Chronic Back Pain

Chronic back pain is back pain that lasts longer than 3 months. The cause of your back pain may not be known. Some common causes include:

Wear and tear (degenerative disease) of the bones, disks, or tissues that connect bones to each other (ligaments) in your back.
Inflammation and stiffness in your back (arthritis).

If you have chronic back pain, you may have times when the pain is more intense (flare-ups). You can also learn to manage the pain with home care.

Follow these instructions at home:

Watch for any changes in your symptoms. Take these actions to help with your pain:

Managing pain and stiffness

If told, put ice on the painful area. You may be told to apply ice for the first 24–48 hours after a flare-up starts.
- Put ice in a plastic bag.
- Place a towel between your skin and the bag.
- Leave the ice on for 20 minutes, 2–3 times per day.
If told, apply heat to the affected area as often as told by your health care provider. Use the heat source that your provider recommends, such as a moist heat pack or a heating pad.
- Place a towel between your skin and the heat source.
- Leave the heat on for 20–30 minutes.
If your skin turns bright red, remove the ice or heat right away to prevent skin damage. The risk of damage is higher if you cannot feel pain, heat, or cold.
Try soaking in a warm tub.

Activity

Avoid bending and other activities that make the pain worse.
Have good posture when you stand or sit.
- When you stand, keep your upper back and neck straight, with your shoulders pulled back. Avoid slouching.
- When you sit, keep your back straight. Relax your shoulders. Do not round your shoulders or pull them backward.
Do not sit or stand in one place for too long.
Take brief periods of rest during the day. This will reduce your pain. Resting in a lying or standing position is often better than sitting to rest.
When you rest for longer periods, mix in some mild activity or stretching between periods of rest. This will help to prevent stiffness and pain.
Get regular exercise. Ask your provider what activities are safe for you.
You may have to avoid lifting. Ask your provider how much you can safely lift. If you do lift, always use the right technique. This means you should:
- Bend your knees.
- Keep the load close to your body.
- Avoid twisting.

Medicines

Take over-the-counter and prescription medicines only as told by your provider.
You may need to take medicines for pain and inflammation. These may be taken by mouth or put on the skin. You may also be given muscle relaxants.
Ask your provider if the medicine prescribed to you:
- Requires you to avoid driving or using machinery.
- Can cause constipation. You may need to take these actions to prevent or treat constipation:
  - Drink enough fluid to keep your pee (urine) pale yellow.
  - Take over-the-counter or prescription medicines.
  - Eat foods that are high in fiber, such as beans, whole grains, and fresh fruits and vegetables.
  - Limit foods that are high in fat and processed sugars, such as fried or sweet foods.

General instructions

Sleep on a firm mattress in a comfortable position. Try lying on your side with your knees slightly bent. If you lie on your back, put a pillow under your knees.
Do not use any products that contain nicotine or tobacco. These products include cigarettes, chewing tobacco, and vaping devices, such as e-cigarettes. If you need help quitting, ask your provider.

You are not able to control when you pee or poop.
You have severe back pain and:
- Nausea or vomiting.
- Pain in your chest or abdomen.
- Shortness of breath.
- You faint.

These symptoms may be an emergency. Get help right away. Call 911.