Rules To Live By

Lose weight. Extra pounds, especially around This patient education brochure, prepared by
the U.S. Army Center for Health Promotion

Managing
the middle, increase stress on the lower back.
and Preventive Medicine, is a product of the
Don’t smoke. Smoking can interfere with blood partnership initiative between DoD agencies and
circulation to the lower back, while a constant the Veterans Administration.

Low cough can bring on a back spasm.

Reduce stress. Economic worries, family

The recommendations that the guidelines present
were derived from a consensus of expert opinion

Back pressures, and fatigue can cause back spasms or

tense muscles. Daily exercise is an excellent
way to relieve stress.
after an extensive review of the medical literature.
The guidelines were also reviewed by orthopedic
surgeons, physicians, nurses, physical therapists,

Pain Walk short distances instead of driving.

orthopedic physician assistants, and ergonomists
from the Departments of the Army, Navy, and Air
Force.
Climb a few flights of stairs instead of taking
the elevator.

Choose a sport that is easy on your back such as

walking, swimming, or bicycling in an upright
position.

The key to managing Be aware there are times when immediate

low back pain medical attention is required (see What Are My
Options?).
is to understand it
and know when Remember, most back pain from minor strains
to ask for help can be resolved with over-the-counter
medicines and simple home treatment.
from a doctor.
This brochure
provides a brief
overview of how
to recognize, understand,
and safely treat your low back pain.

January 1999
 What Are My Options? Self-Care Guidelines Heat

Actions you can take: Over-the-Counter Medicines If ice has not relieved the pain after 2 or 3 days,
apply moist heat.
Most back pain resulting from minor strains can Over-the-counter (OTC) medicines are available * Wrap a hot water bottle in a towel or take a
be resolved with over-the-counter medicines without a prescription. They are very effective warm shower.
and simple home treatment. for reducing inflammation, swelling, and pain. * Apply moist heat about 15 to 20 minutes, two
If the pain gets better as time passes, or the OTC pain relievers include acetaminophen or three times a day.
pain is not the result of a serious injury, then (e.g., Tylenol®) and nonsteroidal anti- Do not use heat if you injured your back in a
successful low back treatment by yourself is inflammatory drugs such as aspirin, ibuprofen fall, or if the heat increases your symptoms.
possible. (e.g., Advil® or Motrin® IB), and naproxen
sodium (e.g., Aleve®). Caution: Do not take Bed Rest
See your doctor if any of the following aspirin with ibuprofen or naproxen sodium.
problems occur within a few days of your back OTCs are medicines and you should take them Staying in bed more than a few days can cause
injury: with caution. If you are taking other medicines, supporting back muscles to become weaker;
talk with your doctor or pharmacist to be sure some movement is necessary to heal properly.
Pain that keeps you from moving. an OTC medicine will not negatively interact
Pain that runs down a leg or goes into an arm. with any of the prescription drugs you are Chronic Low Back Pain
Night pain that keeps you from sleeping. taking. X-rays
Pain that increases after a few days rest.
Pain that does not lessen after rest and basic Treatment Without Medication Your doctor may order x-rays if you have
home treatment. persistent or recurrent low back pain.
There are many safe and effective ways to X-rays are usually not necessary in the
Seek immediate attention from your doctor if relieve your low back pain without using beginning of low back pain treatment. This is
you have any of the following: medication. Sometimes these techniques are used because back muscles, ligaments, and discs do
in combination with drug treatments. Many of not show up on x-rays.
Difficulty controlling your bladder or bowel these pain relief methods can be used at home; X-rays are necessary for significant trauma
movement. others require the help of a doctor. Remember (a fall or blow to the back), or for older
Loss of sensation in the rectal area. to talk with your doctor about any pain relief patients with severe degenerative conditions
Pain following a fall or impact to the back. techniques you are planning to use. (brittle bones).
Severe leg pain down both legs, weakness,
tingling, numbness, or inability to move. Ice Surgery
Pain that is steadily increasing over several
hours. For a day or two, apply ice or a cold pack for Surgery is most often not needed. Nonsurgical
Chills, fever, or night sweats. about 20 minutes at a time, three or four times treatments, exercise, and good body mechanics
Difficulty with balance or coordination. a day. are usually effective at relieving low back pain.
Always wrap ice or cold pack in a thin For complicated disc injury, surgical treatment
protective layer-such as a towel or face cloth. may be necessary depending on the type of
This will protect your skin. back injury. Consult your doctor about surgical
options.
® Use of trademarked names does not constitute
endorsement.
 Treating Your Own Back Press-Ups Lower Back and Hip Stretch

Recovery from an acute injury takes some time. It 1. Lie on your stomach with your legs straight 1. Lie on your back with knees bent and feet flat
is important to increase your activity gradually so and feet together. 2. Prop up your upper body on the floor. 2. Press your lower back onto the
you do not increase your discomfort. with your forearms. 3. Push upward while floor. 3. Grasp one knee with both hands and pull
keeping your pelvis on the floor. 4. Hold for five toward your chest keeping your head on the floor.
If you suffer from an acute back injury- seconds. 5. Gently lower yourself to the floor. 4. Keep the other knee bent and foot on the floor.
Remember to keep your forearms in contact 5. Hold for a count of ten. 6. Return to starting
Perform stretches in a smooth motion and hold with the floor at all times. 6. Repeat five times. position. 7. Repeat with the other leg. 8. Repeat
the position for a few seconds; do not bounce or ten times on each leg for three sets.
jerk while stretching.

Do these stretches and exercises after a day or

two of rest, if rest is necessary.

Get your muscles ready for activity by

stretching. This reduces the tightness in muscles
and provides them with more blood flow.

You may experience some discomfort when Pelvic Tilt

doing these exercises. If the discomfort Backward Stretch
increases and remains the following day, 1. Lie on your back. 2. Bend your knees
consult your doctor. 1. Stand upright. at a 90-degree angle. 3. Tighten stomach muscles
2. Place your feet and buttocks. See Figure A. 4. Slowly push
Devote just 10 to 20 minutes a day to the health a shoulder width apart. your lower back downward. 5. Hold your back
of your back. It will aid your recovery and help 3. Place your hands in this position for five seconds. See Figure B.
prevent further injury. on your lower back. 6. Slowly return to normal and relax. See Figure
4. Lean backward A. 7. Repeat five times.
while keeping your
neck straight. 5. Lean
further back until you
feel a slight stretch
in your back. 6. Hold
for a count of five.
7. Return to the upright Figure A
position. 8. Repeat
three or four times.

Figure B
 Good Body Mechanics Getting into a vehicle. Lifting. 1. When lifting, keep the object close
Can Protect Your Back 1. Use the door to help you sit. to your body. 2. If the object is on the floor,
2. Grasp the steering wheel widen your stance (slightly outside of shoulder
Getting out of bed. 1. Roll on your side and push for support when seated, and width) and bend only at the hips and the knees.
your body up with your arms. slowly swing both legs into 3. Keep your back in its normal arched position
the car. 3. If you use a seat while lifting. 4. Do not lift by bending forward
pad or back support, secure and using your lower back. 5. Do not twist while
it to the seat to prevent you are lifting. 6. Take a breath and breathe out as
slippage. you exert yourself during the lift. 7. Tighten your
stomach muscles and begin the upward lift by
Getting out of a vehicle. using your legs. 8. If you are carrying the object,
1. Use the steering wheel be sure to keep it close to your body and maintain
as leverage to help pivot a straight spine.
2. Bend your knees and your lower body out of the
lower your feet to the car. 2. If possible, slowly
floor. 3. Use your legs to swing legs out of the car
lift your entire body. at the same time to prevent
twisting your back. 3. Use
the door for support as you raise
your body with your legs.
Sleeping. 1. Sleep on a firm, comfortable
mattress. 2. If the mattress is too soft, insert a Sitting. While sitting at work or at home, try to
board under the mattress for firmness. 3. Sleep on maintain good posture. 1. Keep your knees at a
your back with a pillow under your knees or on 90-degree angle. 2. Keep your feet flat on the
your side with a pillow between your bent knees. floor or on a footrest. 3. Use a back support or
4. Sleep on a contoured pillow (with a shallow a rolled up towel to support the normal curvature correct correct
curve for the head) to help keep your neck and of your lower back. 4. Keep your ears, shoulders,
spine aligned during sleep. and hips in a straight line perpendicular to the
floor. 5. Bend your elbows at about 90 degrees,
with your wrists parallel to the floor. 6. Allow
your arms to rest on the soft armrests of a chair.
This will also relieve some compression on your
lower back.

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