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 Medical Self-Care: 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 infections. The goals of treatment are to treat the cause of the backache, relieve the pain, promote healing and avoid re-injury.

Improper lifting causes a lot of backaches. Here are some lifting "dos 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 rear-end. 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 that is too big or 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.

Self-Care Tips
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 two or three days of rest is usually best. Your back muscles can get weak if you don't use them or if you stay in bed longer than that. To make the most of rest:
  • 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.
  • Put a pillow under your knees or lie on your side with your knees bent. This will take pressure off your lower back.
  • When you get up from bed, move slowly, roll on your side, and swing your legs to the floor. Push off the bed with your arms.
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 2 to 3 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 3 to 4 days.

Heat Treatment
Heat makes blood flow, which helps healing. But don't use heat on a back strain until 3 to 4 days after you get hurt. Any sooner and it can make the pain and swelling worse. Use a moist heating pad, a hot-water bottle, hot compresses, 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 3 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.

Relieve the Pain
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 with pain, but not swelling.

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

More Tips

  • After 2-3 days of resting your back, try some mild stretching exercises (in the morning and afternoon) to make your stomach and back muscles stronger. (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 physical therapy doctor), or a chiropractor.

Questions to Ask
Is the back pain extreme and felt across the upper back (not just on one side) and did it come on suddenly (within about fifteen minutes) with no apparent reason such as an injury or back strain? [Note: These may be symptoms of a dissecting aortic aneurysm.] Yes: Seek Emergency Care
No
Did the back pain start inside your chest and move to the upper back? [Note: You may be having a heart attack. The pain may be dull and you may not feel it in the chest at all.] Yes: Seek Emergency Care
No
Was the back pain sudden with a cracking sound? Yes: Seek Emergency Care
No
Did the pain come after a recent fall, injury, or violent movement to the back and are you having a hard time moving your arm or leg? Do you also have numbness or tingling in your legs, feet, toes, arms or hands and/or loss of bladder or bowel control? Yes: Seek Emergency Care
No
Did the pain come on all of a sudden after being in a wheelchair or a long stay in bed, or are you over 60 years old? Yes: See Doctor
No
Is the pain severe, (but not a result from a fall or injury to the back), and has it lasted for more than five to seven days or is there also a sense of weakness, numbness or tingling in the feet or toes? Yes: See Doctor
No
Does the pain travel down the leg(s) below the knee? Yes: See Doctor
No
Does the pain get worse with movement, coughing, sneezing, lifting or straining or does it come with a loss of bowel and/or bladder control? Yes: See Doctor
No
Are any of the following also present?
  • Difficulty in urinating such as pain, burning or itching
  • Increased urge or frequency
  • Foul smelling urine or blood in the urine
  • Fever and shaking chills
  • Abdominal pain
Yes: See Doctor
No
Is the pain felt on one side of the small of your back, just above your waist and do you feel sick and have a fever of 101¡F or higher? Yes: See Doctor
No
Do you also have any of the following?
  • Joint stiffness and pain
  • Redness, heat or swelling in affected joints
  • Cracking or grating sounds with joint movement
Yes: See Doctor
No
Provide Self-Care
(Excerpted from Healthy Self: The Guide to Self-Care and Wise Consumerism)
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