Back pain. Sooner or later, almost everyone gets it. In fact, it’s the most frequent reason for seeing a doctor and for missing work.

Why is this problem so widespread?

There are three main reasons. First, the back routinely undergoes great stresses because we stand erect, walking on two legs. Second, many people are out of shape. Being overweight adds strain on the back, and our sedentary lifestyles weaken our muscles. Third, longer lifespans lead to greater wear and tear on bones and joints.

Besides these sources, many women also develop back pain during pregnancy. That’s due to the increased weight they carry and the relaxing of muscles and ligaments caused by hormonal activity. In addition, there’s osteoporosis, which affects about 20 percent of all American women over the age of 50. Osteoporosis is the loss of bone mass over time. A leading cause of this condition is a drop in estrogen for women at the time of menopause. Osteoporosis can lead to the weakening and failure of bones in the spine.

Fortunately, we can do a lot to prevent hurting our backs. A good first step is to watch your weight. Extra pounds strain the spine as well as other joints and bones. While watching your diet make sure you get enough calcium to combat osteoporosis. Remember, too, that activities like running and swimming burn calories and benefit your heart. Try other forms of exercise as well. Strengthening your back and stomach muscles can go a long way to enhancing back health.

Flexibility also is important as it serves to protect your spine. As we age, we lose flexibility. Practicing Pilates and yoga are excellent ways to maintain strength and mobility. While staying fit does take time, the ongoing commitment provides benefits that are so great that you’ll be glad you made the effort.

While exercise is a good idea, be careful. Don’t be too aggressive with any new physical activity. People can harm their backs when they rapidly change their activity level. Whenever you engage in any physical pursuit, listen to your body. Gradually increase your exercise and activities.

Besides staying fit, make sure that you protect your back. Work is a good place to start because many problems begin there. Do all you can to make your workspace “back friendly.” This is especially true in the modern office. If you spend a lot of time using a computer, arrange your area so you can minimize harm to your back. Make sure that your chair is adjusted so that your feet are on the floor and your knees are level with your hips. Put the screen so its top is just below eye level. Sit straight and centered in front of the screen and the keyboard. The key is to avoid craning your neck. Get a chair with good lower back support. Take frequent breaks: get up and walk around. Also, whenever you lift something heavy, like a box of computer paper, use your legs—not your back. And, no matter where you are—work or home—using good posture and lifting techniques will help keep you from needing to see a physician.

If you do hurt your back, remember that most injuries heal on their own and rarely require surgery. Many patients feel better by just taking it easy for a day or two. Complete recovery frequently occurs in six to 12 weeks. However, there are times when you must see a doctor. These include when you experience:

• Severe pain. If you can’t tolerate the pain, see a physician. Doctors often can provide care that reduces discomfort while natural healing occurs. Treatment options range from injections to medications and therapy. Some serious conditions also can present as back pain, and your doctor can help determine the next steps.

• Weakness or numbness in the arms or legs, and/or loss of control of your bowel and bladder function. This may be a sign of nerve damage and require immediate attention. Evaluation by your physician is always the best course of action in those cases.

While doctors will try to solve back problems without surgery, sometimes no other choice exists. Surgeons typically operate to stabilize bone or to release a pinched nerve. Back surgery usually involves fusion, joining two vertebrae to stop painful movement, and/or a decompression, removing part of a disk or bone spur that is pinching a nerve or the spinal cord.

If your doctor suggests surgery, learn all you can about the recommended procedure. Modern surgical techniques are sophisticated, but the basics of most operations can be grasped easily. Be sure to ask why a procedure is needed, what will happen during it, and what results you can expect. Ask to see your x-rays. They often can help clarify any questions you may have. Never agree to an operation unless you feel comfortable that you understand what will happen. If you don’t get satisfactory answers or have any misgivings, seek a second opinion.

Remember it’s your back, and if you take care of it, it will take care of you and allow you to enjoy an active, pain-free life.  

Mark B. Kerner, M.D., is an orthopedic spine surgeon with Virginia Orthopedic Spine and Specialists, a Bon Secours Medical Group specialist practice located at the MAST One Center in Portsmouth. See www.bshr.com/ortho for more information.