Lower back pain is a very common problem—even in young, healthy men and women. It may be a chronic problem lasting years or an acute episode lasting several weeks. The most frequent cause in younger patients is muscle spasm; less common is a disc herniation in which nerve roots are impinged as they exit the vertebral column. Consult your doctor if you experience numbness or weakness in your legs, which may suggest acute disc herniation. For back pain caused by muscle spasm, I recommend muscle relaxants or a nonsteroidal pain medication such as ibuprofen, which helps reduce inflammation. Take the recommended dose every six hours for maximum anti-inflammatory benefit. It is important to manage pain so you stay ambulatory; inactivity may prolong recovery. At night, try sleeping on your side with a pillow between your legs. Many patients find placing heating pads on the affected area helpful.
—Mary Parker, MD, New York Presbyterian Hospital
Ninety percent of adults develop back pain at some time during their lives. Most back pain is not caused by anything serious, but be sure to see a physician if the pain lasts longer than a few weeks; is associated with fevers or chills, weight loss, excessive fatigue, night sweats, numbness or tingling, or changes in urination or elimination; or occurs primarily at night.
After an evaluation by a physician, you may be prescribed a program of supervised stretching and strengthening exercises and physical therapy. Studies have shown that acupuncture also can be helpful for both new and lasting back pain. Although acupuncture's healing mechanism is unknown, experts speculate that it helps block pain impulses at the spinal cord and stimulates production of natural pain-relieving substances. You may need anywhere from 3 to 12 visits.
—Alex Moroz, MD, Rehabilitation Medicine and Medical Acupuncture, New York
Clients generally come to me with lower back pain after playing weekend warrior, lifting improperly, or suffering from dysfunctional ergonomics at work. The first step in treatment is to elongate affected muscle groups with massage and manual therapy to break the pain/spasm cycle. Second is to learn stretches and proper ergonomics when lifting and sitting; for example, bending at the knees and leaning forward slightly when lifting, and sitting in a chair that puts your knees and hips at a 90-degree angle to support the lower back's natural curve.
As a massage therapist I treat lower back injuries with myofascial release, myofascial trigger point therapy, and deep-tissue massage. These help realign muscle tissue and the fascia between skin and muscle layers. You may also benefit from stretching exercises, such as those in yoga or tai chi, for core muscle groups (abdominal and low back muscles).
—Marvin Q. Joiner, Medical Massage Therapist (MMT), and Licensed Massage Therapist (LMT), Houston