Maybe it happened when you were shoveling snow. Or maybe you were picking up a bag of mulch at Home Depot that was a little heavier than you’d thought. Or maybe you weren’t doing much of anything—and suddenly, ouch—your back went out.
According to National Institutes of Health (NIH), some four out of five Americans will experience acute lower back pain during their lifetimes. It’s one of the leading causes of work absences, behind colds and flu. It’s also the second biggest reason we visit the doctor.
Turns out, though, that there’s rarely a reason to run to the doc so fast. In general, says the NIH, lower back pain generally improves by itself, over time—sometimes as little as a few days and typically within 4 to 6 weeks.
Moreover, often at patients’ behest, doctors order MRI or CT scans to pinpoint the cause of the pain. But diagnostic imaging is usually unnecessary, says the American Academy of Family Physicians (AAFP)—and what’s more, may not help you recuperate faster.
In the meantime, here’s what you can do to ease the pain and get back to life ASAP.
Stay on your feet
If you’ve thrown your back out, your first inclination—understandably—may be to hit the sack.
Not so fast. “[Movement] helps to get the inflammation out and relax the spasm,” says Charla R. Fischer, MD, an orthopedic surgeon at NYU Langone Orthopedic Center and a spokesperson for the American Academy of Orthopaedic Surgeons (AAOS).
And bed rest may make you stiffer, and can even weaken your bones and muscles.
So go about your regular day, to the extent possible (passing on team sports and lifting weights, of course).
Light exercise is good, too, says Fischer, such as gentle stretching or walking.
Of course, if you’re in agony, you may have no choice besides resting. In that case, lie face-up in bed with pillows elevating your head, shoulders and knees, or curling on your side to a fetal position, says the NIH.
Hit the medicine cabinet
When it comes to over the counter pain relievers, Acetaminophen (Tylenol) is fine, says Fischer, but ibuprofen (Advil, Motrin) or naproxen (Aleve) will help reduce swelling, too.
For that reason, doctors say, it’s often better to take the meds regularly over the course of a few days, rather than only popping pills when the soreness becomes intense.
Debating between cold compresses and heat packs? Try both. Cold may lessen swelling, while heat helps relax muscles, and lowers inflammation. “Whatever helps you to feel better,” says Fischer.
Some experts suggest using ice for the first two or three days, and then switching over to heat. “The most important thing is to apply heat or ice for only 20 to 30 minutes at a time,” says Fischer, “up to 3 times a day.”
What probably doesn’t help: lumbar back braces. Lots of people swear by these wide belts, which supposedly lend extra support to your core muscles. But research, including a review of 15 back pain studies, found that they don’t much help ease or prevent acute pain.
Know when it’s more serious
If your pain is the result of a serious trauma, like a car accident or fall, see a doctor right away, says the AAFP. That’s also true if you’re over 70, have diabetes or osteoporosis, or a history of cancer.
In addition, leg pain or weakness may hint at a herniated disc or other spinal condition. Signs like fever, unexplained weight loss or bladder problems are rare but serious, and could indicate an infection or tumor.
Finally, see a doctor if your pain goes longer than four weeks or never improves—if it’s “higher than a five out of 10, after three to five days of home treatment,” says Fischer.
Many strains and sprains are caused by lifting heavy objects or making abrupt movements, especially if you’ve been relatively inactive beforehand.
Weekend warriors are especially prone—sorry, golfers—and your odds go up as you get older. The following tips can also help:
Lift the right way. Don’t ever bend at the waist. Instead, spread out your feet, bend your knees and flex your stomach muscles. Lift with your legs, keeping your back straight and the object close to your body.
Sit smarter. It’s well known that sitting is bad for your health—but sometimes you have no choice, especially if you have a desk job. So get an adjustable chair with good lumbar support, and for reinforcement, place a pillow on the seat behind your lower back. And take periodic breaks to get up and move around.
Improve your core. Activities like swimming and walking can improve your flexibility and build up those crucial abdominal and back muscles, according to the AAOS. Certain exercises better posture, too, placing less pressure on your lower back, say researchers at Harvard Medical School.