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.


  • 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.


  • 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

1 Comment

  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

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