Taking care of your back
Most of us have experienced low back pain. It can be a frightening,
and debilitating condition that never seems to go away soon enough. As a
physician who cares for people with back pain, I'd like to share the
some of the most frequent questions that my patients ask me about the
treatments and prevention of simple low back pain. There is plenty of
controversy surrounding management of low back pain, but I've tried to
this advice upon clinical medical research, personal experience and some
What happened, and why am I hurting?
Understandably, most patients want to know exactly what was injured and
they have pain. Unfortunately, there is usually no easy, simple answer .
the back is a complex arrangement of bones, called vertebrae, ligaments
connect bone to bone), muscles and tendons (which connect muscles to
vertebrae are arranged one on top of another, somewhat like a stack of
chips. There is a disc, a cushion of cartilage sandwiched between every
vertebrae. Most experts believe that these tissues are injured due to
repetitive overexertion. The pain is caused by inflammation of these
tissues. Inflammation is part of the body's repair process. In addition
being an important part of the skeleton, the vertebrae and surrounding
protect the spinal cord, which is made up of nerve fibers. Pain also can
caused when the inflammation of injured tissues affects the adjacent
Why can't you do some x-rays to figure out what's going on?
The problem with regular x-rays is that they aren't helpful to evaluate
injuries to the soft tissues, so we consider taking x-rays only to
health of bones that might be injured due to a fall or a direct blow to
Did I rupture a disc?
A ruptured or herniated disc causes pain due to inflammation's effect
adjacent nerve or if the disc material physically pushes on a nerve.
of a herniated disc include pain that goes down the back of the leg,
weakness and numbness. If your physician suspects a herniated disc, he or
may order a CAT scan or an MR scan to confirm the diagnosis. The need for
surgery for a herniated disc varies from case to case. Recent research
shown that herniated discs frequently get better over time without
How can I make this pain better?
Medications like aspirin, ibuprofen and naproxen decrease pain by
inflammation. Acetaminophen (Tylenol) decreases the pain, but it does not
the pain-causing inflammation. All of these medications are available
counter, and it's important to follow the dosage directions carefully.
doctor can prescribe stronger medications if these non-prescription items
work. Using an ice pack or a heating pad can help relieve the pain; which
you use is a personal choice, but most experts recommend using an ice
as a "Kold Pak" for 20 minutes, three or four times per day to reduce low
In addition to medications, you may benefit from a short period of bed
but no more than two or three days is helpful. Many experts encourage as
walking as can be tolerated to avoid deconditioning. Finally, physical
therapists can teach you a set of exercises to help your back recover.
How can I prevent this from happening again?
The good news is most back pain goes away on its own in less than six
Whether strengthening the muscles of the back or the abdomen can decrease
risk of future injury is controversial. There is also debate as to
exercises to increase the flexibility of the back are helpful. Others
programs to increase strength of the arms and legs and to improve
cardiovascular fitness. Finally, many experts believe that there are
lifting techniques that may prevent back injuries. These techniques
hefting the item to estimate its weight before you lift it, keeping the
close to your body, and using the power of your leg muscles to help. A
therapist or other health professional can evaluate your body mechanics
make suggestions to improve your way of using your back.
I've touched on only a few concerns that patients have about their back
For future information or counseling, contact your primary care
Edward I. Galaid is director of clinical services, Environmental and
Occupational Medicine, in The Emory Clinic. The publication of "Wellness"
coordinated through the Seretean Center for Health Promotion.