Topic Overview

Is this topic for
you?

This topic provides a general overview of low back pain. If you
have been diagnosed with a herniated disc or spinal stenosis, see the topic
Herniated Disc or
Lumbar Spinal
Stenosis
.

What is low back pain?

Low
back
pain can happen anywhere below the ribs and above the legs.
It is possible to hurt your back when you lift, reach, or twist. In fact,
almost everyone has low back pain at one time or another.

What causes low back pain?

Causes of low back pain
include:

Often doctors don’t know what causes low back
pain.

What are the symptoms?

Depending on the cause, low back pain can cause 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 can also cause leg symptoms,
such as pain, numbness, or tingling, often extending below the knee.

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 or you lose bladder or bowel control.

Most low back pain is
short-term (acute) and will go away in a few weeks. It is more likely to become
long-lasting (chronic) if you are depressed or under
stress.

How is low back pain
diagnosed?

Your doctor will ask questions about your past health,
symptoms, and activities. He or she will also do a physical exam. Your answers
and the exam can help rule out a serious cause for the pain. In most cases,
doctors are able to recommend treatment after the first exam.

Tests such
as X-rays,
CT scans, and
MRIs usually don’t help.

But if you have a back pain problem that has lasted longer than 6 weeks,
or if your doctor thinks you may have more than muscle pain, it might be time
for one of these tests.

How is it
treated?

Most low back pain will improve with basic first aid, which
includes continuing to do light activity such as walking, and taking
over-the-counter pain medicine as needed.

Walking is the simplest and
maybe the best exercise for the lower back. It gets your blood moving and helps
your muscles stay strong.

Your doctor or physical therapist can
recommend more specific exercises to help your back muscles get stronger. These
may include a series of simple exercises called
core stabilization.
Strengthening the muscles in your trunk can improve your posture, keep your
body in better balance, and lower your chance of injury.

If your
symptoms are severe or you still have symptoms after 2 weeks of self-care, see
your doctor. You may need stronger pain medicines, or you might benefit from
manual therapy.

Each
of the various treatments for back pain work for some people but not for
others. You may need to try different things to see which work best for you,
such as:

  • Spinal manipulation.
  • Massage.
  • Acupuncture.

Having 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.

How can you 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. “Good posture” generally means your ears, shoulders, and hips
    are in a straight line.
  • Get regular, low-impact exercise. Walk, swim,
    or ride a stationary bike. Stretch before you exercise.
  • Sleep on your side.
  • Watch your weight.
  • Don’t try to lift things that are too heavy for you.
    When you must lift, learn
    the right way to lift.

If you sit or stand for long periods at
work:

  • Sit or stand up straight, with your shoulders back.
  • Make sure your chair fits you and 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.

Frequently Asked Questions

Learning about low back pain:

Being diagnosed:

Getting treatment:

Ongoing concerns:

Cause

Often doctors don’t know what causes low back
pain. The most common causes of low back pain
are:

  • Injury or overuse. This can include
    sprains or
    strains of soft tissues
    such as ligaments and muscles, fractures or
    compression fractures of
    bones, or injuries to the small joints between the bones of the spine.
  • Pressure on nerve roots from conditions such as a
    herniated disc or
    spinal stenosis.
  • Osteoarthritis, which is
    usually caused by getting older.

    • When osteoarthritis affects the small
      joints in the spine, it can lead to back pain by making the joints themselves
      stiff and sore and also by creating pressure on the nerve roots.
    • Osteoarthritis in other joints, such as the hips, can cause you to limp or
      to change the way you walk. This can also lead to back
      pain.

Less common spinal conditions that can
cause low back pain include:

Symptoms

Symptoms of low back pain depend on the
cause.

Back sprain or strain

Symptoms typically
include:

  • Muscle spasms, cramping, and stiffness.
  • Pain in
    the back and sometimes in the buttock. It may come on quickly or gradually. It
    most often occurs in episodes. Certain movements make it worse, and doing light
    activities such as walking makes it feel better. The worst pain usually lasts
    48 to 72 hours and may be followed by days or weeks of less severe
    pain.

Nerve-root pressure

Symptoms typically include:

  • Leg pain. If pain extends
    below the knee, it is more likely to be due to pressure on a nerve than to a
    muscle problem. Most commonly, it’s a pain that starts in the buttock and
    travels down the back of the leg as far as the ankle or foot. This pain pattern
    is known as sciatica (say “sy-AT-ih-kuh”). For more information, see the topic
    Sciatica.
  • Nerve-related problems, such as tingling, numbness, or weakness in
    one leg or in the foot, lower leg, or both legs. Tingling may begin in the
    buttock and extend to the ankle or foot. Weakness or numbness in both legs, or
    loss of bladder and/or bowel control, are symptoms of
    cauda equina syndrome,
    which requires immediate medical attention.

Arthritis of the spine

Osteoarthritis of the spine usually
causes pain that:

  • Is worse in the back and hip region.
  • Starts gradually, gets worse over time, and lasts longer than 3 to 6 months.
  • Is generally worse in the morning or after prolonged periods of
    inactivity. Arthritis pain gets better when you move
    around.

Other conditions

Symptoms of diseases that affect the spine depend on the disease. They may
include:

  • Pain that is worse in the affected part of the spine (for
    instance, if there is a compression fracture, tumor, or infection).
  • Pain that starts gradually, is constant, and may be sharp or a dull ache.
    Bed rest doesn’t help and may make it worse (for example, tumors on the spine
    often cause night pain). The pain lasts longer than 2 to 3 weeks.
  • Fever.
  • Sensitivity of the spine to touch and pressure.
  • Pain that wakes you up from sleep.

What Happens

The course of low back pain depends both on its cause
and on how well you treat your back.

Most low back pain goes away within
several weeks. But after you have had back pain once, you’re more likely to
have it again. Many people who recover have back pain again within a year, and
most people will have it again sometime during their lives.

Long-lasting
(chronic) pain not only makes you tired, irritable, and less productive and
less active but also can trigger other problems. If your back pain causes you
to use your body in different ways (for example, to limp or to sit
differently), pain can develop in other areas of the body. Pain can also cause
biochemical changes in your body that tend to keep the pain going.

What Increases Your Risk

A risk factor is something that increases
your chances of having back pain. Having more risk factors means you have a
higher chance of having back pain.

Physical and family
risk factors

  • Being middle-aged or older
  • Being male
  • Having a family history of back pain
  • Having had a back injury
    before
  • Being pregnant. A woman’s back is significantly stressed by
    carrying a baby.
  • Having had compression fractures of the
    spine
  • Having had back surgery before
  • Having spine problems
    since birth

Risk factors you can
change with lifestyle changes

  • Not getting regular exercise
  • Doing a job or other activity that requires long periods of sitting, heavy
    lifting, bending or twisting, repetitive motions, or constant vibration, such
    as using a jackhammer or driving certain types of heavy equipment
  • Smoking. People who smoke are more likely than people who don’t smoke to
    have low back pain.
  • Being overweight. Excess body weight, especially
    around the waist, may put strain on your back, although this has not been
    proved. But being overweight often also means being in poor physical condition,
    with weaker muscles and less flexibility. These can lead to low back pain.
  • Having poor posture.
    Slumping or slouching on its own may not cause low back pain. But after the
    back has been strained or injured, bad posture can make pain worse. “Good
    posture” generally means your ears, shoulders, and hips are in a straight line.
    If this posture causes pain, you may have another condition such as a problem
    with a disc or bones in your back.
  • Being under stress. Stress and other
    emotional factors are believed to play a major role in low back pain,
    particularly chronic low back pain. Many people unconsciously tighten their
    back muscles when they are under stress.

Risk factors you might change with medical treatment

  • Having long periods of depression
  • Using medicines long-term
    that weaken bones, such as corticosteroids
  • Having an illness or disease
    that causes chronic
    coughing

When to Call a Doctor

Call 911 or
other emergency services immediately
if:

  • Back pain occurs with
    chest pain or other symptoms of a heart attack.
  • A person has signs of
    damage to the spine after an injury (such as a car accident, fall, or direct
    blow to the spine). Signs may include:

    • Being unable to move part of the
      body.
    • Severe back or neck pain.
    • Weakness, tingling, or numbness
      in the arms or legs.

Call your doctor now if:

  • You have new numbness in your
    legs or numbness in your legs that is getting worse.
  • You have new
    weakness in your legs or weakness in your legs that is getting worse. (This
    could make it hard to stand up.)
  • You have a new loss of
    bowel or bladder control.
  • You have new or increased back pain with fever, painful urination, or other
    signs of a urinary tract infection.
  • You have long-term back pain that
    suddenly gets much worse, and you did not cause it by being more active.
  • You have a history of cancer or HIV infection, and you have new or
    increased back pain.
  • Pain wakes you from sleep.

For more information, see the topic
Back Problems and
Injuries
.

Watchful waiting

Most low
back pain doesn’t require a visit to a doctor.

If the pain doesn’t get
better after 1 or 2 days and you can’t do your normal daily activities, call
your doctor.

If you still have mild to moderate
pain after at least 2 weeks of home treatment, talk with your doctor. He or she
may want to check for problems that may be causing your back pain.

Who to see

The
following health professionals can diagnose the cause of back pain, evaluate
back injuries, and start treatment.

You may also be referred to one of the
following specialists:

To prepare for your appointment, see the topic Making the Most of Your Appointment.

Exams and Tests

Your doctor will begin by asking
questions about your medical
history
, your symptoms, and your work and physical activities.
He or she will also do a physical
exam
. The questions and exam can help rule out a serious cause
for your pain. Your doctor may also ask questions about stress at home and at
work that may make you more susceptible to chronic pain.

If your back
pain has lasted for less than 6 weeks, it may be best to wait to do any
testing. This is because most back pain goes away on its own in a month or
so.

But if you have a back pain problem that has lasted longer than 6
weeks, or if your doctor thinks you may have more than muscle pain, it might be
time for a test.

Which tests are used?

Tests
for low back pain include:

Sometimes other
tests can be useful, such as a bone
scan
or an electromyogram
and nerve conduction
. These are used to look for bone, nerve,
and muscle/nerve problems that might be causing low back pain.

Treatment Overview

Experts divide low back pain into two
categories:

  • Acute: This is pain that has lasted less than 3
    months. Most people get better with home treatment.
  • Chronic:
    This is pain that has lasted longer than 3 months. People with chronic back
    pain are usually helped with more intensive treatment.

Treatment for acute low back pain

Learn about the
first aid steps you can
take when you first get back pain, such as using heat or ice, taking medicine,
and not resting too much.

Sometimes acute low back pain lasts longer
than a few days, even after you try first aid steps. In such a case, you might
add another treatment, such as manual
therapy
or stronger pain medicine.

If your pain is very
bad, your health care provider may recommend short-term use of an
opioid painkiller or a
muscle relaxant. Some
people consider epidural steroid
shots.

Dr. Keller

Answers From an
Expert:

“Stay as active as you can. Doctors used to say to rest, but
it turns out that this is not the case. The more active you are, the better you
will be, and the faster you will heal.”-Dr. Robert Keller

Read more advice from this back
specialist
.

A woman sweeping the floor

One
Woman’s Story:

“I thought, ‘Okay, it will hurt for a day or two, and
that’s it.’ But it lasted a lot longer. It took about 3 weeks. I guess we’re
used to fast cures. We take an aspirin, and the headache goes away. We take the
antibiotic, and the infection disappears.” –Lorna

Read more about how Lorna learned to
be patient with her back
.

Treatment for chronic low back pain

If you have chronic back pain, one type of treatment by itself doesn’t
always stop your pain. Spinal
manipulation
can work to relieve low back pain. Other treatments
can too.

Prevention

There is no clear evidence that you can
prevent low back pain. But there are some things you can do that may help
prevent it. And they can prepare you for faster recovery if you do have low
back pain.

To learn more, see
Living With Low
Back Pain
.

Living With Low Back Pain

Almost everyone has low back pain at some
time. The good news is that most low back pain will go away in a few days or
weeks with some basic self-care. This includes first aid, self-massage and
using heat or ice.

Basic
self-care can also help prevent back problems from coming back.

A man

One Man’s Story:

“Some people get better fast, but others take a lot of time. That was my
case. If you have back pain, do what you can for it, but don’t be in a hurry.
It usually gets better.”-Jack

Read more about how Jack learned that he didn’t need
surgery
.

Ease back into your daily activities

Some people are afraid that
doing too much may make their pain worse. In the past, people stayed in bed,
thinking this would help their backs. Now experts think that, in most cases,
getting back to your normal activities is good for your back, as long as you
avoid things that make your pain worse.

  • For the first day or two
    of pain, take it easy. But
    as soon as possible, get back to your normal daily life and activities.
  • Movement helps your muscles stay strong. Lying down for too long can make
    your problem worse.
  • If you are an athlete, return to your activity
    carefully. Choose a low-impact option until your pain is under control.

Avoid or change activities that cause pain

  • Try to avoid
    bending, lifting, or reaching. These movements put extra stress on your back.
  • When you sit, place a small pillow, a rolled-up towel, or a lumbar
    roll in the curve of your back for extra support.
  • When you brush your
    teeth, put one foot on a stool.
  • Don’t wear shoes with high heels. Wear
    low-heeled shoes.
  • Try different sleeping positions.
    • If you sleep
      on your side, try putting a pillow between your knees.
    • If you sleep on
      your back, use a pillow under your knees.
    • You can also try rolling up
      a small towel and using it to support your lower
      back.

Pay attention to your body mechanics and posture

Body mechanics are
the way you use your body. Posture is the way you sit or stand.

  • To
    prevent a return of low back pain, you will need to take extra care when you
    lift. When you must lift, bend your knees and flex from your hips. Don’t let
    your spine slump.

  • Think about your posture, whether you are
    sitting or standing.
    Slumping or slouching alone may not cause low back pain. But after the back has
    been strained or injured, bad posture can make pain worse. “Good posture”
    generally means your ears, shoulders, and hips are in a straight line. If this
    posture causes pain, you may have another condition such as a problem with a
    disc or bones in your back.

Stretch and strengthen your back

When you no longer have acute pain,
you may be ready for gentle strengthening exercises for your stomach, back, and
legs, and perhaps for some stretching exercises. Exercise may not only help
decrease low back pain but also may help you recover faster, prevent reinjury
to your back, and reduce the risk of disability from back pain.

Walking
is the simplest and perhaps the best exercise for the low back. Your doctor or
a physical therapist can recommend more specific exercises to help your back
muscles get stronger. These may include a series of simple exercises called
core stabilization. The muscles of your trunk, or core, support your spine.
Strengthening these muscles can improve your posture, keep your body in better
balance, and decrease your chance of injury.

A man and a dog

One Man’s
Story:

“I discovered that what you have to do is this: You do as
much as you can.”-Robert

Read more about how Robert controls his back pain by
staying
active
.

Take care of stress

Stress and
low back pain can create a vicious circle. You have back pain,
and you begin to worry about it. This causes stress, and your back muscles
begin to tense. Tense muscles make your back pain worse, and you worry more …
which makes your back worse … and so on.

There are lots of ways to
teach yourself to relax.

A woman holding her head in her hands

One Woman’s Story:

“I had too much to do and too little time.
That means stress. And when I start stressing, my back starts aching. Before I
knew it, my back was screaming at me.”-Cathy

Read more about how Cathy made time to deal with her
stress
.

Manage your weight

Extra body weight, especially around the waist,
may put strain on your back.

If you want to get to a healthy weight and
stay there, lifestyle changes will work better than dieting.

Here are
the three steps to reaching a healthy weight:

  • Eat a
    healthy diet.

  • Get
    moving.
    Try to make physical activity a regular part of your day, just like
    brushing your teeth. Start small, and build up over time. Moderate activity is
    safe for most people, but it’s always a good idea to talk to your doctor before
    you start an exercise program.
  • Change your thinking. Our
    thoughts have a lot to do with how we feel and what we do. If you can stop your
    brain from telling you discouraging things and have it start encouraging you
    instead, you may be surprised at how much healthier you’ll be-in mind and body.

Quit smoking

People who smoke take longer to heal-from any injury,
not just back pain. If you stop smoking, you may feel better sooner.

People who smoke are also much more likely to have back pain than people who
don’t smoke. This is because the nicotine and other toxins from smoking can
keep spinal discs from getting all the nutrients they need from the blood,
making disc injury more likely. These discs cushion the bones in your spine. An
injured disc can cause low back pain.

Smoking also increases your
risk of bone loss (osteoporosis).

Medications

Medicine can decrease low back pain and
reduce muscle spasms in some people. But medicine alone isn’t an effective
treatment for low back pain. It should be used along with other treatments,
such as walking and using heat or ice.

Medicine choices

There are several medicines your doctor may
recommend, depending on how long you have had pain, what other symptoms you
have, and your medical history. Be safe with medicines. Read and follow
all instructions on the label.

The medicines recommended most often
are:

  • Acetaminophen (Tylenol) and
    nonsteroidal anti-inflammatory
    drugs
    like ibuprofen and naproxen. You can buy these
    medicines without a prescription. Some of them also come in stronger doses. For
    those, you’ll need a prescription.
  • Muscle relaxants. These medicines
    can help with severe muscle spasms that happen when the back pain starts (acute phase). Side effects,
    such as drowsiness, are common.
  • Opioid pain relievers. These are
    very strong medicines that are sometimes tried to ease severe back pain
    that has not been controlled by other medicines. They are usually taken for
    only 1 to 2 weeks.
  • Antidepressants. Some of these medicines,
    such as amitriptyline and
    duloxetine, not only treat
    depression but also may help with chronic pain.

Other medicines
sometimes used for low back pain are:

  • Anesthetic or steroid injections.
    These have been prescribed for chronic low back pain, but they have not been
    researched enough to know if they work well for back pain. They may give
    short-term relief from leg pain related to a back problem.
  • Anticonvulsants.
    These are sometimes used to treat low back pain, even though there isn’t strong
    evidence that they help.
  • Botox
    injection
    . This is a shot into the back muscles. It has not
    been well tested for chronic low back pain.

Medicines that work for
some people don’t work for others. Let your doctor know if the medicine you are
taking doesn’t work for you. You may be able to take another medicine for your
back pain.

Surgery

When you’re in a lot of pain, you might
wonder if you need surgery to fix what’s wrong so that you can feel better.

Every case is different. But most people don’t need surgery for low back
pain.

When surgery may help

Most back surgeries are done to treat nerve pain from herniated discs. Surgery might be an option when a disc
problem causes pain in your leg that prevents you from doing everyday tasks.
You may have pain, numbness, or tingling through your buttock and down the back
of your leg (sciatica) or
in the front of your thigh.

Other problems that may require surgery
include:

  • A spinal fracture caused by an injury.
  • An
    infection in your spine.
  • A problem that causes your spine to be
    unstable.
  • A tumor in your spine.
  • Spinal stenosis.
  • Loss of
    feeling or weakness in your back or legs that gets worse over time.
  • Loss of control of your bowel or bladder.

Having surgery for a
herniated disc or another back problem is a big decision. Talk to your doctor
about it.

Surgery
choices

There are several types of back surgery. Some, like a
discectomy, can help people who have severe symptoms. Others have not been
proved to work.

If you do need surgery, you and your doctor will decide
which type is best for you. Types of surgeries include:

Rehabilitation after surgery

A comprehensive rehabilitation program
is very important after most back surgery. As you regain flexibility,
recondition your back and stomach muscles, and increase your endurance for
activity, you increase your chances of treatment success.

If you are
unable or unwilling to commit to physical therapy after surgery, you may not be
a good candidate for surgery.

Deciding
whether to have surgery

If you and your doctor are considering surgery,
get as much information as you can about possible results, and consider whether
you will be willing to do physical therapy after surgery. It is also a good
idea to get a second
opinion
before you decide to have surgery.

Back
surgery isn’t always successful. Depending on the condition, you may still have
back pain after surgery.

Other Treatment

You can choose from a number of
treatments for your low back pain. Because some of these treatments are new or
not yet well researched, they may not be covered by health insurance.

The following complementary treatments are often used for low back pain.

  • Massage
    may reduce low back pain for a short time. It is probably most effective if you also learn to do
    exercises for your back and
    learn the best ways to lift
    and move to protect your back.
  • Biofeedback
    hasn’t been well studied as a treatment for low back pain. Recent research
    hasn’t shown that biofeedback is effective for controlling low back pain.
  • Acupuncture
    may help reduce pain and increase the ability to be active for a short time
    after treatment but not any more than other treatments.footnote 1
  • Acupressure uses pressure on certain
    points in the body to decrease symptoms. Small studies suggest that acupressure
    reduces pain and allows a person to be more active.footnote 2
  • Relaxation techniques can help
    reduce muscle tension, stress, and depression.
  • Yoga is another way to stay
    active and get help with relaxation and managing stress. Small studies suggest
    that yoga classes may help people with chronic low back pain control their
    symptoms and stay more active.footnote 3, footnote 4 It is not
    clear whether yoga is more helpful than other activity or treatment for chronic
    low back pain. There are different types of yoga. Talk to your doctor before
    you start a yoga program.
  • Capsaicin cream may help relieve pain.footnote 5 Capsaicin is a substance contained in cayenne peppers. Capsaicin cream is applied directly to the skin over the painful area.

Here are some other treatment choices to
think about:

Experimental
treatments

New and experimental treatments are constantly being
developed and offered to people who have low back pain. If you are considering
such a treatment, be sure to ask your doctor for two things:

  1. The
    scientific evidence that shows that the treatment works and is safe.
  2. The results that your doctor has seen in his or her own practice.

Experimental treatments include:

  • Surgery to replace a
    ruptured or herniated
    disc
    with an artificial disc. This treatment has been approved
    by the U.S. Food and Drug Administration (FDA). Long-term studies haven’t been
    done.
  • Botulinum toxin (Botox)
    injection
    . This may relax painful muscle spasms in the low
    back.
  • Radiofrequency ablation of
    nerves
    . This may reduce chronic low back pain in some people by
    preventing pain signals from reaching the brain. It is sometimes used for pain
    from problems with the small joints in the spine called facet joints.
  • An intrathecal pain pump. This is a small tube inserted under the skin and
    deeper tissues along the midline of the back and into the spinal canal. The
    tube connects to a small reservoir of medicine inserted under the skin of your
    belly. The medicine is regularly delivered to the area of pain through the
    tube.

Coping With Chronic Back Pain

Low back pain can take a toll on your
mental health. You may feel fear, frustration, and anger or have depression and
anxiety because of ongoing pain. Those common reactions can make your pain last
even longer. If pain is starting to get you down:

  • Let people know
    when you need a helping hand. Ask family members or friends to help out with
    physical tasks you can’t do right now.
  • Be honest with your doctor
    about your pain. Ask for a referral to a counselor or pain management
    specialist. A prescription antidepressant or antianxiety medicine may also help
    with chronic pain.
  • Work with your health professionals and your work
    supervisor to make a return-to-work plan, if needed. Ask for an ergonomic
    consultation if you need to learn how to do some of your job duties differently
    to avoid hurting your back again.
A man

One Man’s Story:

“I started feeling sad and angry a lot. I didn’t want to do anything. My
back was hurting more. I was having trouble focusing on my work. My life just
started feeling smaller and smaller.”-Ravi

Read more about how Ravi learned he had depression and
how he fought
back
.

Emotional support is important

You may have to lean on friends and
family when facing difficult situations caused by chronic pain or other
problems. Your loved ones can play an important role in supporting your
recovery. Your doctor and community also may give you extra support.

Asking for support from others is not always easy. It can be hard to tell
someone about your problems. But don’t be afraid to ask for help.

Where
you can get support

  • Family. Family members can help you cope
    by giving you comfort and encouragement.
  • Friends. Building
    strong relationships with others is important for your emotional well-being.
    Helping is a big part of friendship. At times you may be the one who encourages
    a friend.
  • Counseling. Professional counseling can help you cope
    with situations that interfere with your life and cause stress. Counseling can
    help you understand and deal with your pain. You can learn ways to stop
    negative thoughts. See the topic
    Stop Negative Thoughts: Choosing a
    Healthier Way of Thinking
    .

  • Your doctor. Find someone you trust and feel comfortable with. Be
    open and honest about your fears and concerns. Your doctor can help you get the
    right treatments, including treatment for depression or other problems.
  • Religious groups. Religious or spiritual groups may help you meet
    people and get involved in the community. Some religious organizations can help
    you get counseling or other social support services.
  • Social
    groups.
    Social groups can help you meet new people and get involved in
    activities you enjoy.
  • Community support groups. In a
    support group, you can talk to others who have dealt with the same problems or
    illness as you. You can encourage one another and learn ways of coping with
    tough emotions.
A woman

One Woman’s
Story:

“I really work at finding the good things in my day. It helps
me get through the day, and I think it makes my pain not bother me as
much.”-Patty

Read
more about how Patty used positive thinking to help her back
pain
.

How friends and
family can help

Your loved ones can offer support by:

  • Giving encouragement. This can keep you from feeling hopeless or
    alone.
  • Offering to help. Getting a helping hand can keep you
    from feeling overwhelmed. This may include helping with small daily tasks or
    bigger problems.
  • Going to medical visits. Your loved ones can
    offer support by being involved in your medical care.
  • Being honest
    and realistic.
    Make sure your loved ones understand how serious the problem
    is. They can help by not setting unreachable goals or by not acting like the
    problem will just go away.
  • Respecting your wishes. You are
    responsible for your decisions. Your loved ones can offer support and
    encouragement without interfering with your major decisions.

Having trouble getting support from
friends and family? There are steps you can take to
make your social support
stronger
.

Staying active

Having chronic back pain can make exercising-even
walking-difficult. Being active is often the last thing you want to think
about.

But the truth is that easing back into daily activity and physical
therapy exercises can help relieve back pain and can lead to long-term
improvement for low back pain.footnote 6

So be as active as you can. Take short walks as often as you can. Talk to a
physical therapist,
chiropractor,
osteopathic doctor, or
physiatrist about exercises
you can do.

Other Places To Get Help

Organizations

American Academy of Orthopaedic Surgeons
www.orthoinfo.aaos.org

National Institute of Arthritis and Musculoskeletal and Skin Diseases (U.S.)
www.niams.nih.gov

References

Citations

  1. Furlan AD, et al. (2005). Acupuncture and dry-needling for low back pain. Cochrane Database of Systematic Reviews (1).
  2. Hsieh LL, et al. (2006). Treatment of low back pain by acupressure and physical therapy: Randomised controlled trial. BMJ, 333(7543): 696-700.
  3. Tilbrook HE, et al. (2011). Yoga for chronic low back pain: A randomized trial. Annals of Internal Medicine, 155(9): 569-578.
  4. Sherman KJ, et al. (2011). A randomized trial comparing yoga, stretching, and a self-care book for chronic low back pain. Archives of Internal Medicine, 171(22): 2019-2026.
  5. Gagnier JJ, et al. (2016). Herbal medicine for low back pain: A Cochrane review. Spine, 41(2): 116-133. DOI: 10.1097/BRS.0000000000001310. Accessed June 17, 2016.
  6. Chou R (2010). Low back pain (chronic), search date April 2009. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.

Other Works Consulted

  • Agency for Healthcare Research and Quality (2010). Complementary and Alternative Therapies for Back Pain II (Evidence Report/Technology Assessment No. 194). Rockville, MD: Agency for Healthcare Research and Quality. Also available online: http://www.ahrq.gov/downloads/pub/evidence/pdf/backpaincam/backcam2.pdf.
  • American Geriatrics Society Panel on Pharmacological Management of Persistent Pain in Older Persons (2009). Pharmacological management of persistent pain in older persons. Journal of the American Geriatrics Society, 57(8): 1331-1346.
  • Carragee EJ (2005). Persistent low back pain. New England Journal of Medicine, 352(18): 1891-1898.
  • Carragee EJ, Hannibal M (2004). Diagnostic evaluation of low back pain. Orthopedic Clinics of North America, 35(2004): 7-16.
  • Chaiamnuay S, et al. (2006). Risks versus benefits of cyclooxygenase-2-selective nonsteroidal antiinflammatory drugs. American Journal of Health-System Pharmacy, 63(19): 1837-1851.
  • Chaparro LE, et al. (2014). Opioids compared with placebo or other
    treatments for chronic low back pain:
    an update of the Cochrane review. Spine, 39(7): 556-563. DOI: 10.1097/BRS.0000000000000249. Accessed February 6, 2015.
  • Chou R, et al. (2009). Imaging strategies for low-back pain: Systematic review and meta-analysis. Lancet, 373(9662): 463-472.
  • Chou R, et al. (2009). Interventional therapies, surgery and interdisciplinary rehabilitation for low back pain: An evidence-based clinical practice guideline from the American Pain Society. Spine, 34(10): 1066-1077.
  • Chou R, et al. (2011). Diagnostic imaging for low back pain: Advice for high-value health care from the American College of Physicians. Annals of Internal Medicine, 154(3): 181-189.
  • Deyo RA, et al. (2004). Spinal-fusion surgery-The case for restraint. New England Journal of Medicine, 350(7): 722-726.
  • Furlan AD, et al. (2015). Massage for low-back pain. Cochrane Database of Systematic Reviews (9). DOI: 10.1002/14651858.CD001929.pub3. Accessed October 30, 2015.
  • Garra G, et al. (2010). Heat or cold packs for neck and back strain: A randomized controlled trial of efficacy. Academic Emergency Medicine, 17(5): 484-489.
  • Kanayama M, et al. (2007). A minimum 10-year follow-up of posterior dynamic stabilization using Graf artificial ligament. Spine, 32(18): 1992-1996.
  • Kovacs FM, et al. (2003). Effect of firmness of mattress on chronic non-specific low-back pain: Randomised, double-blind, controlled, multicentre trial. Lancet, 362(9396): 1599-1604.
  • Mercier LR (2008). The back. In Practical Orthopedics, 6th ed., pp. 143-184. Philadelphia: Mosby Elsevier.
  • Modic MT, et al. (2005). Acute low back pain and radiculopathy: MR Imaging findings and their prognostic role and effect on outcome. Radiology, 237(2): 599-604.
  • Roelofs PDDM, et al. (2008). Non-steroidal anti-inflammatory drugs for low back pain. Cochrane Database of Systematic Reviews (1).
  • Tay BKB, et al. (2014). Disorders, diseases, and injuries of the spine. In HB Skinner, PJ McMahon, eds., Current Diagnosis and Treatment in Orthopedics, 5th ed., pp. 156-229. New York: McGraw-Hill.
  • Thorson DC, et al. (2010). Health Care Guideline: Adult Low Back Pain, 14th ed., pp. 1-74. Bloomington, MN: Institute for Clinical Systems Improvement.
  • U.S. Preventive Services Task Force (2004). Primary Care Interventions to Prevent Low Back Pain in Adults: Recommendation Statement. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspsback.htm.
  • Urquhart DM, et al. (2008). Antidepressants for non-specific low back pain. Cochrane Database of Systematic Reviews (1).

Credits

ByHealthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP – Emergency Medicine
Adam Husney, MD – Family Medicine
E. Gregory Thompson, MD – Internal Medicine
Kathleen Romito, MD – Family Medicine
Specialist Medical Reviewer Kathleen Romito, MD – Family Medicine

Current as ofMarch 21, 2017