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Lifestyle Changes to Manage Low Back Pain and Sciatica
General Guidelines for Managing Low Back Pain and Sciatica
- Alter your activities
- Practice good posture
- Follow a home exercise program
- Lose weight if you are overweight
- If you smoke, quit
- Manage stress
- Modify your environment
- Avoid excessive, prolonged, or forceful bending or twisting of your back.
- Do not lift heavy objects. Learn the proper way to lift even light objects, using your knees rather than your back for leverage. If necessary, have a physical therapist or ergonomic specialist teach you proper body mechanics for daily activities.
- When lifting, squat down next to the object, hold the object close to your chest, maintain a straight back, and use your leg muscles to slowly rise.
- Plan ahead and ask for assistance with lifting or moving heavy objects.
- Avoid sitting for long periods. When you do sit, choose seats with good lumbar support. You may be able to use a standing desk at intervals to help avoid prolonged sitting.
- Avoid standing for long periods as well. If you need to stand, place a low footstool in front of you and alternate placing each foot on it for a period of time. This will take some of the load off your back.
- Consider job retraining if your work requires a lot of heavy lifting or sitting. Ask whether your company has someone who specializes in helping redesign the workplace for the restrictions an individual with back pain requires.
- Cognitive behavioral therapy
- Stress management classes
- Relaxation techniques
- Breathing exercises
- Don't wear high-heeled shoes.
- If you sit for long periods of time, use a stool to bring your knees above your hips.
- Avoid having objects (such as, a wallet) in your back pocket while sitting.
- Use a lumbar support pillow when sitting or driving.
- Sleep on a firm mattress.
- Don't sleep on your stomach.
- Sleep on your side or on your back with a wedge or pillow under the lower part of your legs.
- Some people find that an adjustable mattress is helpful because it allows them to change firmness depending on how their back feels on any given night. Others (generally those who sleep on their sides) find that firm foam mattresses are better for them than conventional mattresses. Finding the best mattress is individual—what works best for one patient may not be good for another.
When to Contact Your Doctor
- Pain that doesn't subside, or worsens with rest
- Pain that is worse when you are reclining
- Pain that is severe or that has gotten dramatically worse
- Progressive weakness or numbness in a leg or foot
- Difficulty walking, standing, or moving
- Numbness in the genital or rectal area
- Loss of bowel or bladder control
- Burning or difficulty with urination
- Fever, unexplained weight loss, or other signs of illness
- If there has been any trauma, fall, or impact
- If you have a history of cancer, back pain should be evaluated
Conn's Current Therapy 2001. 53rd edition. WB Saunders Company; 2001.
Pain. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/chronic%5Fpain/detail%5Fchronic%5Fpain.htm#Spine. Accessed October 27, 2008.
Physical activity guidelines for Americans. US Department of Health and Human Services. http://www.health.gov/paguidelines/guidelines/chapter1.aspx. Accessed October 27, 2008.
Physician quality reporting system 2011 quality measures. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 5, 2011. Accessed November 3, 2011.
Textbook of Primary Care Medicine. 3rd ed. Mosby, Inc.; 2001.
2/17/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php. Bigos SJ, Holland J, et al. High-quality controlled trials on preventing episodes of back problems: systematic literature review in working-age adults. Spine J. 2009;9:147-168.
2/24/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php. Sahar T, Cohen M, et al. Insoles for prevention and treatment of back pain. Cochrane Database Syst Rev. 2009;(1):CD005275.
11/29/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed. Gatti R, Faccendini S, et al. Efficacy of trunk balance exercises for individuals with chronic low back pain: a randomized clinical trial. J Orthop Sports Phys Ther. 2011;41(8):542-552.
- Reviewer: Rimas Lukas, MD
- Review Date: 09/2012
- Update Date: 09/27/2012