Q: I am a 35-year-old man who has had pain in my lower back for the past couple of weeks, and I’d like to know some methods for low back pain relief. Because my mother and an aunt both have arthritis, I’m also wondering if I'm developing arthritis, too.
A: It's possible, but very unlikely, that you have arthritis of the spine, but the most common cause of acute low back pain in people your age is back strain. This condition is caused by strain to the muscles or ligaments supporting the spine or a herniation of the lumbar disks (cartilage pads that cushion the vertebrae). It is not always possible to differentiate between the two causes, nor is it necessary. In the vast majority of cases, the pain improves and subsides over several weeks.
Sometimes, however, the conditions that cause acute back pain can lead to more chronic and serious problems. Clues to a different and more serious cause include: persistent pain, pain and numbness that radiate down both the legs, bothersome pain at night plus fever, weight loss and swelling of the joints. If you experience any of these, it's important you consult a doctor who can examine you carefully, X-ray your back and perform some lab tests. Possible causes of pain in these cases could include ankylosing spondylitis or an infection or tumor of the spine.
Assuming your problem is simple back strain (and unless you develop other symptoms, you can safely assume it is), the following advice can help you achieve low back pain relief:
- Try to stay active. Prolonged bed rest (more than four days) has the potential for weakening muscles and prolonging the pain.
- Exercise in moderation. Start with a few minutes of daily walking, swimming or stationary cycling and build up to 20 or 30 minutes at a stretch once pain subsides. If the exercise causes too much pain, try another. Avoid aggravating activities. Jogging, golf or tennis are out until pain subsides.
- You can continue your daily work routine if your job does not consist of strenuous manual labor.
- Use medications. Acetaminophen or an over-the-counter nonsteroidal anti-inflammatory drug such as ibuprofen can offer low back pain relief and keep you mobile. Prescription muscle relaxants, sometimes prescribed for back pain, may do little to help your pain and may cause unwanted side effects, including dizziness, drowsiness or dry mouth.
- Use hot and cold treatments. An ice pack or hot water bottle applied to your lower back can be soothing.
- Practice proper lifting techniques. Lift objects close to your body at navel level and avoid twisting, bending and reaching while lifting.
- Avoid prolonged sitting. If you work at a desk, change positions often. Placing a support at the small of your back, using armrests to help support your body weight, and reclining your chair back slightly may make sitting more comfortable.
By following this simple advice and being patient, you’ll find low back pain relief shortly – most people do.
Doyt Conn, MD, Rheumatologist