What causes back pain?

In most cases, there isn't a clear cause. Back pain can be caused by overuse, strain, or injury. For example, people often hurt their backs playing sports or working in the yard, being jolted in a car crash, or lifting something too heavy.

Aging plays a part too. Your bones and muscles tend to lose strength as you age, which makes injury more likely. The spongy discs between the bones of the spine (vertebrae) may suffer from wear and tear and no longer provide enough cushion between the bones. A disc that bulges or breaks open (herniated disc) can press on nerves, causing back pain.

In some people, back pain is the result of arthritis, broken vertebrae caused by bone loss (osteoporosis), illness, or a spine problem.

Although most people have back pain at one time or another, there are steps you can take to make it less likely.

How can you have a healthy back?

Reduce stress on your back through good posture

Slumping or slouching alone may not cause low back pain, but after the back has been strained or injured, bad posture can make pain worse.

• Sleep in a position that maintains your back's normal curves and on a mattress that feels comfortable. Sleep on your side with a pillow between your knees, or sleep on your back with a pillow under your knees. These positions can reduce strain on your back.
• Stand and sit up straight. "Good posture" generally means your ears, shoulders, and hips are in a straight line.
• If you must stand for a long time, put one foot on a stool, ledge, or box. Switch feet every now and then.
• Sit in a chair that is low enough to let you place both feet flat on the floor with both knees nearly level with your hips. If your chair or desk is too high, use a footrest to raise your knees. Place a small pillow, a rolled-up towel, or a lumbar roll in the curve of your back if you need extra support.
• Try a kneeling chair, which helps tilt your hips forward. This takes pressure off your lower back.
• Try sitting on an exercise ball. It can rock from side to side, which helps keep your back loose.
• When driving, keep your knees nearly level with your hips. Sit straight, and drive with both hands on the steering wheel. Your arms should be in a slightly bent position.

Reduce stress on your back through careful lifting

• Squat down, bending at the hips and knees only. If you need to, put one knee to the floor and extend your other knee in front of you, bent at a right angle (half kneeling).
• Press your chest straight forward. This helps keep your upper back straight while keeping a slight arch in your low back.
• Hold the load as close to your body as possible, at the level of your belly button (navel).
• Use your feet to change direction, taking small steps.
• Lead with your hips as you change direction. Keep your shoulders in line with your hips as you move.
• Set down your load carefully, squatting with your knees and hips only.

Exercise and stretch your back

• If you have any health problems or if you have not exercised in many years, talk to your doctor about what type of exercise is good for you. Walking may be a good choice to start with.
• Stretch your back muscles. Here are a few exercises to try:
  • Lie on your back, and gently pull one bent knee to your chest. Put that foot back on the floor, and then pull the other knee to your chest.
  • Do pelvic tilts. Lie on your back with your knees bent. Tighten your stomach muscles. Pull your belly button (navel) in and up toward your ribs. You should feel like your back is pressing to the floor and your hips and pelvis are slightly lifting off the floor. Hold for 6 seconds while breathing smoothly.
  • Sit with your back flat against a wall.
• Keep your core muscles strong. The muscles of your back, belly (abdomen), and buttocks support your spine.
  • Pull in your belly and imagine pulling your navel toward your spine. Hold this for 6 seconds, then relax. Remember to keep breathing normally as you tense your muscles.
  • Do curl-ups. Always do them with your knees bent. Keep your low back on the floor, and curl your shoulders toward your knees using a smooth, slow motion. Keep your arms folded across your chest. If this bothers your neck, try putting your hands behind your neck (not your head), with your elbows spread apart.
  • Lie on your back with your knees bent and your feet flat on the floor. Tighten your belly muscles, and then push with your feet and raise your buttocks up 8 to 10 centimetres (3 to 4 inches). Hold this position 6 seconds as you continue to breathe normally, then lower yourself slowly to the floor. Repeat 8 to 12 times.
  • If you like group exercise, try Pilates or yoga. These classes have poses that strengthen the core muscles.

Lead a healthy lifestyle

• Stay at a healthy weight to avoid strain on your back.
• Do not smoke. Smoking increases the risk of osteoporosis, which weakens the spine. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.