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Leaflet: How to manage your back

Musculoskeletal (MSK) Services

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Last updated: April 2020
Next review: April 2022

The content of this leaflet is currently being reviewed. For any queries, please contact the service directly.

Musculoskeletal – How to manage your back

Your spine is strong and it is very difficult to damage.

Your spine is made of strong bones, ligaments and muscles. The discs act like shock absorbers. This makes your spine strong and flexible and difficult to damage.

Bed rest is bad for your back. Stay as active as possible.

Staying in bed for longer than a day or two can make your back pain feel worse. This is because you will stiffen up, your muscles will get weaker and you will lose physical fitness. You could also feel more depressed.

Take your pain killers on a regular basis. Do not wait for your pain to be bad.

Pain relief may not make your pain go completely, but it should help keep you active. Pain killers such as paracetamol and anti-inflammatory tablets like ibuprofen may be helpful. Do not take either aspirin or ibubrofen if you have a stomach ulcer, indigestion or asthma.

It is normal to have good and bad days

  • If your pain is more severe, you may need to take stronger painkillers for a few days.  Your pharmacist or GP will be able to advise you on this. It is important to stay as active as you can. Gradually build up on activities and exercise over a few days or weeks.
  • Learn how to pace your activities. Try not to do too much on a good day and then nothing on a bad day. Gradually increase how much you can do.
  • Stay at work if possible. Modify or change your activity if needed.
  • You do not need to be pain free to stay at or return to work. It may be possible to modify or change your activities at work to help you stay at or return to work.
  • Try not to become an avoider. Low back pain is very common. Low back pain should not make you disabled, unless you let it. It is rarely a serious condition or disease. Staying active helps you get better faster and prevents further back problems.

Do some regular exercise. Examples include walking, cycling and swimming.

It is good to do regular exercise each day such as walking and cycling. Gradually increase how much you are doing until you reach your optimum level and then maintain it.

Avoid sitting in low, soft chairs

Sit in an upright chair with a folded, rolled up towel against the small of your back. Some people find it helpful to have regular breaks from sitting.

Sleep on a supportive mattress. Avoid long periods of rest, other than sleep.

If you lie on your side, you can try to support your waist with a small pillow and another between your knees.

If you lie on your back, place a pillow under your knees to take some strain off your lower back.

Some people find it helpful to get out of bed by rolling onto your side, bending your knees and pushing yourself up with your arms into a sitting position over the side of the bed.

Hints and tips

  • Always lift and carry items close to the body. It is important to lift and carry objects close to the body, as much as possible. Bend your knees and use your strong leg muscles to lift with. Try to look up to where you are lifting to. If you are carrying shopping, split it and carry equal amounts in both hands. Do not carry loads further than you have to.
  • Adjust your chair at work and your car seat to the correct height and position. Your chair should be the correct height for your desk. The small of your back should be supported. Your hips and knees should be at 90° and your feet supported on the floor or a small stool.
    Some people find it helpful to have regular breaks from sitting. Have regular breaks, stretch and walk.
  • Sports and hobbies can be continued. It is safe for you to do normal activities, sports and hobbies. However, you may need to change the length of time and the intensity that you do them.
  • If you experience any of the symptomsbelow it is best to see a doctor. Severe pain that gets worse instead of better, If you feel unwell, difficullty in passing or controlling urine, numbness around your back passage or genitals, weakness or numbness in both legs.