Managing back pain

At some point, almost everyone tweaks their back. It could be from lifting groceries, picking something up off the floor, or even sneezing too hard. Such an injury produces what doctors call acute back pain, meaning it's a temporary setback and will go away in time as the injury heals. For a while, though, the pain can range from annoying to debilitating.

"Most often, acute back pain happens because of weak muscles related to aging and inactivity," says Dr. Christopher Bono, professor of orthopedic surgery at Harvard-affiliated Massachusetts General Hospital. "This makes muscles more susceptible to stress overload and strains."

Red flags

Most episodes of acute back pain will resolve on their own with home remedies. However, sometimes symptoms are related to a more serious problem, such as a spinal fracture, infection, nerve damage, or a tumor. Situations that require immediate medical evaluation of back pain include

• severe or incapacitating pain
• fever with back pain
• recent significant trauma (such as a fall or car accident)
• numbness or weakness in your feet or legs
• a history of cancer.

Road to recovery

In more typical cases related to just muscle strain and spasm, symptoms usually last a few days, but pain and stiffness sometimes linger for a couple of weeks or longer.

Frequent episodes, however, can discourage people from staying active. "They are fearful about straining their back, so they may avoid exercise or participating in daily life activities," says Dr. Bono.

Managing acute back pain is a two-step approach. First, treat the pain to speed up recovery. Then strengthen the back muscles and improve flexibility to prevent future episodes.

Common treatments for acute back pain include oral or topical over-the-counter pain medications, cold or heat applications, and limited rest.

Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs) are often the go-to remedies for back pain. They include ibuprofen (Advil) and naproxen (Aleve). NSAIDs help reduce pain and — in higher doses — calm inflammation. Acetaminophen (Tylenol) is also a pain reliever, but it is not an NSAID and does not help with inflammation. Some people find topical agents applied to the skin over the most painful area helpful. Examples include those that contain lidocaine or capsaicin.

Cold and heat therapies. It's best to use cold compresses or an ice pack — not heat — immediately following a back strain. This can alleviate pain by numbing the area and preventing or reducing swelling. About 24 hours after the onset of back pain, though, consider switching to a heating pad or a hot water bottle. The warmth soothes and relaxes aching muscles and increases blood flow, which helps the healing process.

Rest. Bed rest can be helpful relief from back pain, mainly if your pain is so severe that it hurts to sit or stand. But try to limit it to a few hours at a time and for no more than one or two days.

A healthier back

Once back pain subsides, Dr. Bono recommends strengthening key muscles that support the back and improving spinal flexibility. "This can help you lift and twist more confidently and lower the risk of straining a muscle."

He suggests core-strengthening exercises like planks and side planks, forward bends (where you sit or stand and reach toward your toes), and back stretches (like the "cat-cow" yoga pose).

"Also, don't forget to keep moving during the day, as prolonged sitting contributes to weak core and back muscles," says Dr. Bono. "Set a timer on your phone to get up and move around every hour. Go for a walk, do some stretches, or get a drink of water."

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