Back school is in session.

Your first and perhaps most important lesson on back pain is that most people with back pain get high marks when they choose to stay active. Notably, when back pain strikes, your first instinct may be to stop doing your normal activities for fear of pain or further injury.

As you begin to discover how best to take care of back pain, you’ll find in this lesson that you’re better off learning by doing, literally. Instead of halting activity for fear of pain or harm, you’ll find that most people recover faster from back pain by gradually resuming their activity over a short period of a few days to a few weeks.

Toward the end of this lesson, you’ll get a brief introduction to spinal anatomy that will be useful as you go through the rest of the program.

Go With the Guidelines . . .

The best treatments for back pain are the ones that are chosen based on science. Medical scientists have compared today’s research and have recommended the approaches that work the best. The final product is called a “guideline.” Spine practitioners rely on these guidelines when choosing the best treatments for their patients.

Guidelines for low back pain have now been developed in many parts of the world. These guidelines are similar. Here are some examples of the advice these guidelines give to patients with low back pain:

• Stay active and continue usual activities.
• Avoid bed rest for more than two days.
• Advance your activity levels over a short period of time.
• Use time, not pain, as a guide for gradually resuming activity.
• If you are working, you should stay working.
• If you are off work due to back pain, you should probably return to work sooner rather than later, using modifications when and where you need them.

Face Your Fears

Research has shown that recovery from a back problem has a lot to do with peoples' fear of pain and how they deal with it. People who have back pain may be fearful that physical or work activities will do them more harm. This fear can prevent full recovery, which helps explain why some people with back pain recover while others go on to have chronic, disabling pain.

Fear of pain is determined by a variety of factors, including personality, coping skills, and past pain and stress. Response to pain can range from confrontation to avoidance. Facing your fears, by confronting them, gives you the confidence to gradually return to your regular activities after back pain. This is seen as a healthy response. On the other hand, avoidance is when you steer clear of activities that you think will cause pain. This can lead to exaggerated notions of pain and increased disability over time. Unfortunately, it can also lead to problems of inactivity, such as spine inflexibility, weakness, and weight gain.

Avoidance behavior has been linked to more disability and work loss in people with low back pain. In fact, medical experts think that fear of pain and what is done about it may be more disabling than the pain itself. The role of "fear-avoidance beliefs" (beliefs that activities will lead to more pain and injury) can slow recovery from a back problem. There’s a reason why we're here to offer you enthusiasm and to instill optimism about the positive steps you’re taking with BackCare 101. By encouraging you to get back to normal life activities we'll actually be helping you overcome fear. In this way we are here to help you avoid becoming inactive so you’ll be better able to get back to daily and work activities.

Take Control

There are steps you can take to keep back pain from controlling your life. Regain control of your situation by taking an active role in your recovery. Rely on BackCare 101 to learn all you can about your condition. Learn ways to take care of back pain when it strikes. And get moving sooner, rather than later. By taking the upper hand, you'll experience a greater sense of well-being and control, leading to improved chances for early recovery.

In each lesson of BackCare 101 we'll offer you ideas to help you take control of your condition. Remember you can get back to work and other normal activities swiftly. It won't cause harm and can actually help you get better faster. Learn about spine anatomy; it will help you understand why back pain happens, why a particular exercise works, and why we keep encouraging you to use proper posture and safe movement. Apply the strategies we'll show you for taking care of back pain. And attempt to stay active, even when you feel some pain.

Taking control may require you to take action to improve your spine health. If you smoke, there are a lot of resources available to help you quit. Because of the limited blood supply in the tissues of the low back, smoking speeds up natural age-related changes in the spine and impairs healing. If you are out of shape, we're going to guide you in ways to improve your fitness level. Improving fitness is a key part of combating future back problems. Together, these strategies make it less likely that back pain or injury will strike again in the future.

Take Action

Passive treatments, such as rest, massage, and heat or ice, can ease pain. But they are often not long-lasting if you are not also following a plan to actively resume your ordinary activities and work.

Active rehabilitation speeds recovery and reduces the possibility that back pain will become a chronic problem. Active rehabilitation involves a plan to get you back to work and play. It limits inactivity, while using active exercises (not just passive treatments). Taking action helps you resume normal activity as swiftly—and safely—as possible.

Exercising does more than help you gain flexibility, coordination, and strength. It can give you a brighter outlook in spite of your back problem. People who take part in active exercise for their back generally find it easier to do daily activities. This is because exercising actually reduces feelings of fear, disability, and depression. Notably, it gives people a sense that they really can control their pain.

Exercise therapy can help you in many ways. First, it helps you to use important muscles of the back and abdomen again. But perhaps more important, it can help you to safely do activities without hurting your back. And at its best, exercising can give you the confidence to resume the tasks of your everyday life.

Anatomy Basics

Viewed from the side, the spine has three natural curves. The low back (lumbar spine) curves inward. The natural curves help balance and cushion the spine. A slight inward curve in the low back is called the neutral spine position. By learning to position your back in its neutral position, you may find that it is easier to control back pain. Learn by doing. Positioning your spine with safe alignment as you rest, move, and work can help your back feel better. It’ll also protect your back for the years ahead. Once positioned correctly, you’ll learn to work the muscles around the trunk and abdomen to help you maintain these healthy postures. People who do so often feel better and are able to do more with less pain.

Exercises

Exercise is vital to spine health. People who stay active after a bout of back pain do better than those who take bed rest or who limit their activity for fear of hurting their back. Even basic exercises can be used to get you moving safely. Safe exercises promote healing and control pain. Take ample time to learn and do the exercises designed for you in each practice session in BackCare 101.