Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2003;67(10):2191-2192

What can cause pain in my lower back?

Injuries, such as a muscle strain or spasm, sprains of ligaments (they attach one bone to another bone), joint problems, or a “slipped disc,” can cause pain in your lower back. The most common cause of back pain is using your back muscles in activities you are not used to, like lifting heavy furniture or doing yard work.

A slipped disc happens when the disc between the bones bulges and presses on nerves. This often is caused by twisting while lifting. But many people never know what caused their slipped disc.

What can I do for pain relief?

The best position for relief when your back hurts is to lie on your back on the floor with pillows under your knees, with your hips and knees bent and your feet on a chair, or just with your hips and knees bent. This takes the pressure and weight off your back.

Call your family doctor if:

  • Pain goes down your leg below your knee.

  • Your leg, foot, groin, or rectal area feels numb.

  • You have fever, nausea, vomiting, stomachache, weakness, or sweating.

  • You lose control going to the bathroom.

  • Your pain was caused by an injury.

  • Your pain is so intense you cannot move around.

  • Your pain does not seem to be getting better after two to three weeks.

If you have a hurt back, you may need a day or two of this sort of rest. Resting longer than this can cause your muscles to weaken, which can slow your recovery. Even if it hurts, walk around for a few minutes every hour.

Heating pads can help relax painful muscle spasms. Use heat for 20 to 30 minutes at a time. Ice packs and massages also may give relief.

Nonprescription medicines that reduce pain or swelling include aspirin, acetaminophen (brand name: Tylenol), naproxen (brand name: Aleve), ketoprofen (brand name: Orudis), and ibuprofen (brand name: Motrin).

Is there relief for ongoing back problems?

Treatment of ongoing back problems must be directed at the cause. This may mean losing weight (being overweight can make back pain worse), getting your muscles in better shape, or improving your posture when you are sitting, standing, and sleeping.

What is the best way to sit?

Sit in chairs with straight backs or low back support. Keep your knees a little higher than your hips. Adjust the seat or use a low stool to prop your feet on. Turn by moving your whole body rather than by twisting at your waist.

When driving, sit straight and move the seat forward. This helps you not lean forward to reach the controls. You may want to put a small pillow or rolled towel behind your lower back if you must drive or sit for a long time.

What is the best position for standing?

If you must stand for long periods, rest a foot on a low stool to relieve pressure on your lower back. Every five to 15 minutes, switch the foot you are resting on the stool. Maintain good posture: keep your ears, shoulders, and hips in a straight line, with your head up and your stomach pulled in.

What is the best position for sleeping?

The best way to sleep is on your side with your knees bent. You may put a pillow under your head to support your neck. You also may put a pillow between your knees.

If you sleep on your back, put pillows under your knees and a small pillow under your lower back. Do not sleep on your stomach unless you put a pillow under your hips.

Use a firm mattress. If your mattress is too soft, put a board of half-inch plywood under the mattress to add support.

What exercises can I do to strengthen my back?

Some specific exercises can help your back. One is to gently stretch your back muscles. Lie on your back with your knees bent and slowly raise your left knee to your chest. Press your lower back against the floor. Hold for five seconds. Relax and repeat the exercise with your right knee. Do 10 of these exercises for each leg, switching legs.

While some exercises are specific for your back, it also is important to stay active in general. Swimming and walking are good overall exercises to improve your fitness.

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Copyright © 2003 by the American Academy of Family Physicians.

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