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Back Pain Doesn't Have to Be a Pain

It's the most common cause of disability in this country and ranks second only to headaches as the most frequent type of pain. Back pain has many causes--many of which are preventable.

CBS medical contributor Dr. Jordan Metzl, a sports medicine specialist with the Hospital for Special Surgery in New York City, has some tips on dealing with and avoiding back pain.

Since the back is a balanced network of bones, ligaments, muscles, and nerves that work together to balance and bear the weight of your body and the loads you carry, back pain is fairly common, Metzl says.

A number of things may contribute to back pain, including poor muscle tone, excess weight (especially around your middle), improper or heavy lifting, and injuries like those that can come from a fall. Poor posture and sitting or standing in one position for a long time also put extra stress on your back.

There are a number of different types of back pain, Metzl says.

Back Pain: Three Types

The first is called "discogenic back pain." This happens when normal wear and tear or strain causes the spinal disc to bulge or rupture, resulting in a herniated disc. People who experience this type of back pain often get a shooting pain from the legs to the toes. Treatment might require anti-inflammatory drugs or muscle relaxants, physical therapy to strengthen the muscles around the spine, or surgery. Metzl says it is very important to see a doctor if you develop these symptoms.

The second type is "bone-related back pain," particularly something called "spondylolysis." This is a stress fracture in the spine and is especially common in young athletes who use their back for sports.

An example would be someone who participates in gymnastics, ballet, or figure skating. This type of back pain is frequently treated with a brace so that the spine can heal on its own. It's important to diagnose and treat this properly, especially in young athletes, because this can lead to a lifetime of back problems, Metzl says.

Muscle injuries are most common in adults. This happens when the muscles along the spine are not strong enough, resulting in soreness and pain. Sometimes this pain results when a person's back or stomach muscles don't provide enough support for the back and spine.

"Muscle-related back pain" is the kind of pain that can leave you lying on your couch for several days. The key, Metzl says, is prevention through strengthening the muscles. If this condition does develop, it's important to get in to see your doctor so he or she can evaluate this and probably send you to a physical therapist. So exercise is very important as the treatment to strengthen these muscles.

See a doctor if your back pain gets worse and not better, Metzl says.

Preventing Back Pain

There are things you can do to prevent back pain--and they involve keeping your back healthy and strong, Metzl says.

Exercise and weight control can both be a big help, because less weight equals less stress on your back. Regular aerobic activities that don't strain or jolt your back can increase strength and endurance in your lower back, allowing your muscles to function better. Walking, swimming, and biking can all be good aerobic exercises. Talk with you doctor about which activity might be best for you, Metzl says.

Make sure to use proper body mechanics. For example, when standing, make sure you maintain a neutral pelvic position. If you must stand for long periods of time, alternate placing your feet on a low footstool to take some of the load off your lower back. Also, when sitting, make sure you keep good posture so you can take the load off the spine.

Metzl says that during the winter, a lot of patients go to the doctor or injuries related to snow shoveling. These are mostly muscle injuries in which the muscles around the spine aren't strong enough, so after shoveling they hurt and become sore.

When shoveling, Metzl says, don't make the mistake of bending down and using your back to lift the snow. Instead, push the snow: Don't lift it. Use your legs, not your back, to push. Consider investing in an ergonomic snow shovel. It helps you stand straight so you don't have to use your back to shovel.
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