Some Basics...

• Lower back pain is a reason that many people go to the doctor and emergency rooms. It is a common reason for people to miss work. More than 8 out of 10 people have back pain in their lives.
• In most cases, the cause of lower back pain is not serious.
• For most people, severe pain does not always mean that there is a serious problem. In fact, a person can have severe back pain from minor problems like lumbar (muscle) strain and arthritis.
• Without treatment, the pain usually gets better within 4-6 weeks. Treatment can help the pain to go away faster. Bed rest is not a good way to treat back pain.

Common Causes

• Arthritis
• Herniated disk
• Lumbar strain
• Kidney infection
• Kidney stone
• Spine fracture
• Spinal tumor

What is Lumbar Strain?

• Muscle strain is a common cause of new lower back pain in people 18-50 years old.
• People with muscle strain say their pain is made worse by bending or twisting. They also note that their back muscles are tender to touch.
• A person can strain his or her back by lifting something too heavy. This can also happen by bending or twisting the back in an awkward way.

Does Bed Rest Help?

• People with back pain do not need to stay in bed.
• Keep doing day-to-day activities if it is not too painful. This may help the back get better faster. Staying active is healthier than too much rest.

Pain Scale

• None: No pain. Pain score is 0 on a scale of 0 to 10.
• Mild: The pain does not keep you from work, school, or other normal activities. Pain score is 1-3 on a scale of 0 to 10.
• Moderate: The pain keeps you from working or going to school. It wakes you up from sleep. Pain score is 4-7 on a scale of 0 to 10.
• Severe: The pain is very bad. It may be worse than any pain you have had before. It keeps you from doing any normal activities. Pain score is 8-10 on a scale of 0 to 10.

1. What You Should Know:
   • Twisting or heavy lifting can cause back pain.
   • With treatment, the pain most often goes away in 1-2 weeks.
   • You can treat mild back pain at home.
   • Here is some care advice that should help.
2. Cold or Heat:
   • Cold Pack: For pain or swelling, use a cold pack or ice wrapped in a wet cloth. Put it on the sore area for 20 minutes. Repeat 4 times on the first day, then as needed.
   • Heat Pack:
     • If pain lasts over 2 days, apply heat to the sore area. Use a heat pack, heating pad, or warm wet washcloth. Do this for 10 minutes, then as needed.
     • For widespread stiffness, take a hot bath or hot shower instead. Move the sore area under the warm water.
3. Sleep:
   • Sleep on your side with a pillow between your knees. If you sleep on your back, put a pillow under your knees.
   • Avoid sleeping on your stomach.
   • Your mattress should be firm. Avoid waterbeds.
4. Activity:
   • Keep doing your day-to-day activities if it is not too painful. Staying active is better than resting. You do not need to stay in bed.
   • Avoid anything that makes your pain worse. Avoid heavy lifting, twisting, and too much exercise until your back heals.
5. Pain Medicines:
   • You can take one of the drugs listed below if you have pain.
   • They are over-the-counter (OTC) pain drugs. You can buy them at the drugstore.
   Acetaminophen (Tylenol):
   • Regular Strength Tylenol: Take 2 pills (650 mg) every 4-6 hours. Each pill has 325 mg of acetaminophen.
   • Extra Strength Tylenol: Take 2 pills (1,000 mg) every 8 hours. Each pill has 500 mg of acetaminophen.
   • Do not take more than (3,000 mg) of this drug per day.
   Ibuprofen (Motrin, Advil):
   • Motrin and Advil: Take 2 pills (400 mg) every 6 hours. Each pill has 200 mg of ibuprofen.
   • A second choice is to take 3 pills (600 mg) every 8 hours.
   Naproxen (Aleve):
   • Aleve: Take 1 pill (220 mg) every 8 hours. Each pill has 220 mg of naproxen.
   • A second choice is to take 2 pills (440 mg) every 12 hours.
   Extra Notes:
   • Use the lowest amount of a drug that makes your pain feel better.
   • Your doctor might tell you to take more than what is shown above. That is because your doctor knows you and your health problems.
   • Acetaminophen is safer than ibuprofen or naproxen in people over 65 years old. Acetaminophen is in many OTC and prescription drugs. It might be in more than one drug you are taking. Be careful how much you take. Too much of this drug can hurt the liver.
   • Caution- Acetaminophen: Do not take it if you have liver disease.
   • Caution- Ibuprofen and Naproxen:
     • Do not take ibuprofen or naproxen if you are pregnant.
     • Do not take these drugs if you have stomach problems or kidney disease.
     • Do not take these drugs for more than 7 days without checking with your doctor.
   • Read all package instructions.
6. Prevention:
   • The only way to stop future backaches is to keep your back muscles strong.
   • Lack of exercise or movement may cause you to have back pain. Staying active is healthy for your back.
   • Walking, stationary biking, and swimming can help strengthen your back.
   • Being overweight puts more weight on your back. This can cause back pain or make it worse. If you are overweight, work with your doctor to become healthier.
7. Good Body Mechanics:
   • Lifting: Stand close to the object to be lifted. Keep your back straight and lift by bending your legs. Ask for lifting help if needed.
   • Sleeping: Sleep on a firm mattress.
   • Sitting: Avoid sitting for long periods of time without a break. Avoid slouching. Put a pillow or towel behind your lower back for support.
   • Posture: Sit up straight.
8. Strengthening Exercises:
   • During the first couple days after an injury, avoid strengthening exercises.
   • Here are some exercises that can help strengthen your back. Do the following exercises 3-10 times each day, for 5-10 seconds each time.
     • Bent Knee Sit-ups: Lay on your back. Curl forward lifting your shoulders about 6 inches (15 cm) off the floor.
     • Leg Lifts: Lay on your back. Lift your foot 6 inches off floor (one leg at a time).
     • Pelvic Tilt: Lay on your back with knees bent. Push your lower back against the floor.
     • Chest Lift: Lie face down on the ground. Put your arms by your sides and lift your shoulders off the floor.
9. Call Your Doctor If:
   • Numbness or weakness
   • Bowel/bladder problems
   • Pain lasts more than 2 weeks
   • You get worse