Back to Basics

A timeline for managing that pang in your back

Raise your hand if you’ve ever had a backache. Your hand is up, isn’t it? That’s probably because back pain is almost as universal as the common cold.

“About 80 percent of adults will experience back pain during their lifetime,” says Warner Pinchback, MD, a spokesman for the American Academy of Orthopaedic Surgeons. “It causes an extreme amount of lost work hours, too.”

In fact, it’s one of the most frequently cited reasons for taking a sick day.

Don’t want to have to devote your time off to back pain? We hear you. Our timeline walks you through the potential progression of back pain and offers tips on squashing those aches sooner rather than later.

Day 1: Welcome to Ouch-ville
Uh-oh. You overdid it in the garden, in your exercise class, picking up your toddler … fill in the blank. And there’s a stabbing, aching, throbbing sensation in your back. The good news is that the most common cause of a backache is overactivity (likely a pulled muscle), which means the pain should go away with a little TLC and time.

“Apply ice and rest a day,” Pinchback says. “You can also try sleeping in a fetal-type position with your knees pulled up to your chest to stretch the muscles.”

Also consider wearing a back brace, which you can get at most drugstores, suggests David Hanscom, MD, a board-certified orthopaedic surgeon and the author of Back in Control: A Spine Surgeon’s Roadmap Out of Chronic Pain. “It can help you get through the day by releasing pressure along the spine,” he says.

Day 2: Get Off the Couch
When back pain strikes, you shouldn’t get too comfy on the sofa. Being sedentary can make things worse. “It used to be that people would go to bed for a week with back pain,” Hanscom says. “But we don’t recommend that anymore. The key is to keep moving, but minimize bending.”

Go for a walk, and try some light stretching to keep your muscles from getting stiff and to keep the pain from intensifying. If the discomfort is still strong, try taking an over-the-counter pain reliever, such as aspirin or ibuprofen.

Day 14: Pick Up the Phone
Still hurting? It’s time to make an appointment with your physician.

“If the pain is 80 percent the same intensity as when it started, then it’s time to see the doctor,” Hanscom says. “Back pain is just a symptom. There are many things that can cause it.”

But don’t panic. Even if the pain has lasted this long, it’s still probably just a strain. And in that case, treatment options can include prescription medication, starting an exercise or physical therapy program or both, Pinchback says.

“If that doesn’t work, then more investigative studies, such as an MRI or a CT scan, may help determine where the pain is coming from,” he adds.

If you’re experiencing leg pain with your backache, it could be a sign of a herniated disk. Or maybe you notice numbness in your arms or legs. That could be a sign of spinal stenosis (a narrowing of the spinal canal) or it might be a side effect of arthritis, which can damage the spine.

Just keep in mind that time can heal most (back) wounds. “Because the back is complex, sometimes treatment options have to be delayed to give things time to respond,” Pinchback says.

Day 90: Develop a Long-Term Plan
You’ve entered chronic back pain territory. Chronic back pain is defined as lasting more than three months and often has a neurological component, but that doesn’t mean you’re facing a lifetime of pain with no options.

“There’s always something you can do to improve your back pain status,” Pinchback says. “As orthopaedic surgeons, we are interested in the quality of life and in making sure patients are comfortable so they can get back to their normal state.”

Your doctor might suggest making permanent lifestyle changes—from the way you sleep to the way you eat—or, in some cases, may recommend surgery. Plus, exercise can help relieve persistent pain, so don’t be surprised if it’s part of your treatment plan.

“Strengthening your core, back and leg muscles will often eliminate the need for surgery altogether,” Pinchback says. “But even when you don’t have back pain, you need to exercise on a regular basis to stay strong.” 

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