COPING WITH BACK PAIN

Many individuals have an occasional backache, but when the pain becomes severe or you experience the pain more frequently you should consult a doctor.

An article in the December 6, 2000, issue of The Journal of the American Medical Association (Wassell et al) reports on a study of frequent use of a back belt (a belt designed to protect the back from possible injury when lifting) by workers who lift merchandise. The researchers did not find any benefits to using a back belt.

Possible Causes of Back Pain:
Some common causes of back pain are

Stretched or strained muscles in the back

Injuries (such as from a fall) that cause trauma to muscles, bones or other tissues in the back

Herniated (or "slipped") disks (this occurs when part of a disk that provides cushioning between two vertebrae — the bony structures that make up the backbone or spinal column — bulges out, which can cause pressure on surrounding tissue, such as nerves)

Osteoporosis (decreased density of the bones) — can cause vertebrae to become fractured or compressed

Being overweight

Bad posture

Being pregnant

Back pain can be a symptom of a number of other medical problems. Therefore, your doctor may ask you a number of questions about other symptoms you may be experiencing along with your back pain.

Self-Help Ideas for Easing Back Pain:
Short periods of rest lying flat on your back with your knees raised (by a pillow, for example); long periods of bed rest may weaken the muscles, adding to the problem and increasing the time to recover

Limited rest combined with gentle exercise and lighter than normal activities

Taking nonprescription pain relievers and/or anti-inflammatory medications following the manufacturer's instructions
Consult your doctor if the above strategies do not work for you. Your doctor may prescribe anti-inflammatory drugs, drugs that relax the muscles, and/or painkillers. Under severe conditions, back pain caused by structural problems with the backbone may require surgery.

Protecting Your Back When Lifting:
Lift with leg muscles, not back muscles; bend your knees (by squatting down to pick up object) not your waist or back

Keep back straight (do not bend over) while lifting

Keep the weight of what you are lifting close to your body

Do not twist when lifting

Preventing Back Pain:
Get regular exercise
Stretch before exercise and other physical activities
Do exercises to strengthen and make back muscles more flexible
Do exercises to strengthen the abdominal muscles
Always keep a good posture when standing and sitting
Avoid standing or being in one position for too long a period of time
Lose weight if you are overweight

When to See a Doctor:
If you experience:

Severe pain that makes it difficult to move
Fever and/or vomiting with the back pain
Pain, numbness, or tingling in another part of your body
Weakness in another part of your body
Bowel problems or bladder problems, such as losing control of going to the bathroom
Pain that lasts for more than three to four days

For More Information:
American Academy of Orthopaedic Surgeons
800/824-BONES
Send a self-addressed, stamped business-size envelope to:
Low Back Pain
American Academy of Orthopaedic Surgeons
P.O. Box 2058
Des Plaines, IL 60017

American Academy of Family Physicians
Low Back Pain: Tips on Pain Relief and Prevention
800/274-2237, ext. 5103

Additional Sources: National Institute of Neurological Disorders and Stroke, National Institute for Occupational Safety and Health, The AMA Home Medical Library, The AMA Family Medical Guide, The AMA Encyclopedia of Medicine

Brian Pace, M.A., Writer
Richard M. Glass, M.D., Editor

(JAMA. 2000; 284:2826)

Published in JAMA: December 6, 2000