What is back pain?

In most cases, there isn't a clear cause for back pain. It may be related to problems with muscles and ligaments of the back. It may also be related to problems with the nerves, discs, or bones of the back. Moving, lifting, standing, sitting, or sleeping in an awkward way can strain the back. Arthritis is another cause of back pain.

Although it may hurt a lot, back pain usually improves on its own within several weeks. Most people recover in 12 weeks or less. Using self-care, such as ice or heat and light activity (like walking) may help you feel better sooner.

Good posture helps protect your back when you sit, stand, and walk. Good posture means your ears, shoulders, and hips are in a straight line, with your spine in three front-to-back curves that give it an "S" shape. These curves help absorb stress and impact on your back.

Health care professionals who often diagnose the cause of back pain include:

• Primary care providers. Examples are:
  • Family doctors.
  • Internists.
  • Osteopathic physicians.
  • Chiropractors.
  • Physical therapists.
  • Nurse practitioners.
  • Physician assistants.
• Emergency doctors.

If your back pain is severe or long-lasting, health professionals who can treat you include:

• Orthopedists.
• Rheumatologists.
• Neurologists.
• Neurosurgeons.
• Physiatrists.

You can also get care from:

• Acupuncturists.
• Certified massage therapists.

When you first feel back pain, try these steps:

• Walk. Take short walks several times a day. You can start with 5 to 10 minutes 3 or 4 times a day and work up to longer walks. Walk on level surfaces and avoid hills and stairs until your back is better.
• Relax. Find a comfortable position for rest. Some people are comfortable on the floor or a medium-firm bed with a pillow under their head and another under their knees. Some people prefer to lie on their side with a pillow between their knees. Don't stay in one position for too long and avoid bed rest after the first day of back pain.
• Try heat or ice. Try using a heating pad on a low or medium setting for 15 to 20 minutes every 2 or 3 hours. Try a warm shower in place of using the heating pad once a day. Or you can buy single-use heat wraps that last up to 8 hours. You can also try an ice pack for 10 to 15 minutes every 2 to 3 hours. You can use an ice pack or a bag of frozen vegetables wrapped in a thin towel. There is not strong evidence that either heat or ice will help, but you can try them to see if they help. You may also want to try switching between heat and cold.
• Take pain medicine exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.

When your back hurts all or most of the time, it can affect more than just your body. There's an emotional side to chronic pain. Family members and friends can help you cope by giving you comfort and encouragement. Support groups can be a great source of comfort and advice.

We all "hold" stress in different ways. Some people hold stress in their minds. They may worry so much about a problem that they can't think clearly.

If you hold stress in your body, it can affect your back. You may start to tense your back muscles, which can lead to back pain or make it worse.

Stress and back pain can create a vicious circle. You have back pain, and you start 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.

In most cases, there isn't a clear cause. Back pain can be caused by overuse, strain, or injury. For example, people often hurt their backs playing sports or working in the yard, being jolted in a car accident, or lifting something too heavy.

Aging plays a part too. Your bones and muscles tend to lose strength as you age, which makes injury more likely. The spongy discs between the bones of the spine (vertebrae) may suffer from wear and tear and no longer provide enough cushion between the bones. A disc that bulges or breaks open (herniated disc) can press on nerves, causing back pain.

In some people, back pain is the result of arthritis, broken vertebrae caused by bone loss (osteoporosis), illness, or a spine problem.

Although most people have back pain at one time or another, there are steps you can take to make it less likely.

Physical therapy may help you when back pain makes it hard to move around and do everyday tasks. This treatment helps you move better and may relieve pain. It also helps improve or restore your fitness level and how well you function.

The goal is to make daily tasks and activities easier. For example, physical therapy may help with walking, going up stairs, or getting in and out of bed.

Your physical therapist will examine you and make a treatment plan. You may need help with flexibility, strength, endurance, coordination, and/or balance.

This treatment almost always includes exercise. It can include stretching, core exercises, weight lifting, and walking. You may learn an exercise program so you can do it at home.

The therapist also may use manual therapy, education, and techniques such as heat, cold, water, ultrasound, and electrical stimulation.

Physical therapy may be used alone or with other treatments.