Expert Q&A: Back Strain or Arthritis?

Question: I am a 35-year-old man who has had pain in my lower back for the past couple of weeks, and I’d like to know some methods for low back pain relief. Because my mother and an aunt both have arthritis, I’m also wondering if I'm developing arthritis, too.

A: It's possible, but very unlikely, that you have arthritis of the spine. The most common cause of acute low back pain in people your age is back strain. This condition is caused by strain to the muscles or ligaments supporting the spine or a herniation of the lumbar disks (cartilage pads that cushion the vertebrae). It is not always possible to differentiate between the two causes, nor is it necessary. In the vast majority of cases, the pain improves and subsides over several weeks. 

Assuming your problem is simple back strain (and unless you develop other symptoms, you can safely assume it is), the following advice can help you achieve low back pain relief: 

• Stay active. Prolonged bed rest (more than four days) has the potential for weakening muscles and prolonging the pain. 
• Exercise in moderation. Start with a few minutes of daily walking, swimming or stationary cycling and build up to 20–30 minutes per day.   
• Keep working. You can continue your daily work routine if your job does not consist of strenuous manual labor. 
• Use medications. Acetaminophen or an over-the-counter nonsteroidal anti-inflammatory drug (such as ibuprofen) can offer low back pain relief and keep you mobile. Prescription muscle relaxants may do little to help your pain and can cause unwanted side effects. 
• Use hot and cold treatments. An ice pack or hot water bottle applied to your lower back can be soothing. 
• Lift carefully. Lift objects close to your body and avoid twisting, bending and reaching while lifting. 
• Avoid prolonged sitting. If you work at a desk, change positions often. Place a support at the small of your back, use armrests, and recline your chair back slightly to make sitting more comfortable. 

Doyt Conn, MD 

Professor of Medicine 

Emory University School of Medicine 

Atlanta, Georgia