Modifying activities and learning techniques to decrease stress on the back are important to resolving or controlling low back pain and sciatica. Since back pain tends to recur, lifestyle changes should become a way of life if you hope to avoid future episodes.
Prolonged bed rest is usually not advised. Bed rest can weaken muscles and slow recovery. In most cases, your doctor will recommend that you continue normal activities as much as is tolerated. Stay active within the limits of your pain and avoid activities that worsen the pain.
Guidelines for activity include:
Poor posture and slouching can put more pressure on your lower back. Stand and sit straight, and avoid sitting up in bed.
Exercises to stretch and strengthen the back and stomach muscles should be done regularly. You may also want to include balance exercises that work the trunk muscles.
A low-impact aerobic program will further improve your physical fitness and help you maintain a healthy weight. Choose exercises that you enjoy and that you can do on a routine basis. Activities that are back-friendly include walking, swimming, or biking. Exercise also can help you manage stress. Check with your doctor before starting any exercise program. The 2008 USDA Physical Activity Guidelines Advisory Committee Report recommends at minimum 2 hours and 30 minutes a week of moderate aerobic activity, and strengthening exercises at least 2 days a week.
Maintenance of good weight is important for your overall health. While scientific evidence is inconclusive as to how much obesity contributes to back pain in general, extra pounds can increase pressure on the spinal muscles and discs. Follow the dietary and exercise plan recommended by your doctor. To lose weight, you have to consume fewer calories than you expend. To maintain a healthy weight, eat an equal number of calories to those you expend. Even more exercise than minimum recommendations may be required to lose weight.
Smoking may contribute to degeneration of the discs in the spine. Also, smokers risk possible re-injury to the back during a coughing attack. Smoking can adversely affect healing if you are having back surgery. To heal properly, you should quit smoking at least 2 weeks before a spinal fusion procedure and stay tobacco-free for 6 months afterwards.
Stress can increase muscle tension. Take time out to relax, exercise, and practice relaxation techniques. If you need support or assistance in reducing stress, you may want to try some of the following techniques:
Certain changes to your workspace, attire, and home can reduce the stress on your back:
While some people think that using shoe inserts will prevent back pain, so far there's not a lot of evidence to support this.
More serious symptoms associated with back pain that may require immediate medical attention include:
2008 physical activity guidelines for Americans. US Department of Health and Human Services. https://health.gov/paguidelines/guidelines/chapter1.aspx. Accessed December 27, 2017.
Acute low back pain. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114958/...te-low-back-pain. Updated October 25, 2017. Accessed December 27, 2017.
Chronic low back pain. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116935/Ch...ic-low-back-pain. Updated June 30, 2017. Accessed December 27, 2017.
Counseling and education for chronic low back pain. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T910282/Counseling-and-education-for-ch...ic-low-back-pain. Updated December 22, 2017. Accessed December 27, 2017.
Exercise therapy for chronic low back pain. EBSCO DynaMed website. Available at: http://www.dynamed.com/topics/dmp~AN~T906250/Exercise-therapy-for-ch...ic-low-back-pain. Updated November 27, 2017. Accessed December 27, 2017.
Natour J, Cazotti Lde A, Ribeiro LH, et al. Pilates improving pain, function and quality of life in patients with chronic low back pain: a randomized controlled trial. Clin Rehabil. 2015;29(1):59-68.
Sciatica. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115166/Sciatica. Updated May 8, 2017. Accessed December 27, 2017.
2/24/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T116935/Ch...ic-low-back-pain. Sahar T, Cohen M, et al. Insoles for prevention and treatment of back pain. Cochrane Database Syst Rev. 2009;(1):CD005275.
11/29/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T906250/Exercise-therapy-for-ch...ic-low-back-pain. Gatti R, Faccendini S, Tettamanti A, Barbero M, Balestri A, Calori G. Efficacy of trunk balance exercises for individuals with chronic low back pain: a randomized clinical trial. J Orthop Sports Phys Ther. 2011;41(8):542-552.
Last reviewed November 2018 by EBSCO Medical Review Board Michael Woods, MD, FAAP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.