 Low back pain is a common problem seen by physicians. There are many different causes of low back strain. Some people hurt their backs while lifting or while exercising. Others seem to have low back pain for no apparent reason. This can be a recurring and debilitating problem that can alter your normal daily activities. Back pain can range from simple irritation to a paralyzing pain requiring a visit to the physician. Hello, I'm Dr. Matt Hughes. And I'm Dr. Ben Gonzalez. Dr. Hughes and I are emergency medicine physicians, and back pain is one of the common complaints we see in the emergency department. The purpose of this instructional video is to explain some of the causes of occurring low back pain. We're going to describe what you can do to treat it, and most importantly, what you can do to prevent low back pain from happening. First, let's talk about the anatomy of the lower back. The basic unit of the lower back consists of two lumbar vertebrae sandwiching a disc that is composed of a gel-like substance. The vertebrae have facets or joints between them and the disc acts as shock absorbers between the vertebrae. The vertebrae themselves are held in position by ligaments and supporting muscles that run along the spine. All the muscles of the trunk are vital to the support of the back. These include the stomach muscles. In fact, one of the major reasons why people get lower back pain is simply because of weak stomach muscles. Let's talk about how the back gets injured. An obvious reason is trauma. Things like falling, car accidents, and direct blows cause back injury. What I want to focus on is that chronic back pain. That pain that just won't go away and keeps coming back. Remember the guy that hurt his back while lifting the heavy box? His injury actually started weeks and months ago. The muscles that go up and down your back work hard to keep you standing straight and keep you moving. His back had been working overtime to make up for the weaker stomach muscles. The act of lifting, well, was the straw that broke the camel's back. The back can give up at any time while you're walking, exercising, lifting, and even sitting down. Of course, even if you do exercise your stomach muscles, you can still overexert your back to the point of pain. In some people, changes in the bones and curves of the spine occur over the years. This can irritate nerves and ligaments, facet joints, and muscles that cause back pain. Other contributors to chronic low back pain include stress, job type, and smoking. So now that you have a better understanding of the causes of lower back pain, what can you do about it once it happens? The first thing you should do is ease up on your activity. Give your back a rest. However, if possible, avoid prolonged periods of bed rest. Strict bed rest was once recommended, but has since been found out to help. Try to continue your routine activity, just ease up a bit. Avoid lifting heavy objects for 10 to 14 days. So what about medicines? There are many different over-the-counter brand name medications that are useful for lower back pain. These break down into two basic types, acetaminophen and NSAIDs such as ibuprofen, naproxacin, and aspirin. Acetaminophen and NSAIDs can be taken together. Read the labels carefully, and if you are pregnant or have any questions, speak to your primary care physician. Ice packs or heat applied 15 to 20 minutes at a time, 3 to 4 times a day, helps relieve pain. Alternate and experiment with ice packs or heat to optimize your relief. If your job requires prolonged standing or sitting, try to change positions often. Placing a stool under one foot helps relieve lower back disc pressure. When lying down or going to sleep, lay on your back and place a pillow or two under your knees. Another technique is to lay on your side with a pillow between your knees. This will help relieve stress off your lower back. It's important to try these things first. Sometimes the pain is too much or different from your usual back pain. When should you go see your primary care physician? Here's a list of triggers or red flags that may indicate you need to see a physician and possibly need an x-ray. You are over 50 years old. You have numbness or weakness in your legs or feet. Severe pain that shoots down your legs. You've ever had cancer or tuberculosis. You have unexplained weight loss. You've abused drugs or alcohol. You have fever. Your pain lasts more than a month. You have associated abdominal or testicular pain. If you lose bowel or bladder function. So how can you avoid back pain in the first place? A proper lifting technique is essential. First, you want to face the object you're about to lift. Then bend at the knees. Pick it up. Turn. Face where you're going to place the object and set it down. Never lift and twist at the same time. A very important part of preventing back pain is to strengthen your stomach. Bent knee sit ups or crunches are appropriate. Spending a few times a week strengthening your stomach can help prevent months and years of back pain. If you are overweight, it's helpful to lose a few pounds. If you have any underlying medical conditions or need help getting started on an exercise program, consult your primary care physician. Improving your overall general health by eating a healthy diet, drinking plenty of water, exercising regularly and cutting down on poor health habits such as smoking has been shown to decrease your chances of recurrent back pain. Remember, these preventative measures are just that. Preventative, not cures. Consult your primary care physician for any question you may have. The video you just saw focused upon common medical problems often encountered in an emergency department. Many of these problems can be managed by primary care physicians such as family practitioners, internists and pediatricians and others. As a first step towards managing your health care, we urge you to contact your primary care physician as they are typically acquainted with your medical history and can maintain continuity in your care. If you do not have a regular physician, we strongly encourage you to establish a relationship with one.