Topic Overview
 Emergencies
 Check Your Symptoms
 Home Treatment
 Prevention
 Preparing for Your
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Emergencies

Yes	Do you have any of the following symptoms that require emergency treatment? Call 191 or other emergency services immediately. โทรแจ้ง 191 / สถานพยาบาลใกล้บ้านท่าน / ร่วมด้วยช่วยกัน/ จส100

• Pain in the upper back that occurs with chest pain that is crushing, squeezing, or feels like a heavy weight on the chest or that occurs with any other symptoms of a heart attack
• Signs of shock
• Back pain that follows a severe injury, such as a:
  • Motor vehicle accident
  • Fall from a height of 15 ft (4.57 m) or higher
  • Major sports-related injury
  • Direct blow to the spine with a moving object
  • Forceful strike on top of the head or fall onto the buttocks
  • Penetrating injury, such as a gunshot wound or stab wound
• Immediately following a back injury, signs of a spinal cord injury, including:
  • Loss of bowel or bladder control
  • Weakness in the legs
  • Numbness or tingling in the buttocks, genital area, or legs

Note: If you suspect a spinal injury, do not move the person unless there is an immediate threat to his or her life, such as a fire. If there is immediate danger, keep the head, neck, and back supported and aligned while you move the person to safety.

Check Your Symptoms

If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.

See conditions and diseases to review high-risk health conditions that may increase the seriousness of your back problem or injury.

Note: If you have any of the following symptoms, evaluate them first.

• New or increased back pain, especially flank pain with painful urination or other urinary problems: Go the topic Urinary Problems, Age 4 and Older.
• Bleeding: Go to the topic Cuts or Puncture Wounds.

Yes

Do you have leg weakness?

Yes

Do you have numbness or tingling in the buttocks, genital area, leg, or foot?

Yes

Did your back pain start after a recent back injury?

Yes

Do you have back pain but no known injury?

Yes

Did you have a tailbone (coccyx) injury?

Yes

Have you had back pain for longer than 2 weeks?

Do you have any of the following symptoms?

• Back pain and abdominal problems: Go to the topic Abdominal Pain.
• Cramping back pain that may be caused by your menstrual period: Go to the topic Menstrual Cramps.
• Neck pain: Go to the topic Neck Problems and Injuries.
• Shoulder pain: Go to the topic Shoulder Problems and Injuries.
• A burn, scrape, or bite: Go to the topic Burns, Scrapes, or Animal and Human Bites.

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

Home Treatment

If you do not need to visit your health professional immediately, try home treatment to relieve your symptoms.

For an injury to the tailbone (coccyx):

• Apply ice or a cold pack to the tailbone area for 15 to 20 minutes, 3 to 4 times a day, for the first 24 to 48 hours. Cold decreases inflammation, swelling, and pain.
• A warm sitz bath for 20 minutes, 3 to 4 times per day after the first 24 to 48 hours, can be soothing to the tailbone area. Sitting in a hot tub or warm bath may also feel good, as long as you are not sitting directly on your tailbone.
• Sit up straight; avoid slumping or slouching.
• Do not sit on hard, unpadded surfaces.
• Use a doughnut-shaped pillow to take pressure off the tailbone area.
• Avoid constipation. Straining to have a bowel movement will increase tailbone pain. See the topic Constipation in Related Information.

For a back injury:

• Apply ice or a cold pack to the injured area for the first 24 to 48 hours. Apply cold packs or ice for 15 to 20 minutes, 3 to 4 times a day or up to once an hour for at least the first 3 days. Cold decreases swelling and pain.
• After the first 24 to 48 hours, heat may help relieve pain and muscle spasm. Use a warm pack or heating pad set on low. Apply the heat to the injured area for 20 to 30 minutes. Inspect your skin frequently during the application. Repeat every 2 to 3 hours. Never fall asleep with a heating pad in place.
• Avoid sitting up in bed, sitting on soft couches, and twisting or sitting in other positions that make your symptoms worse.
• Continue with your usual daily activities unless you have severe leg pain with back pain. Bed rest can help relieve back pain, but it may not speed the healing. Modify or avoid any activity makes your pain worse.
• Try one of the following sleep positions if you have difficulty sleeping at night:
  • Lie on your back with your knees bent and supported by large pillows, or lie on the floor with your legs on the seat of a sofa or chair.
  • Lie on your side with your knees and hips bent and a pillow between your legs.
  • Lie on your stomach if it does not increase your pain.
• Try the following exercises:
  • Take short walks (3 to 5 minutes every 3 hours) on level surfaces as soon as you can to help keep your muscles strong. Avoid hills and stairs. Walk only distances that you can manage without pain, especially leg pain.
  • Do pelvic tilt exercises, gently moving the spine and stretching the lower back. Lie on your back with your knees bent and feet flat on the floor. Slowly tighten your stomach muscles and press your lower back against the floor. Hold the position for 10 seconds. Do not hold your breath. Slowly relax.
• Relax your muscles.
  • See the topic Stress Management in Related Information for progressive muscle relaxation exercises.
  • Have someone gently massage the muscles of your back to relax and soothe painful muscles.
• Stop smoking. Smoking may delay healing because it interferes with blood supply and collagen metabolism. See the topic Quitting Tobacco Use in Related Information.

After 2 to 3 days of home treatment:

• Continue with daily walks, increasing the walks to 5 to 10 minutes 3 to 4 times a day.
• Try swimming, which is good for your back. It may be painful immediately after a back injury, but lap swimming or kicking with swim fins often help prevent back pain from recurring.
• Begin easy exercises that do not increase your pain as soon as your pain has improved. One or two of the exercises in the Prevention section may be helpful. Start with 5 repetitions twice a day and increase to 10 repetitions as you are able.
• Take a yoga class or get a massage.
• Avoid acupuncture, which has not been proven to effectively treat back pain.

Back pain responds positively to a gradual increase in physical activity. Try to get back to your normal routines and activities as soon as possible. Rest without activity may actually increase or prolong back pain.

Symptoms to Watch for During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment:

• Weakness or numbness in the legs develops.
• You lose bowel or bladder control.
• Your back pain is getting worse or not improving after 1 to 2 weeks.
• Your symptoms are becoming more severe or frequent.

Prevention

The frequency of back pain has increased dramatically in all developed countries. The more time we spend sitting at desks, in cars, or in front of television, the more we must do to prevent back pain.

• Maintain an ideal body weight. This reduces the load on your lower back.
• Practice good posture and body mechanics. To reduce stress on your back, see:
  • Back posture.
  • Standing and walking.
  • Sitting.
  • Body mechanics.
  • Lifting.
  • Sleeping.
• Adjust your car seat so that you are not reaching for the steering wheel while driving. Your arms should be in a slightly flexed, comfortable position.
• Always wear your seat belt while you are in a motor vehicle.

Exercises to prevent back pain

The exercises in this topic and general aerobic exercise, such as walking, swimming, and cycling, will help prevent back injury and pain. They will also speed your recovery from injuries and decrease your chances of having chronic pain.

Do not do these exercises if you have just injured your back. Instead, see the Home Treatment section of this topic.

• You do not need to do every exercise. Do the ones that help you the most.
• If any exercise increases your back pain, stop the exercise and try something else. Stop any exercise that causes the pain to radiate away from your spine into your buttocks, legs, or feet, either during or after the exercise.
• Start with 5 repetitions, 3 to 4 times a day, and gradually increase to 10 repetitions. Do all exercises slowly.

Extension exercises

Extension exercises strengthen your lower back muscles and stretch the stomach muscles and ligaments.

• Press-ups
• Shoulder lifts
• Backward bends

Flexion exercises

• Curl-ups
• Knee-to-chest exercise

Additional strengthening and stretching exercises

Stretching and strengthening exercises help keep your back healthy.

• Prone buttocks squeeze
• Pelvic tilts
• Hamstring stretch
• Hip flexor stretch

Exercises to avoid

Many common exercises actually increase the risk of low back pain. Avoid:

• Straight leg sit-ups.
• Bent leg sit-ups during acute back pain (may be safe if back is kept in neutral position).
• Leg lifts (lifting both legs while lying on your back).
• Lifting heavy weights above the waist (military press or bicep curls while standing).
• Any stretching done while sitting with the legs in a V position.
• Toe touches while standing.