Back Pain Dos and Don'ts

Medically Reviewed by Melinda Ratini, MS, DO on March 10, 2014
7 min read

Back pain is the most commonly reported pain condition in America. About 59 million Americans have had a recent episode of back pain, and about 80% of all people will have back pain at some time.

Whether you already struggle with back pain or are trying to prevent back trouble, there are dozens of opportunities in your daily routine for you to protect your back -- or put it at risk.

You spend about a third of your life sleeping. One of the best ways to protect your back is with a mattress and sleep positions that support it, says Lauren Polivka, PT, DPT, a physical therapist at Balance Gym in Washington, D.C. “If you don’t have the right support system, you can set yourself up for injury.”

Make bedtime a haven for your back by:

  • Getting the right mattress. No matter how comfortable a squishy-soft feather bed may seem at first, a firmer mattress is usually the best for your back, Polivka says. “The types of beds where partners can choose a different level of support can be good, because differences in body structure and size can make what’s comfortable for one person different from another.”
  • Keep your bed in shape. If you’re waking up stiff and sore, check your mattress. How long has it been since you replaced it? “It’s the same as with running shoes: you put a lot of pressure on the mattress and deforming the foam over time,” Polivka explains. Twice a year, flip the mattress over and check for divots, dents, wear and tear and breakage. If there are spots where the mattress isn’t springing back the way it used to, it’s time to spring for a new one. Consumer Reports recommends that you consider changing your mattress if yours is at more than 5 to 7 years old.
  • Sleep smart. The worst sleep position for your back? On your stomach. “It puts your neck in a more extended, rotated position -- because you can’t sleep face down -- and that puts the most strain on your joints,” Polivka explains.

Instead, sleep either on your side or your back, using pillows for support. If you prefer your side, the best aid is a body pillow that can support your weight between your knees and help align your arms. Back sleepers should put a pillow between their knees.

  • Rising and shining. Do you jump (or roll grumpily) out of bed when the alarm clock rings? Don’t. Instead, take a minute to stretch fully and let your body wake up before getting a move on. This can help prevent injuries, Polivka says.

Do you spend more than an hour a day in your car? You’re not alone -- 85% of Americans commute by car, reporting an average of 50 minutes a day behind the wheel. Bad positioning in your vehicle can quickly add up to back pain. Here’s how to make your commute less taxing on your back.

  • Get the right vehicle. If you’re debating between a wagon and a minivan, or a sports car and a sedan, the bigger vehicle is usually the better choice -- for your back, not necessarily the environment. “Bigger cars allow you to make more adjustments in your seating,” explains Polivka. The more vertically you can sit, allowing you to keep your knees level with or below your hips, the better for your back. “That puts the least compression on your lumbar spine.”
  • Set your seat properly. Don’t push it so far back that you have to lean and hunch forward to reach the steering wheel.
  • Play with pillows. Some people rush right out and buy support pillows for use in their car, only to find it useless for their specific needs. “Get a few towel rolls and small throw pillows from home and try them out,” Polivka says. “Some people need support higher, between their shoulder blades, while others need something lower at their lumbar spine. Try before you buy.”
  • Take breaks. If you have a long trip ahead of you, stop about every hour to stand, stretch, and redistribute your weight.

Many of us are desk jockeys. We sit through most of our day, often in the same position, hour after hour, talking on the phone and staring at computer screens. Is it any wonder we’re stiff?

“Sitting hurts your back more than standing,” says Trent Nessler, PT, DPT, MPT, a vice president with Champion Sports Medicine in Birmingham, Alabama. “That’s because your legs are shock absorbers, and when you sit, you end up putting all that weight on your spine. Most of us let our chests fall forward and slump when we sit, which dramatically increases the pressure on the spine.”

  • Position your computer properly. You should be seated at eye level to your screen, so that you don’t have to look too far down or too far up to do your work.
  • Sit smart. You don’t necessarily need the perfect, custom ergonomic chair, Nessler says. “There are lots of expensive, ergonomic chairs, but nothing replaces common sense.” Get a chair that provides support for your middle and lower back. “If your knees are at 90 degrees and your spine is at a neutral posture, that’s the right position for you.”
  • Use a footrest. “If the balls of your feet are supported on something, it makes it easier to rest on the ‘sit bones’ deep in your glutes, which helps unload your spine,” Polivka says.
  • Take a break. Set a timer on your computer and, every 45-50 minutes, get up for a few minutes to stretch and walk around. When you sit back down, make sure you’re getting into a supported position with a neutral spine -- neither slumped forward nor pushed back.

If you don’t work at a desk and you stand or lift things a lot at work, then your job has its own set of back hazards. One of the most important things for someone who stands a lot, whether you’re a grocery clerk or a college professor, is wearing the correct kind of shoe. “You want the right type of cushion and sole,” says Polivka. “Not a Converse sneaker or a ballet flat with no support. You want a shoe that can cushion and absorb the forces coming out of the ground. Lots of companies now are making nice dress shoes that have arch support in the feet.”

Whether you’re delivering a lecture or ringing up groceries, you should also keep a small footrest near you, where you can put one foot up to unweight one side of the body, then switch.

Do a lot of lifting on the job? Read on for more back protection tips.

While working outside the home or inside the home, or both, many people spend a lot of their time bending and lifting -- whether they’re grabbing a file, mopping a floor, or unloading a warehouse truck. A little-known fact: You can hurt yourself just as much while lifting something small as you can while hoisting a huge, heavy box. “I’ll see people who’ve bent over to pick up a coin and they’ve thrown their back out,” says Nessler.

Use the right form and technique to bend, lift, and reach. “When I check in at the doctor’s office, I’ll see a receptionist rummaging in a file cabinet below her, bending down at the waist with her hips straight,” says Polivka. “It makes me cringe!”

There are three key “lift postures” that many physical therapists recommend:

  • The squat lift. This is for heavy objects. Get your body as close to the object as possible, plant your feet shoulder width apart, squat down, wrap your arms around it, and stand up, using the power of your legs. “Whether it’s a baby or a heavy box, keeping the item as close to your trunk as you can allows your trunk to act as the stabilizer,” says Nessler.
  • The “golfer’s lift.” This is for small objects like that dropped coin. It would be silly to do a full power squat lift for a coin or a pen. Instead, put all your weight on one leg, and using the opposite hand, brace yourself with one hand on a desk, chair, or other sturdy object. Then bend straight from the hip, letting the non-weight-bearing leg come off the ground a little behind you as you pick up the object.
  • The “crane lift.” This is for heavier objects when you can’t use a squat lift -- like groceries in a car trunk or a baby in a crib. Stand with your knees shoulder width apart, as close to the object as you can get. Bend at the hips, sticking your buttocks out behind you. Grab the item and lift, pulling it as close to your body as you can as you lift up. Put it down the same way.

“Some things, you just can’t lift,” says Polivka. “Know your limits.” If you’re using the right posture to lift something and still feel pain in your back or joints, stop lifting. Ask a second person for help. If you have to maneuver very heavy objects frequently, use a hand truck for assistance.

You can also utilize tools to help around the house. Try using knee mats for scrubbing floors or weeding the garden, paint rollers or dusters with extendable handles so you don’t have to lift your arms awkwardly over your head to reach high spots, and a good old-fashioned step ladder. “Bring everything close to you before you move it,” says Polivka. “Don’t reach up to the top shelf of the china cabinet to pull down the heavy glass punch bowl you only use once a year for company. Get the stepladder or stepstool and get it close to you before you lift it and carry it down.”