Injured Your Back? Dos and Don’ts for a Quick Recovery

Angela Santini, MD

Angela Santini, MD is board certified in orthopedic surgery and fellowship trained in spinal surgery. She is a member of the Inova Spine Program with privileges at Inova Loudoun Hospital, which has earned the Gold Seal of Approval® from The Joint Commission for spine surgery. Dr. Santini serves as Chief Medical Director of Virginia Spine and Sports Orthopaedics in Loudoun County.

Back strains can occur anytime, anywhere, during almost any kind of activity. Luckily, “throwing your back out” is usually a temporary situation. The sudden onset of pain caused by twisting, lifting or bending is most often due to a muscle strain. As we age, we become more prone to muscle strains because our muscles lose elasticity.

Most people can identify the injury or activity that caused their pain. One minute you are bending over to tie your shoe, reaching for something in a cabinet or teeing off on the back nine. Then, out of nowhere, “OUCH!” – sudden tension and pain in the mid to lower back.

Throwing your back out can cause intense low-back pain and stiffness. It can even be an on–the-floor-can’t-move debilitating experience. Typical symptoms include muscle spasms with bouts of muscle tightening and difficulty standing up straight. You want pain relief and you want it now!

The good news is, in most cases, your back pain will go away on its own. Here are some at-home tips to help you feel better in the meantime.

DOs

  • Stop what you are doing and apply ice to ease the pain and inflammation. Cold therapy can be continued for about 20 minutes every 6-8 hours for the next 2-3 days. But remember – don’t put ice directly on your skin. It can damage the tissues and nerve endings.
  • You may find it helpful to lie flat on your back on a hard surface for support, rather than a cushy bed. This can help relax the injured muscles in the immediate aftermath.
  • Pain relievers such as acetaminophen, ibuprofen (Advil) and naproxen (Aleve) can help. However, they may not be advisable for anyone with kidney problems or a stomach ulcer. It’s a good idea to check with your doctor about which medications you should or should not take.
  • Once you are upright and stabilized, do whatever you can to stay that way so your injury does not worsen. That means avoiding bending, lifting or twisting through the spine. If you need to pick up something from the floor, keep your spine straight. When you brush your teeth or wash the dishes, maintain a straight, neutral spine, bending forward from your hips.
  • Sleep in a position that’s comfortable for your spine. Put pillows under your knees when you are on your back or a pillow between your legs if you sleep on your side. This helps the muscles to release.
  • If your pain persists after the third day, try a little moist heat. This can help reduce stiffness and improve blood flow to the injured area.
  • Massaging the affected muscle with firm pressure may help reduce tension. Press on the area for 30-60 seconds, then rub the surrounding area in a circular motion.
  • Drink water to stay hydrated when you are recovering from injury. Chronic dehydration can affect the strength and quality of your spinal muscles.
  • If tolerated, try to stay mobile in the first few days after your injury. Move gently. Mild movement is better than bed rest. Any lengthy bed rest can prolong your back pain.
  • When you are ready, engage in slow, easy stretching such as pulling your knees toward the chest. If it hurts doing any exercise, stop, slow down and try again later. Walking for short intervals can also help.
  • Get back to your regular activities, such as work, as soon as you can. Modify activities as needed. But remember, staying active will stimulate blood flow, increase flexibility and prevent spasms.

DON’Ts

  • Do not try to “play through the pain.” It is essential to let your body recover before resuming strenuous activity.
  • Do not sleep on your stomach. This can worsen back pain.
  • Do not perform heavy lifting or repetitive twisting of your back for up to six weeks. This can disrupt the healing process.
  • Do not ignore how you injured yourself. Make changes to the way you lift. Practice good posture and use judgement when lifting heavy items (ask another person to help you). Strengthen your core with abdominal exercises, which can protect your back. Do not sit in one position for long periods of time. Move around and stretch every 20 minutes to help prevent injury. Consider lifestyle changes such as losing weight to reduce your chances of recurring back issues.

After throwing your back out, it is natural to worry that your back will never get better. Listen to your pain and take care of yourself. You will most likely be on the road to recovery with these simple at-home solutions.

Symptoms that require prompt medical attention, but are not an emergency include:

  • Pain that has not reduced with at-home treatments
  • Pain that continues to interfere with your daily activities

Seek emergency medical attention if you have the following symptoms related to your back pain:

  • Bladder or bowel dysfunction
  • Numbness down one or both legs
  • Weakness or pain in your legs
  • Fever greater than 101.5 F, or other symptoms of illness

Back Pain Treatment in Northern Virginia

 To make an appointment, call the Inova Spine Program at 703-776-4700 or visit inovaspine.org

35 Comments

  1. Helen on October 31, 2019 at 3:53 pm

    please let me know are you going to have any classes at inova mount vernon hospital about regading the do’s and don’t on back injuries

  2. Frank on November 14, 2020 at 11:53 am

    I also found that frequent, barely-audible swearing seemed to be palliative. Considering that brushing my teeth was the triggering event, I also think a stern letter to my hygienist would be in order.

    Thanks for the advice!

    • Mary on August 19, 2021 at 9:29 am

      Thank you, Frank. I have found this to be an effective intervention as well.

      • Victor on June 14, 2022 at 6:58 pm

        That is one of the funniest helpful hint I’ve ever read and laughed at and yes I found a little inaudible swearing does help

    • Melody on April 3, 2022 at 8:29 am

      You made me laugh out loud, which hurt really bad since I just injured my back, but I suppose it was worth it. 😂

  3. Joe on December 5, 2020 at 12:15 pm

    By far the most helpful resource in managing my back injury, thank you so much.. You are amazing. You’ve given me the tools and resources to nurse my back back to health the proper way and took away alot of my anxieties.

    • Jean on March 31, 2021 at 9:10 am

      Injured my lower back hauling a water heater up stairs the wrong way. After 5 days the pain was much improved. Then I bent down to pick my socks up off the floor and retriggered the injury. Now I’m back to square one. Should I be concerned or simply continue treatment.

      • JHolc on May 26, 2021 at 10:40 am

        I’m sure you are healed by now but…I have had a few back strains from lifting weights. Mostly mild but two of them were moderate. This sounds like a moderate strain. With mild strains, they usually heal completely within a week. Sometimes just 2 or 3 days. Moderate strains can take longer. Ice for the first 3 days then heat after that. They key to avoiding reinjury is to avoid using the strained muscle so it can heal. It may feel better but that doesn’t mean it is healed enough to use it. I HIGHLY recommend using a back brace during the healing phase, especially when there is still pain. After there is no pain, wait a few more days before trying to do anything that involves the strained muscle. You should be fine after 2 or 3 weeks if you take it easy and avoid reinjury.

      • Stadist on June 16, 2022 at 2:17 am

        The article stresses keeping the back neutral, but I have found this to be important only immediately after injury AND of course when doing any kind of heavy lifting. After few days when most pain is away you really need to start doing mobility exercises that put the lower back on the move and activate and strengthen the muscles there.

        One example of a good exercise is stiff leg deadlift (you can easily google this), first carefully without any weights and then later with small weights, like light dumbells. You really should do this only with light weigts or no weights at all at the beginning, and always slow movements and stop the exercise if pain emerges.

        Also I don’t think the article stresses enough how especially lower back pain issues might be tied to tight hamstrings (a near chronical condition in modern day with how much people are sitting down), so stretching and loosening the tight hamstrings is important. Basically what happens especially when sitting is the tight hamstrings kind of twist hip front and cause lower back to be bent. This also explains why the lower back pain might disappear completely when standing upright but immediately come back when sitting down. When you are standing, the hamstrings are in short form, but when you are sitting there is an angle between hamstring buttock and hip, causing them to be flexed and hamstrings being one of the strongest muscles in human body this will pull your hip forward from below and cause lower back to be bent. You can try to force yourself to sit neutrally, but the hamstrings will always win the weaker lower back muscles in the tug of war of keeping hip and lower back in neutral position. So the stretching of hamstrings and strengthening of lower back muscles is the only solution, no amount of just resting will fix the issue unless the imbalance is addressed.

  4. Rosie B on February 8, 2021 at 3:27 am

    Thank you so much for this article. I’ve looked at loads of advice online and yours is the clearest. It’s the first time that I’ve ever done my back in.

  5. Christopher on April 5, 2021 at 3:46 pm

    Jean, I don’t think you’re “back to square one”, although it may feel like it. I think it is just your body telling you “Don’t do that! I am not healed yet!”

    • Alzo on January 13, 2022 at 3:18 pm

      I know from experience of disc issues that something like reaching for something light can cause severe injury. I was in bed not able to move for 10 days after reaching for a towel. Took 6 weeks before I could go back to work

  6. Lisa on May 1, 2021 at 10:44 pm

    Thanks for clearly written do and don’t.
    I played tennis league match on Monday, Tuesday morning, I felt pain, canceled all tennis and today is Saturday and just feel tightness in lower back. I put heating pad on few times and wrapped with good braces. That makes me to stand straight. Hope I won’t get it again. Lisa

    • Susan on May 25, 2021 at 5:45 am

      Some advice required!
      I bent down down 6days ago to pick up a towel and afterwards my back just went. Lower back pain and stiffness really struggling to walk and lift right leg any height. Done all of the above I do have problems back and forward with back pain just put it down to over use through manual work over the years. 6days on and I’m really still struggling do u thing I maybe should contact my GP. Usually they just want to give u strong painkillers which I struggle to tolerate. Any advice would be much appreciated.

  7. Grace on May 17, 2021 at 8:33 pm

    I am only a teenager and I got back pain from an injury, and my doctor and my mom (who is a physical therapist) are not helping me and not taking me seriously. I am hoping rest is how I can recover, because I have been injured for almost 2 months and I don’t think I ever will get better. This pain is so intense, especially at dance class, and I just can’t deal with it anymore! I want to be normal again.

    • Jon on July 15, 2021 at 4:10 pm

      I’m dealing with the same thing right now. Injured me back playing soccer at 17 and did it again now at 22. And while I’ve felt how you’re feeling, you will get better as long as you believe you will. Stay strong and sometimes it will be hard but just believe you can and will recover and you will. Make sure your parents and doctors are taking you seriously too. Or keep looking until you find one who does. Rest might fix it but you might need to strengthen other muscles to help support you back. And in that case, too much laying down and not enough exercise could be hindering your recovery. All in all, we got this Grace. Things will get better.

    • Erica B on August 17, 2021 at 2:37 am

      I’ve had a back injury 9 years ago, the pain has cone and gone, but lately it’s has been consistent. I’ve been doing stem on and off at the chiropractor office along with PT it helps for a few days. I also find that lidocaine roll on helps for a few hrs and light moderate workouts and back stretches seem to help a bit. So does hot and cold patches.

  8. Pat on June 13, 2021 at 4:57 pm

    Thank you so much for sharing this information. It was really helpful!!

  9. Barbara on June 19, 2021 at 12:46 am

    My back popped 12 weeks ago and still very painful in morning after I have slept. I can’t sit for long.i walk in the day. Don’t know what else to do for pain to go away

  10. Bec on July 17, 2021 at 8:42 pm

    thank you for this! I started having lower back issues when I was doing lower body workouts and running. I can stand up wrong and throw the thing out. 3 weeks ago I went kayaking, and had lower back pain afterwards. The next day I was bending over and then I sneezed. It was the worst pain I have experienced. I couldn’t walk for a day and it has been a slow healing process as I was stupid and tried to play through the pain. I’m glad I found this article!

  11. Andrea on July 23, 2021 at 11:18 am

    I put my back out stretching to reach for a can of air freshener on a high shelf. Hope that I’ll get better soon and be able to resume exercising as I was before. Worried that it’s a sign of things to come as I’m only 32.

  12. Paresh on August 28, 2021 at 1:54 pm

    I drive for hours but a week ago after 2 hours of drive i was not able to walk and laid down due to lower back extreme pain. Rested, iced, felt lot better and just an hour ago i had a sneeze and strong back pain. Now back in bad and read this Article which is the best article i cane across.Thank you so much.

  13. Becca on September 13, 2021 at 11:49 am

    I agree with the positive comments above. It’s weirdly hard to find very clear and consistent advice on how to balance the requirement to get moving as soon as possible with admonitions not to reverse the healing by overdoing it. I slipped on slippery tile and fell a few weeks ago – it was excruciating. Learned to my relief and surprise at the ER (called 911) that I hadn’t fractured my spine, just sprained it badly. I’m 70 and falling is a much bigger deal than it used to be. Scary!
    This little article clarifies and confirms what I’ve learned thru experience over the past few weeks. Lifting and twisting brings hurt the next morning. Moving around to just the first pain ‘reminder’ is good; powering through it leads to an aching, forced sedentary next day.
    Once just standing up wasn’t horribly painful I gradually increased brief walking and very gentle back-sprain- specific exercises. When the pain gets at all intense I rest. (About 30 minutes on my feet does it, but that’s a real improvement.) It seems to be slowly but steadily healing up now. Wish I’d had this advice from day one. Patience. And that middle ground. (Note – that’s advice for a sprain. Other back injuries might be different. I suggest that everyone press their doc for a c-scan or MRI.)

    • Stephanie on September 23, 2021 at 3:38 pm

      This article offers very useful insight and much needed encouragement. Since my back muscle sprain 19 months ago, I’ve been seeking guidance for my extremely frustrating cycle of a slow, patient recovery with reoccurring “reminders” (muscle spasms) resulting in intolerable pain which renders me completely immobile for 1-2 weeks.

      It’s really hard to find the balance between “get moving as soon as you can” with “don’t cross the movement line.” My slow but steady improvement gets eliminated by every small test of explorative movement. Starting over (every 2-3 months) has been a vicious cycle of pain and frustration. Ice and heat helps. Advil or Motrin helps. The Drs. remedy is RX pain medication which I have an adverse reaction to. The PT offered temporary relief.

      Meditation, music, prayer, avoidance behavior (anything other than focus on the pain) helps.
      At “our” age, Becca, lifestyle adjustments probably required.
      My Temperpedic mattress has been replaced with a recliner chair! Ugh…

  14. Shane on October 6, 2021 at 6:51 pm

    I injured my back working on a car. I’m a smaller guy, and I went to take the first lug nut off the tire and I couldn’t get it even by like kicking the tire iron so I started to pull up and I’m pulling as hard as I can and I feel this crazy pop at the lower part of my back and it almost took me down to my knees. I could barely stand and had to holler for my mom. It scared me. Never felt anything like that before. Anyways, I figured the next day was going to be crazy painful but it wasn’t so I decided to still go to work 2 days after the injury. I’m a waiter and when I woke up the day I had to work I could barely get out of my bed but I still went to work anyways. I barely made it through my shift. The pain progressively got worse the more I walked. So I got a back brace and that helped a lot but the more I walk the more the pain progresses. It’s almost like two vertebrae are rubbing together that’s what it feels like. I need some advice. Please. I’m afraid I’m gonna need surgery.

  15. Linda on December 3, 2021 at 2:17 pm

    Thank you for this information. I injured my back a week ago by just stretching. I felt a ‘pop’ and experienced the worst pain ever. When I could finally get out of bed, (about 3 hours) I couldn’t stand or walk without a walker for support. Having never experienced this before I went to the ER, was examined and given a strong pain medication, which I stopped after two days. After 5 days the pain comes and goes but so far is bearable. Thanks for the information.

  16. Parinitha on January 17, 2022 at 10:20 am

    The instructions to apply ice on the affected are well addressed in this post. To ease something, we must not hurt the other thing. Thank you for the great instructions and for the helpful post.

  17. John on February 1, 2022 at 8:27 am

    I would also add that stretching your hamstrings and hip flexors have helped significantly with reducing pain/discomfort.

  18. Lynda on February 20, 2022 at 12:16 pm

    I have suffered with lower back pain for several years now. I have been diagnosed with arteritis and a deuterating disc in lower back. I’m so thankful to run across this info from your desk. This will help me in the near future.

    • Maria on March 12, 2022 at 5:10 pm

      I fell twice on the ice and hit my back. The first time it was just on straight walking area the second time I was on a crazy carpet and fell back and slid down the snowy hill. When I stood up I noticed I had trouble breathing deeply. I have done physio for about 6 weeks and I am still having alot of trouble breathing deeply. It causes me problems sleeping and anxiety. What is going on and please tell me it will subside. It has been very difficult to live with.

    • Jules on May 9, 2022 at 4:33 pm

      I started feeling slight pain in my back around 3 days ago, and then I went to pick something up from the floor randomly and I had this sharp intense pain. After that literally any movement such as walking, getting up from sitting makes my back so painful. The only thing that helps is sitting in one position and not moving, and the minute I move it is the most painful thing. And I’m meant to be going on holiday in 12 days and scared I won’t be able to go if it’s still this bad.

  19. Peter brown on March 13, 2022 at 7:18 am

    Bending over doing some gardening and over stretched to the right pulling a muscle in the left lumbar region. Very painful.

  20. Jessica on March 19, 2022 at 12:38 pm

    Great advice from Dr. Santini. Thank you! I just now sprained my back getting laundry out of the dryer (mild twisting movement). Looked up advice and found this advice. Putting ice on it. Oddly enough, I am getting treatments for sciatica, including PT that starts in two days. This all started last Autumn during stretching classes. I am 60 with RA and probably did not warm up adequately. However, I do have vertebrogenic M54.51 lumbar spine pain. I have some dic issues revealed from MRI, but am not a candidate for surgery. Trying to get more active, safely. Climbed to top of Parthenon last month ( wanted to while I still could). Following day had a massage and was told by PT massage therapist that my body was inflamed and I needed several days of rest. I followed his advice.
    My question is – Is the sciatica related in any way to the sprain? Or is this just more getting older without proper conditioning?

  21. will on June 6, 2022 at 7:17 pm

    is yoga and some jogging (maybe 3 miles) ok to do? Or will this aggravate?

  22. Jessica on June 7, 2022 at 11:43 am

    I strained my lower back when I tried to lift my grandaughter 3 months ago and I’m still in discomfort.
    If I lean forward over the counter I feel the pain again and it bothers me for days. What is my next course of action?

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