Give your back a break
A word of advice for the four-fifths of Americans who know back pain: Consider slacking off, just this once. People who don’t pursue extreme treatment tend to have fewer complications than those who end up rushing into MRIs, x-rays, epidural injections, narcotics, and even spine surgery long before it’s truly necessary, according to research.
As many as 90% of back-pain episodes resolve within 6 weeks, whether they’re the result of an injury or due to a structural or nerve problem. Of course, knowing that fact makes the misery only slightly more bearable, so try these patience-prolonging strategies to relieve your pain and possibly even shorten the wait until Father Time works his subtle magic.
Pop a pill
Even as you practice patience, a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Motrin, Advil) or naproxen (Aleve) can help ease the pain you’re pushing through. The research behind medicine guidelines for lower-back pain finds that these may give slightly better relief than acetaminophen (Tylenol). Over long periods, NSAIDs can cause gastrointestinal problems, so don’t take them for more than 10 days without consulting your doctor.
Go hot and cold
Rethink that mattress
The conventional wisdom is off base: Unyielding coils may not do you any favors, says Carmen R. Green, a physician at the University of Michigan Back & Pain Center. A number of studies over the years suggest that people with lower-back pain who sleep on medium-firm mattresses do better than those with firm beds. As for replacing yours, “there’s no hard-and-fast rule,” Sean Mackey, chief of the division of pain medicine at Stanford University, says, “but if your mattress is sagging significantly or is more than 6 to 8 years old, I’d think about getting a new one.”
Focus on your feet
Some back trouble starts from the ground up. Women whose feet roll inward when they walk (what’s known as pronation) might be particularly susceptible to lower-back pain, according to a recent study in the journal Rheumatology. Another study finds that correcting the problem with orthotics may help. Before you shell out for custom-made inserts, try an off-the-rack model, like those made by Powerstep.
Get on up
Taking it too easy is the enemy here, ancient advice regarding the benefits of bed rest to the contrary. Gentle stretches, walking, and periodically standing up at your desk can help stabilize your spine and prevent muscle imbalances. And despite how hard it is to imagine doing Downward-Facing Dog with a bad back, yoga can work in your favor, too. A 2013 review of studies found strong evidence it can help. Any type works; one to consider is the restorative viniyoga style (or, the kind of yoga people Google most).
Lie in wait
There’s an upside to your discomfort: It’s a legit excuse to get a weekly massage. One study found that people who did had less pain and disability after 10 weeks, compared with the control group—and general relaxation rubdowns worked just as well as structural massage targeted at specific parts of the body. Osteopathic and chiropractic therapies—in which joints and muscles get stretched and repositioned—have been shown to work, too. In a 2013 study published in the Annals of Family Medicine, when people underwent six osteopathic manual treatments over eight weeks, 63% experienced moderate improvement in lower-back pain, with 50% reporting that their improvement was substantial (we’ll just leave these healthiest eco spas here.)
Submit to the needles
While you wait out the pain, acupuncture may provide even more relief than painkillers, according to one 2013 review. In 11 studies of more than 1,100 people, this Chinese medicine staple improved symptoms of back pain better than simulated treatments and, yes, in some cases, NSAIDs. The needles appear to change the way your nerves react and may reduce inflammation around joints (which is only one of the therapy’s benefits), says DeStefano
Recast your misery
No, the pain isn’t in your head. But what is in your head could be making it worse. “Fear, anxiety, and catastrophizing can amplify pain,” says Mackey. “People often get swept up in thoughts like This will never get better.” Because brain circuits that process pain overlap dramatically with circuits involved with emotions, panic can translate into actual pain. Cognitive-behavioral therapy helps you recognize and reframe negative thoughts. Deep breathing can help, too, as can simply shining a light on dark thoughts. “Start by accepting that you have pain,” Mackey says. “Then say to yourself, It will get better.”
Pass on painkillers
The thing about back pain is that it ruins your life—but then it’s over. Until it comes back. Accepting this and packing painkillers in anticipation of another episode can go a long way toward making this pesky cycle more bearable. In the meantime, bolster your back with exercises that strengthen your core and keep you flexible. For inspiration, see 4 exercises that end back pain.
Sometimes, it’s clearly serious: You were injured, or you feel numbness, weakness, or tingling in the legs. Call the doctor, of course. But for routine and mild low back pain, here are a few simple tips to try at home.
Ice is best in the first 24 to 48 hours after an injury because it reduces inflammation, says E. Anne Reicherter, PhD, PT, DPT, associate professor of Physical Therapy at the University of Maryland School of Medicine. “Even though the warmth feels good because it helps cover up the pain and it does help relax the muscles, the heat actually inflames the inflammatory processes,” she says. After 48 hours, you can switch to heat if you prefer. Whether you use heat or ice — take it off after about 20 minutes to give your skin a rest. If pain persists, talk with a doctor.
“Our spines are like the rest of our body — they’re meant to move,” says Reicherter. Keep doing your daily activities. Make the beds, go to work, walk the dog. Once you’re feeling better, regular aerobic exercises like swimming, bicycling, and walking can keep you — and your back — more mobile. Just don’t overdo it. There’s no need to run a marathon when your back is sore.
Once your low back pain has receded, you can help avert future episodes of back pain by working the muscles that support your lower back, including the back extensor muscles. “They help you maintain the proper posture and alignment of your spine,” Reicherter says. Having strong hip, pelvic, and abdominal muscles also gives you more back support. Avoid abdominal crunches, because they can actually put more strain on your back.
Don’t sit slumped in your desk chair all day. Get up every 20 minutes or so and stretch the other way. “Because most of us spend a lot of time bending forward in our jobs, it’s important to stand up and stretch backward throughout the day,” Reicherter says. Don’t forget to also stretch your legs. Some people find relief from their back pain by doing a regular stretching routine, like yoga.
Design your workspace so you don’t have to hunch forward to see your computer monitor or reach way out for your mouse. Use a desk chair that supports your lower back and allows you to keep your feet planted firmly on the floor.
Watch your posture
Slumping makes it harder for your back to support your weight. Be especially careful of your posture when lifting heavy objects. Never bend over from the waist. Instead, bend and straighten from the knees.
Wear low heels
Exchange your four-inch pumps for flats or low heels (less than 1 inch). High heels may create a more unstable posture, and increase pressure on your lower spine.
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