That twinge is telling you something. Don't ignore back pain.

March 22, 2023 Swedish Health Team

[5 min read]

In this article:

  • Maintaining spine health is important for keeping your back pain-free and preserving your mobility.
  • Incorporating exercises that strengthen your back and core can help support your spine and maintain your quality of life.
  • Keeping good posture when you’re sitting and sleeping can also help with pain relief while keeping your spine at its strongest.

Most of us know the feeling: you bend over or pick something up and, ping, there’s an anxiety-provoking twinge or strain in your back or neck. For some of us, it’s mild and goes away on its own. For others it’s a serious or chronic issue, needing urgent or ongoing care. The good news is that that even though about 80% of us will have back or neck pain in our lives at some point, most of us will not need surgery or advanced imaging. Most of our symptoms will resolve on their own with time, movement and gentle therapy.  

To learn more about neck and back care, and for some advice on caring for our spine and managing pain from injuries, we spoke with Wilson Chang, M.D., a pain, headache and rehabilitation medicine specialist here at Swedish.

What are some common injuries that typically require at home care or a visit to our primary care doctor?

Back pain can be quite random: It can be due to an injury like lifting something heavy or twisting. More commonly, one can hurt their back by doing nothing out of the ordinary like getting out of bed or rising from a sit to stand. For actual injuries to the back, heavy lifting is a very common cause of back pain. This includes gym-related activities that overexert the back without proper mechanics or posture. I have patients who have injured themselves while doing deadlifts and squats or using unassisted free weights incorrectly. For normal activities, back pain can present out of nowhere when one is not mindful of the core muscles. While it can be incapacitating, most acute back pain is treatable with physical therapy, home exercise and analgesics.  If pain does not subside or improve within a few days, then patients should consult their doctor.

Help your doctor help you

Bring your doctor all the pertinent information about your injury, the pain you are experiencing and other symptoms that might be related to the injury. Unrelated or minor symptoms that may indeed be associated with an injury. 

There is an excellent mnemonic that can help you discuss your injury with your doctor: PPQRST. 

P stands for provocative, meaning the factors by which pain is made worse or better. Q stands for quality of pain; doctors need to know if the pain is either sharp like a knife or dull like a bruise because any information about how your pain feels is crucial information. R stands for region and radiation of pain. We want to know where your pain located. Does it travel? S stands for severity: this is a scale of 1 to 10, which we use to determine urgency. T stands for timing; the onset of pain often provides the clue to the cause of back pain.

What are some serious symptoms that we should not ignore?

Back pain varies greatly in onset, location, quality and radiation. There are serious symptoms that might require medical intervention, including a sudden, new pain following a fall; sharp, electricity-like pain that starts from the back and radiates down the leg or toe; progressive worsening of a pain point that can be located using one finger; and pain that does not respond to over-the-counter medications or physical therapy. 

When should we call the doctor or seek emergency treatment immediately?

I cannot overstate the importance of recognizing symptoms that warrant immediate medical attention.  Red flag symptoms as I like to call them include incapacitating pain that radiates to the leg/toes, pelvic numbness, balance loss, loss of bowel or bladder control.  These symptoms can be a sign of serious neural injury and requires emergency medical attention.

Help yourself at home

Most of the time, we can treat minor neck and back pain at home with exercise and non-opioid pain medications. There are several over-the-counter medication options that can help improve minor injuries. The most common – and quite popular – oral medications are called non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen.  NSAIDs are very effective and easily accessible.  Another option is acetaminophen. This is also a good analgesic that works very differently than NSAIDs.

For those who prefer a non-oral formulation, topical diclofenac gel is also available and can be just as effective and are available at your local pharmacy. There are also transdermal patches that can reduce pain. Lidocaine or menthol-based patches help numb sensitivity. Some even generate some heat to “distract” your nerves and allow them function normally. 

Get moving!

Exercise and movement can help keep your spine in its best shape to keep holding you up. If you’ve taken a break from sports or are trying a new activity, learn how to protect yourself from injury as you’re getting back in the game. If you are actively experiencing back pain, consult with your physician for pain relief and treatment options before starting a new exercise regimen. You can also work with a physical therapist or athletic trainer to improve your core strength, especially if you are recovering from a back injury or pain.

Incorporate core exercises to strengthen your spine

Your spine is what holds your whole upper body upright, so it’s important to engage and strengthen all your core muscles, including your upper and lower abdominals, obliques and back to maintain spine health and wellness. Try some of the following exercises to help strengthen your core:

  • Side plank: Lie on your side with your forearm on the ground and your elbow under your shoulder. Lift your hips and engage your obliques.
  • Trunk curl: Lie on your back with your knees bent and feet on the ground. Curl your upper body off the ground and hold for a few seconds before returning to the starting position.
  • Bird dog: While on all-fours, extend your opposite arm and leg and hold. Return to all-fours and repeat on the other side.
  • Prone raises or supermans: Lie flat on your stomach with your legs straight and arms extended overhead. Engage your back to lift your arms and legs off the ground. Hold for a few seconds before returning to the ground.

Some activities, including exercises that improve cardiovascular health, can help support your spine by keeping it engaged and fluid. Many of these activities, like walking, running, biking, swimming and yoga, improve bone strength, support good posture and help shore up the muscles that support a healthy spine. They also help you maintain a healthy weight, which is another important factor in spine care and spine health.

Maintain healthy postures (at all hours)

Being seated for long periods can harm your spine because the disks in your spine have the most pressure on them when you are in seated positions. Keeping a good seated posture, including sitting up straight and not hunching forward, helps prevent some of these lower back pain problems. If you work at a desk, make sure to take regular breaks to stand and walk around to take pressure off your back and lumbar spine.

Sleep is another time to think about your spine health. Having a medium to firm mattress helps support your spine during sleep. Consider a bolster for under your knees if you are a back sleeper, as this helps to keep pressure off your lower back, thereby lessening your back pain. For side sleepers, putting a pillow between your knees can help keep your hips and lower back in alignment.

In addition to exercise, what else should we do it treat an injury and relieve pain?

Regular exercise is crucial for maintenance.  I like to think of it like brushing your teeth for good dental health. As long as you do it consistently, every day, it helps to maintain a good health—in this case the back, core, and surrounding supportive muscles.  Treatments such as massage and acupuncture can be explored. They are very safe and non-invasive forms of treatment that don’t involve serious manipulations of back and encourage the body to heal naturally.

Find a doctor

Learn more about spine care and how our specialists from the Swedish Neuroscience Institute and can help you. Our Swedish provider directory can help you find a specialist or primary care doctor that's right for you. Whether you require an in-person visit or want to consult a doctor virtually, you have options. Swedish Virtual Care connects you face-to-face with a nurse practitioner who can review your symptoms, provide instruction and follow up as needed. If you need to find a doctor, you can use our provider directory.

Additional resources

Spine services restore hope

Ouch! What can help your aching back?

Recovering from a health crisis, one step at a time


This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.
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