Back Pain 101

It’s one of the most common reasons we go to the doctor. Here’s everything you need to know to help your aching back.

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To be human is to have a sore back. By the time we reach age 50, 9 out of 10 of us will have experienced back pain, the leading cause of disability in people under 45. Doctors prescribe everything from acupuncture to surgery to bring us relief and, as a society, we spend the same amount of money trying to cure back pain as we do cancer. If you're reading this article, you're probably desperate for your own fix. Here's our guide to what may be causing your problem and how to stop it.

Top 3 Causes of Back Pain

Spinal Problems

Herniated disc -  In between our vertebrae, small sponge-like pads act as cushions to absorb everyday shocks to our spinal column. Aging and injury can cause those discs to rupture or bulge, putting pressure on the nerves in our spine and causing significant pain.

Sciatic pain - Felt in the sciatic nerve, which runs down your leg, sciatic pain can caused by pressure from a herniated disc.

Arthritis - Osteoarthritis often affects the lower back and can cause a painful narrowing of the spinal canal called spinal stenosis.

What Can Be Done

You might be surprised to learn that back surgery is the treatment of last resort. Because the structure of the spinal column is so intricate and the nerves running through it so numerous, back surgery is a risky procedure that only works about 50% of the time. Most experts recommend exhausting other approaches, which are 90% successful in reducing pain, before going under the knife.

Home Treatment

Strengthen your stomach - This will help your back muscles do their work and decrease the pressure on your spine. Try daily stomach crunches or holding "the plank" for several minutes a day if your back will allow it.
Try medication - Over-the-counter anti-inflammatories and/or prescription muscle relaxants can bring down inflammation in the back and quiet spasms, decreasing pain.

Physical therapy can strengthen your back muscles and increase flexibility to help your back return to working condition.

Epidural injections - Doctors can deliver powerful anti-inflammatory medication (steroids) directly into the spine, lowering inflammation profoundly and quickly.

Acupuncture - A study published in the Archives of Internal Medicine in 2009 found that acupuncture (in which tiny needles are inserted into pressure points on your body) was more effective at relieving back pain than traditional approaches such as medication.

When Should You Consider Surgery?

  • You have tried other interventions such as physical therapy, exercises, medications and epidurals that haven't worked.
  • You have pain that shoots from the lower back to below the knee or is accompanied by numbness or tingling in your feet.
  • You feel you can no longer live with the pain you are experiencing.

Emotional Stress

When we're stressed, we tend to hold a lot of tension in our lower back, which, in turn, can severely exacerbate and prolong back pain.

What You Can Do

  • Exercise both to relieve stress and strengthen back muscles.
  • Apply an ointment with camphor and menthol that activates cold receptors and desensitizes heat receptors to decrease pain.
  • Try willow bark - Though it's from the same root as aspirin, willow bark, which is sold at health food stores in capsule form, has been shown to be as effective or even more effective than aspirin and other pain relievers.
  • Get a massage to decrease tension across the shoulders and bring blood flow and oxygen to the area. Thai massage is particularly effective for back pain, because it stretches your body at the same time as you are massaged, teaching your body how to relax and release pain.

Daily Habits

Little things you do every day can add up to a big pain in the back.

  • High heels - Three-inch heels put 7 times more pressure on your feet than flat shoes, throwing off your posture and spinal alignment. In fact, nearly half of women who wear high heels will experience a foot injury that can cause back pain.
  • Heavy bags and thick wallets - Carrying more than 10% of your body weight (about 16 pounds) creates an imbalance in your posture and strains the muscles in your back and shoulders. Likewise, thick wallets inserted into your back pocket are wedges that disrupt the balance of the pelvis and spine and can actually contribute to arthritis.
  • Driving - People who drive cars for more than 4 hours a day are 6 times as likely to miss work due to back problems than those who drive under 2 hours daily.
  • Sitting - People who sit for their jobs have more back problems than those who do manual labor.
  • Slouching - Bad posture can put the equivalent of 100 extra pounds of stress on your lower back.
  • Lifting -  The worst thing you can do for your hardworking back is to bend and twist while trying to lift something, which gives the disks in your back no support. That's when they can slip and pinch nerves.


What You Can Do

  • Switch to pumps and never ever wear 3-inch (or higher) heels.
  • Do a daily bag edit - When you get home for the day, search through for the extra things you picked up and won't need the next day. Keep your bag's weight to a few pounds and switch your carrying shoulder often. If you must bring a heavy bag on some days, balance it with another bag on your other shoulder. Consider purchasing a back-friendly backpack or messenger bag.
  • Keep your wallet under 1/4 inches thick - Edit receipts weekly, carry only your crucial cards, and avoid having wads of small bills.
  • Take driving breaks every 1 and a half hours and stretch.  
  • Get up and move - If you work at a desk all day, get up and stretch every 20-30 minutes. Try putting your hands on your hips and bending backward until you feel a stretch.
  • Set up a healthy workstation - Most office chairs are designed for men around 5 feet 10 inches tall who weigh 180 pounds. The rest of us have to customize chairs to give us the proper back support. Purchase a lumbar roll or try using a partially inflated beach ball behind your lower back for support. Make sure your feet are planted on the ground with your knees at hip level or slightly lower. Keep your arms relaxed at your sides with your elbows directly under your shoulders. Have your computer monitor an arm's length in front of you with the mouse at easy reaching distance. If you talk frequently on the phone at work, purchase a head set or ask your employer to purchase one for you.
  • Lift with your knees and keep your back straight when you have to pick up something heavy.
  • Stretch it out - To keep your spine able to flex and extend, try doing the butterfly stretch regularly. Lay face down with your stomach resting on a pillow. Put your forehead on a rolled towel to keep your neck in a comfortable neutral position. Bring your arms out to your sides with elbows bent to 90 degrees. With your lower body relaxed, squeeze your shoulder blades together and lift your chest off the mat. Hold for 3-6 seconds and release. Work up to 3 sets of 5-10 repetitions.