Backaches

Most backaches come from strained muscles in the lower back. Other causes include back injuries such as a slipped or herniated disc, arthritis, osteoporosis and urinary tract infection. The goals of treatment are to treat the cause of the backache, relieve the pain, promote healing and avoid re-injury.

Lifting causes a lot of backaches. Here are some lifting Do's and Don'ts to help you avoid straining your back.

Do's:

• Wear good shoes with low heels, not sandals or high heels.
• Stand close to the thing you want to lift.
• Plant your feet squarely, shoulder width apart.
• Bend at the knees, not at the waist. Keep your knees bent as you lift.
• Pull in your stomach and buttocks.
• Keep your back as straight as you can.
• Hold the object close to your body.
• Lift slowly.
• Let your legs carry the weight.
• Get help or use a dolly to move something very heavy.

Don'ts:

• Don't lift if your back hurts.
• Don't lift if you have a history of back trouble.
• Don't lift something that's too heavy.
• Don't lift heavy things over your head.
• Don't lift anything heavy if you're not steady on your feet.
• Don't bend at the waist to pick something up.
• Don't arch your back when you lift or carry.
• Don't lift too fast or with a jerk.
• Don't twist your back when you are holding something. Turn your whole body, from head to toe.
• Don't lift something heavy with one hand and something light with the other. Balance the load.
• Don't try to lift one thing while you hold something else. For example, don't try to pick up a child while you are holding a grocery bag. Put the bag down, or lift the bag and the child at the same time.

Rest -- Resting the back can help treat the pain and avoid re-injury. Resting doesn't have to be in bed, but lying down takes pressure off your back so it can heal faster. Up to three days of bed rest is usually recommended. Your back muscles can get weak if you stay in bed longer than that. To make the most of rest:

• When you need to get up from bed, move slowly, roll on your side and swing your legs to the floor. Push off the bed with your arms.
• Get comfortable when you are lying, standing and sitting. For example, when you lie on your back, keep your upper back flat but your hips and knees bent. Keep your feet flat on the bed. Tip your hips down and up until you find the best spot.
• Take pressure off your lower back. Put a pillow under your knees or lie on your side with your knees bent.

Cold treatment -- Cold helps with bruises and swelling. You can make a cold pack by wrapping ice in a towel. Use the cold pack for 20 minutes, then take it off for 20 minutes. Do this over and over for two to three hours a day. Lie on your back with your knees bent and put the ice pack under your lower back. Start as soon as you hurt your back. Keep doing it for three to four days.

Heat treatment -- Heat makes blood flow, which helps healing. But don't use heat on a back strain until three to four days after you get hurt. If you use heat sooner, it can make the pain and swelling worse. Use a moist heating pad, a hot-water bottle, hot compresses, a heat lamp, a hot tub, hot baths or hot showers. Use heat for 20 minutes, then take the heat off for 20 minutes. Do this up to three hours a day. Be careful not to burn yourself.

Massage -- Massage won't cure a backache, but it can loosen tight muscles.

Braces or corsets -- Braces and corsets support your back and keep you from moving it too much. They do what strong back muscles do, but they won't make your back stronger.

Pain relief -- Take aspirin, ibuprofen or naproxen sodium for pain. Note: Do not give aspirin or any medication containing salicylates to anyone 19 years of age or younger, unless directed by a physician, due to its association with Reye's syndrome, a potentially fatal condition. Acetaminophen will help the pain but not the swelling.

Don't overdo it after taking a painkiller. You can hurt your back more and then it will take longer to heal.

More tips:

• After two to three days of resting your back, try some mild stretching exercises to make stomach and back muscles stronger. Exercise in the morning and afternoon. (Always ask your doctor before starting an exercise program.)
• Don't sit in one place longer than you need to. It strains your lower back.
• Sleep on a firm mattress.
• Never sleep on your stomach. Sleep on your back or side, with your knees bent.
• If your back pain is chronic or doesn't get better on its own, see your doctor. He or she can evaluate your needs. A referral may be given to a physical therapist, a physiatrist (a doctor schooled in physical therapy) or a chiropractor.