Back-Pain-14 Ways to Keep Back Pain at Bay
Maybe you lifted  something heavy or swung a golf
club a little  too enthusiastically. Or maybe you've
been sitting in  an uncomfortable desk chair for two
weeks, sweating  over a deadline. Whatever the reason,
now you're flat  on your back, wishing for something--
anything--that  will put an end to the agony. Take
heart--you're  not alone. Almost every American
suffers from  back pain at some point in his or her life.
The bad news is  that unless you have a major injury
or disc problem,  your doctor may not be able to do
much for you  other than prescribe some pain
medication and  advise you to rest. The good news is
that by  following some simple steps, you can be on
your feet again  in just a few days. Even better, you
can avoid having  to endure similar discomfort in the
future.
Go  to bed.
"Bed rest is a  way of removing the strain from the
muscles," says  Daniel S. J. Choy, M.D., director of
the Laser  Laboratory at St. Luke's--Roosevelt
Hospital Center  and an assistant clinical professor of
medicine at  Columbia University College of
Physicians and  Surgeons in New York. "The back
muscles' job is  to hold you erect. If you lie down, it
takes the stress  off of the muscles." The best way to
lie is flat on  your back with two pillows underneath
your knees.  Never lie facedown, Choy says, since this
position forces  you to twist your head to breathe and
may cause neck  pain. Make an effort to get up and
start moving  around after three days, since longer
periods of bed  rest may make the muscles weaker and
more prone to  strain, he adds.
Ice  it.
Applying an ice  pack to the painful area within 24
hours of the  injury can help keep inflammation and
discomfort to a  minimum, according to Willibald
Nagler, M.D.,  Anne and Jerome Fisher Physiatrist-in-
Chief and  chairman of the Department of
Rehabilitation  Medicine at The New York Hospital--
Cornell Medical  Center in New York. "Ice does one
thing--it  decreases the nerve's ability to conduct a
painful  stimulus," he says. Nagler suggests wrapping
ice cubes in a  plastic bag, then applying the bag on
top of a thin  towel that has been placed on the skin.
Leave the ice  pack on for 20 minutes, take it off for
30 minutes, then  replace it for another 20 minutes, he
says.
Take  a hot bath.
If more than 24  hours have passed since the injury
occurred, ice  will not help reduce pain or
inflammation.  After that time, heat may help increase
the elasticity  of the muscles by about ten percent,
Nagler says.  Jerold Lancourt, M.D., an orthopedic
surgeon at North  Dallas Orthopedics & Rehabilitation,
P.A., in Dallas,  tells his patients to soak in a hot bath
for 20 minutes  or more. Pregnant women, however,
should not sit  in a hot bath for too long, since raising
the body  temperature over 100 degrees Fahrenheit for
long periods may  cause birth defects or miscarriage.
Invest  in a new mattress.
A soft, sagging  mattress may contribute to the
development of  back problems or worsen an existing
problem,  according to Henry J. Bienert, Jr., M.D., an
orthopedic  surgeon at Tulane University School of
Medicine in New  Orleans. If a new mattress is not in
your budget,  however, a three-quarter-inch-thick
piece of plywood  placed between the mattress and
box spring may  help somewhat. "The verdict's not
back yet on  water beds," he adds. In any case, try to
sleep on your  back with two pillows underneath your
knees.
Get  a massage.
If you're lucky  enough to have an accommodating
spouse, friend,  or roommate, ask him or her to give
you a rubdown.  "Lie face-down and have someone
knead the  muscles," Choy says. Local massage
therapists may  also make house calls. You can check
the yellow pages  for listings or ask a friend for a
referral.
Relax.
Much back pain  is the result of muscles made tight by
emotional  tension, Lancourt says. He recommends
that his  patients practice relaxation and deepbreathing
exercises, such  as closing their eyes,
breathing  deeply, and counting backward from 100.
Take  two aspirin.
Taking an  over-the-counter analgesic such as aspirin,
acetaminophen,  or ibuprofen may help relieve your
pain. However,  be aware that not all medications--not
even  nonprescription ones--are for everyone.
Pregnant women,  for example, should not take any
medication  without first checking with their doctor.
And people with  ulcers should stay away from
analgesics  containing aspirin, according to Lancourt.
"Any medicine  should be taken with knowledge of its
side effects,"  he says. "Make sure to get the advice of
your  doctor."
Use  a cushion.
"The seats of  most cars and trucks are not well
designed," Choy  says. "They should support the small
of your back."  If your seat doesn't, Choy suggests that
you buy a small  cushion that can be fitted to provide
the missing  support. He adds that the most desirable
sitting position  is not one in which your back is
straight up and  down. It's better to be leaning back at
an angle of  about 110 degrees. If you sit for long
hours, Choy also  recommends that you periodically
get up and walk around.
Put  your arm behind your back.
If you have to  sit for long periods in a chair that
doesn't support  your lower back and you don't have a
cushion, try  rolling up a towel or sweater so that it has
about the same  circumference as your forearm. Then
slide the  rolled-up cloth between your lower back and
the chair,  recommends Billy Glisan, M.S., an exercise
physiologist and  the director of injury prevention
programs for the  Texas Back Institute in Dallas. In a
pinch, you can  simply slide your forearm between
your lower back  and the back of the chair to ease the
strain on your  back. Even with the best back support,
however, sitting  is still stressful on your back, so try
to make small  adjustments in the curvature of your
lower back every  few minutes or so, advises Glisan.
Swim.
Swimming is the  best aerobic exercise for a bad back,
according to  Choy. Doing laps in the pool can help
tone and tighten  the muscles of the back and abdomen.
Walking is  second best, he says. You can also try the
Extra! Extra! -  "Back-Saving Exercises."
Lift  with your knees bent.
The large  muscles of your legs and buttocks are better
equipped to bear  heavy weights than your back
muscles are,  according to Bienert. "Pretend you have
a goldfish bowl  filled with water on the top of your
head," he says.  "When you squat down to pick
something up,  don't spill a drop." Bienert also
recommends  strengthening leg and buttock muscles to
facilitate  squatting.
Carry  objects close to your body.
When picking up  and carrying heavy objects, pull in
your elbows and  hold the object close to your body,
Choy recommends.  "If you have to reach something
on a shelf, get  right under it and rest it on your head,"
he says. "Then,  the weight is carried by the erect
spine, and you  don't ask as much of your muscles."
Stay  alert.
Careless  activity is the number-one cause of back
injury,  according to Lancourt. "If you have had
previous back  pain, be very careful," he says. "Avoid
bending and  twisting and lifting. Avoid being caught
off guard.  Sometimes it's better to hire somebody to
do things, such  as yard work or carrying heavy
suitcases, than  to hurt yourself and miss three months
of  work."
Watch  your weight.
Maintaining your  ideal weight may help take the
strain off the  back muscles, according to Bienert.
"The less you  have to carry, the less load you have,"
he says.  "Secondly, when you gain weight in your
abdomen, you may  become sway-backed, which can
accentuate back  pain.
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