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The most common cause of back pain is muscle strain. As we get older, many of us get less exercise. As a result, the muscles in the abdomen and back that support the spine weaken and get out of shape. Things which used to be done with ease, such as hauling a bag of groceries, lifting a baby or raking leaves, suddenly cause pain.

Lifting something when your back is out of shape is like someone pulling you out of a crowd to run the 26 mile Boston Marathon. Of course, even the best-trained athlete can get back pain, but in general, the better conditioned you are, the less likely you are to feel pain.

Muscle strain is not the only cause of back pain. The thirties and forties are the years when arthritis and other types of natural degeneration in the small joints of the back begin to catch up with us. Spinal stenosis is a narrowing of the canal in the vertebrae that surround the spinal cord. This narrowing puts pressure on the nerves in the lower back and causes pain.

Another common cause of back pain is a herniated disk. Disks are small pads made of a tough, elastic outer covering (called the annulus) and a soft center. The disks act like shock absorbers between the vertebrae. Over time, a disk can herniate, meaning the annulus is torn and the soft center has extended out to press against a nerve root, causing horrible pain.

Poor posture also increases strain on the back and can aggravate arthritis and lead to disk problems.

When should you consult a doctor?

• When the pain is so intense that you cannot move.
• If the pain spreads to our legs or buttocks.
• If your legs or feet feel numb or tingly.
• If you lose control of your bladder or bowel movements.
• If pain is accompanied by a fever or abdominal pain.

Is surgery the only option?

Often back pain is relieved without surgery or drugs. About 60 percent of back pain sufferers return to work within one week, and 90 percent are back on the job in six weeks.

Tips for preventing and treating back pain.

• Do an early morning stretch. Some experts recommend stretching before getting out of bed.
• Walking is an excellent way to strengthen your back muscles and those of your buttocks, abdomen, and legs.
• Sitting puts more strain on your back than standing. If you must sit for an extended time, change position often and give your back a break by standing and walking around every hour or so.
• Kneel, don’t bend. Avoid bending at the waist to pick up something. This motion increases your risk of injury by creating tension in the back.
• While lifting, let your legs do the work.
• Maintain good posture.
• Avoid high heels.
• Check you mattress to ensure proper support.

Finally, if you need to hear yet another reason to quit smoking...smoking decreases blood flow to the back and can weaken disks. So, if you smoke...quit.