Back Care

Causes of back pain:

Back pain is a common ailment, affecting eight out of ten people at some point in their lives.

The spine has a difficult job in that it must support the weight of the upper body and still be able to bend and twist in any direction. The greatest strain is placed on the lower back, particularly among people who do a lot of sitting or who are underactive.

Many conditions may cause back pain. Some, like pregnancy and emotional tension, are common, natural occurrences. Other factors that contribute to back problems include physical trauma, athletic injuries, poor physical fitness or being overweight. Additional examples:

  • Overuse or improper use of the back (poor body mechanics) may cause painful muscle spasms or back strain, i.e. stretching or tearing of muscles.
  • Weak abdominal muscles may cause back sprain, i.e. stretched or torn ligaments rather than muscles, due to improper positioning of spine.
  • Slipped or ruptured discs may cause pain if discs press upon the spinal nerves. Pain may radiate throughout the legs as well as the back.
  • Strain or soft tissue damage, secondary to injury
  • Improper posture may cause back strain or sprain due to improper bending, lifting, sitting or standing. 

Ways to relieve back pain:

Ice or heat?  The application of either ice or heat to sore back muscles can greatly relieve pain.

  • Ice may be applied at any time. Use ice for 10-20 minutes, placing a wet towel between the ice bag and your body. 
  • Heat is not recommended for the first 48 hours after the onset of back pain. After 48 hours, using heat or ice generally depends on what feels best to you. Use heat for a maximum of 20 minutes at a time.

Backward or forward movements: Some people find that doing slight backward or forward bends can help relieve back pain. If an exercise decreases your symptoms, repeat it frequently throughout the day.

Backward positions:

Backward Positions


Place hands on the small of your back. Bend backward from the waist, keeping your knees as straight as possible. Slowly return to an upright position. Repeat 2-10 times.

Lie down

Lie face down on a soft but firm surface with your head turned to the side and your arms at your sides. Relax for a couple of minutes.

Lie down

From this prone position, slowly raise your upper body enough to lean on your elbows. Relax as much as possible while maintaining this position for 5-30 seconds. Repeat 2-10 times.

Chair bend


Lean forward in your chair and lower your chest to your knees. Return to a sitting position by placing your hands beside your legs, using them to push yourself slowly back to an upright position. Hold 5-30 seconds. Repeat 2-10 times.


Forward positions:

Legs on chair


Lie on your back, placing your legs on a chair. Increase your comfort by placing a pillow under your legs. Relax for a couple of minutes.

Knees to chest

Lie on your back with knees bent, feet flat on the floor. Tilt your pelvis slightly so that your spine is flat on the floor. One at a time, slowly raise each bent knee to your chest. Next, hug both knees to your chest, then lower them one at a time. Hold for 5-30 seconds. Repeat 2-10 times.

How to stand, sit, bend, lift and sleep:

How to stand:

How to stand

Improve your posture. Stand with your lower back in a neutral position by standing tall with your chin and stomach tucked in. Try keeping your earlobe over your shoulder and your shoulder over your hip.

When standing for long periods, put one foot up on a foot rest to reduce the tendency to stand with a sway back.

Avoid wearing shoes that have high heels or are worn out.

How to sit:

How to sit

Sit in your chair with both feet on the floor and your back against the chair back. The chair should keep your back in a neutral position, with a small but comfortable inward curve.

If you sit for long periods, it is essential to get up frequently and walk around.

Pay attention to your posture while doing activities that require sitting, such as driving and watching TV.

How to bend:

How to bend



When bending forward, always bend your knees. Squat, keep your back in a neutral position and go down on one knee.

How to bend


Or do a "golfer's bend," countering the forward movement by letting one leg rise in back.

How not to bend



Do not bend like this, because it can strain the back.


How to lift: When lifting, use one of the bending techniques described above and:

Sequence of lifting

Hold the object close to your body, lifting with your legs.

Keep your elbows close to your body

Do not twist at the waist

Keep your spine in a neutral position

Get help to lift

Do not lift anything that is heavier than you can manage. Get help if the object is too large or heavy.

How to sleep:

It's best to sleep on a firm mattress with a soft top layer. If your mattress is soft, try placing a bed board beneath it to increase the firmness.

Here are suggested sleep positions to reduce back pain while lying down. Choose one that works best for you.

Sleep on side with pillow



On your side with hips and knees bent and a pillow between knees and ankles.

Sleep back with pillow under knees

On your back with a pillow beneath bent knees for support.

Sleeping on stomach Correctly

On your stomach with or without a pillow under your torso. Note: this position is not the best for those with neck pain.

Sleeping on stomach - No

Do not sleep like this.  Avoid using big pillows beneath your head as they put a strain on your back.

Preventing back pain:

To prevent back problems:

  • Practice good posture
  • Maintain a healthy weight
  • Do the physical exercises below
  • Engage in relaxation exercises

Exercises: These exercises are designed to strengthen the muscles that support your back. Try 2-3 repetitions, building up to 10 repetitions if no increase in symptoms.

Abdominal drawing-in:

Abdominal Drawing-In

Lie on your back as shown. Contract your abdominals by bringing your belly button in and back towards your spine, without holding your breath. Hold for 5 seconds.




This exercise strengthens buttock muscles. Lying on your back, perform abdominal drawing-in, as above, holding throughout this exercise. Gently raise your hips, keeping a straight line between your knees and shoulders. Do not arch your back. Hold for 5 seconds, then slowly lower hips to the floor.

Opposite arm and leg lift:

Opposite arm and leg lift

Start on your hands and knees with a flat back. Contract your abdominal muscles by drawing your belly button inward toward your spine. Slowly raise your left arm and right leg until horizontal with your torso (leg and arm in a straight line). Do not rotate your torso. Do not allow your back to sag. Hold for 5 seconds. If this is too difficult, start by raising just your arm or leg.

Side plank:

Side Plank

Lie on your right side, supporting yourself with your right elbow, forearm and wrist. Contract your abdominal muscles by drawing the belly button inward toward your spine. Press firmly into the floor with your supporting arm, raising your torso and pelvis upwards until they form a straight line with your legs. Do not let your torso rotate forward or backward. Do not let your hips move toward the rear. Hold 5 seconds. Repeat on the other side.

Endurance activity:

Using an elliptical machine

These are activities that can be sustained for up to 20 minutes to improve muscle and cardiovascular endurance and are vital in the healing process of lower back pain. It is important to include endurance exercises that will not increase or produce lower back pain. Examples include using an elliptical machine, riding a stationary bike, swimming and walking.

Sports activity:

When you are pain-free in your daily life and during endurance activities, you may begin a graduated return to sports. This may include participating for a shorter time and/or in a less competitive environment.



Stress reduction through relaxation is also an important way to control lower back pain. Relaxation comes in many forms, including mindfulness-based meditation, visualization, positive self-talk, or any number of strategies that help you to release tension from your muscles.

For more information:

UHS Physical Therapy - for U-M students

MHealthy Back Care - for U-M employees