"My Back Is Killing Me": What to Do

By Jane Farrell

Back pain affects millions of adults – in any three-month period, according to the National Institutes of Health (NIH), about one in four U.S. adults has at least one day of back pain, mostly in the lower back.

But while it’s a common problem, it doesn’t have a simple answer. The NIH says it could be a strained muscle or a problem with a disc, or a bone problem that could be due to a fracture or tumor.

“We rarely find out exactly what it is,” Dr. Gunnar Andersson, an orthopedic surgeon at Rush University Medical Center in Chicago, told the NIH newsletter NIH News in Health. “As long as it stays as back pain, we are typically not that concerned.”

The center of the back is the spin, the NIH says, which consists of 33 bones called vertebrae. The spinal-cord nerves run in a tunnel through the middle of the bones. Spongy discs between the vertebrae act as cushions, and ligaments and tendons hold it all together.

The back, like many other parts of our body, changes with age. Discs can degenerate and it’s possible to get arthritis in the small joints of the back. The NIH says those changes can show up on an MRI or other scans, but the same changes can show up on people who don’t have back pain. Risk factors for back pain include obesity, smoking or inactivity with irregular bursts of exercise.

The good news, the NIH says, is that most back pain goes away by itself. For a new pain in the back, Andersson told NIH News in Health, he usually advises taking over-the-counter medications for the pain and staying away from activity that is hard on the back—lifting, carrying, bending, and twisting. “Then, wait for the problem to disappear, which it will in the great majority of people over a few weeks,” he says.

However, if your back hurts most of the time for more than 3 months, you have chronic back pain. Treatments for that vary and depend on the source of the pain. If the pain comes from a fracture or tumor, those problems can be treated, the NIH says.  Surgery can help if the pain is due to a ruptured (herniated) or conditions such as spinal stenosis (narrowing of the spinal column, which can put pressure on the nerves) or degenerative spondylolisthesis (when one vertebra slips over another).

But, the NIH explains, surgery isn’t the right choice for everyone. Talk to your health care provider about which is right for you. For most people, even chronic pain eventually clears up without surgery, the NIH says. It’s important, Andersson says, to stop the pain from taking over. Research has shown that patients who stay active are better off. Just be sure to avoid activities that might strain the back. “It’s important not to succumb to the pain and become afraid of moving,” Andersson says. “It doesn’t seem to make much difference what you do, as long as you stay active.”