCP may refer you to a spine surgeon.However, spine surgery is rarely a first-line treatment. There are lots of nonsurgical options you can try before spine surgery ever becomes a consideration.\u201cRoughly 80% to 90% of patients with back pain get better within three to six months using conservative therapy,” Dr. Vivekanandan says. \u201cNonsurgical medical options coupled with lifestyle changes can alleviate back pain for a majority of patients without surgery.”Nonsurgical Options for Back PainThe first treatment options Dr. Vivekanandan considers for new patients with low back pain are different pain management techniques.Targeted injections\u00a0include epidural steroid injections that the surgeon uses to target the level of the pain. The injection consists of cortisone and lidocaine. \u201cPatients often see improvement right away or within a week or so, and the relief may last up to several months,” she adds. The injections may need to be repeated.Radiofrequency ablation (RFA)\u00a0is a\u00a0minimally invasive procedure\u00a0through which the surgeon makes a tiny incision to access the joint. Radiowaves are used to burn the nerve that is overlying the bone to decrease pain stemming form that joint, mostly in the lumbar region.Prescription muscle relaxers\u00a0are another option to control muscle spasms that cause back pain. The muscle relaxant cyclobenzaprine or Flexeril is a commonly used medication to reduce muscle spasms in addition to NSAIDs. \u201cThere are a lot of muscles around the spine,” Dr. Vivekanandan says. \u201cThese medications can help with muscle spasms and improve sleep.”EMG test\u00a0is a nerve conduction study to localize where pain is coming from. An EMG may be needed to determine next steps.Often, nonsurgical treatments have an immediate effect in reducing pain and discomfort.Dr. Vivekanandan also recommends the following lifestyle changes, if they apply to you:Improve your diet.People who have healthy eating habits live longer and are at lower risk of developing serious illnesses, such as type 2 diabetes and obesity. Healthy eating can help manage chronic conditions and prevent complications.Get to an ideal weight and maintain it.Losing weight is particularly critical if you have a BMI of 30+. Staying at a healthy weight goes a long way in spine health.Stop any form of nicotine.Dr. Vivekanandan cautions that nicotine in any form is linked with quicker spinal degeneration. Although less than 10% of patients need surgery, quitting nicotine will help you be healthier if you are one of them.Use proper body mechanics.Don’t just grab that big box and heave it. Pay attention to your form. \u201cRemember, there’s more stress on the body during BLT: bending, lifting, and twisting,” she says.That means lifting with the legs, not the back. Here are more proper lifting tips:Keep your feet shoulder-width apart and your back straight; squat down behind the object.Place hands on either side of the object.Using your core muscles for assistance, begin to straighten your knees and stand up.Remember to lift with your legs, not your back.Surgical Options for Back PainIf conservative efforts have failed or your pain is severe and persistent, your surgeon may recommend surgery. Surgery might be indicated if pinched nerves are causing serious numbness, weakness, loss of bowel or bladder control, or difficulty walking. As with any surgery, a patient’s age, overall health, and other factors are considered.Spinal surgery involves various procedures that can relieve pressure on the nerves in the back. The type of surgery depends on the underlying condition and outcome goals. Many of these procedures are minimally invasive and can be accomplished with only small incisions.Some common procedures include:Laminectomy.\u00a0In this procedure, a section of bone called the lamina is removed from one or more vertebrae through a small incision, decreasing pressure on the spinal cord.Discectomy.\u00a0This is a procedure to remove disc fragments that can cause back pain and nerve pressure.Foraminotomy\u00a0or\u00a0foraminectomy.\u00a0These procedures expand the openings for the nerve roots to exit the spinal canal. A foraminectomy generally removes more tissue than a foraminotomy.Osteophyte removal.\u00a0This procedure removes bone spurs that are causing pinched nerves.Kyphoplasty.\u00a0In this minimally invasive procedure, the surgeon injects bone cement into the cavity to harden and stabilize a fractured vertebra.Artificial disc surgery.\u00a0This procedure replaces the damaged discs, allowing the spine to move with materials that mimic the motion of your natural disc.Fusion surgery.\u00a0This surgery permanently joins together two or more vertebrae in the spine so there is no movement between them. It is sometimes combined with one or more other procedures to stabilize the spine.How Can I Prevent Low Back Pain from Returning?After you’ve had low back pain, you’re likely to have it again. But there are some things you can do to help prevent it. And they can help you get better faster if you do have low back pain again.To help keep your back healthy and avoid further pain:Practice good posture when you sit, stand, and walk.\u00a0“Good posture” generally means your ears, shoulders, and hips are in a straight line.Get regular, low-impact exercise.\u00a0Walk, swim, or ride a stationary bike. Stretch before you exercise.Sleep on your side and put a pillow between your knees.\u00a0If you need to sleep on your back, put a towel roll in the curve of your back. Or put a pillow under your knees.Watch what you lift.\u00a0Don’t try to lift things that are too heavy for you. When you must lift,\u00a0do it the right way.If you sit or stand for long periods at work,\u00a0sit or stand up straight, with your shoulders back. Make sure your chair fits you and has good back support. Make sure to keep both feet flat on the floor. It also may help to put a small pillow or a rolled-up towel in the curve of your back. Take regular breaks to walk around. If you have to stand in one position for a long time, put one foot on a low stool, and change feet every now and then.If your work involves a lot of bending, reaching, or lifting,\u00a0use the right techniques. And don’t depend on a “back belt” to protect your back.Spine Care for Back PainIf you experience severe symptoms, or your symptoms linger over a long period of time, you and your provider have many treatment options available \u2014 both nonsurgical and surgical.Help is available, so reach out to your primary care provider or an orthopaedic provider to learn about possible treatments for your pain.For more information about UPMC Spine Care, visit our\u00a0website.Editor's Note: This article was originally published on February 7, 2022, and was last reviewed on December 22, 2023."},{"@context":"https:\/\/schema.org\/","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"2022","item":"https:\/\/share-dev.upmc.com\/2022\/#breadcrumbitem"},{"@type":"ListItem","position":2,"name":"02","item":"https:\/\/share-dev.upmc.com\/2022\/\/02\/#breadcrumbitem"},{"@type":"ListItem","position":3,"name":"Treating and Preventing Back Pain: What You Need to Know","item":"https:\/\/share-dev.upmc.com\/2022\/02\/preventing-back-pain\/#breadcrumbitem"}]}]