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Patient Discussion Handout 1:  Back problems - Yes or No?? 
  The news is good.  Your clinician has not found any dangerous causes for your back problem.  Almost everyone has a low back problem at some time. In only one person out of 200 does the problem eventually have a serious cause.  A medical history and physical examination alone are very good at detecting these uncommon cases. 
  Expect to recover soon.  Nine out of 10 persons with low back problems recover reasonable activity tolerance within 1 month, and half within a week.  Therefore, an early x-ray of your back or other tests would only waste your time and perhaps be confusing.  If your recovery happens to be slower than normal, your clinician will then look further for a reason when there is a greater chance of detection. 
  With back symptoms, you should continue your usual activities as soon as possible.  You might have to slow your pace and strenuous activity or heavy lifting could give you trouble if you work outside the home.  Office work may require few changes. On the other hand, if your job involves heavy labor - like a furniture mover - you will may have trouble working as usual right away.  The longer you alter your normal activity the greater the chance symptoms will linger or you may need some "spring training" to regain comfortable tolerance of daily activity. 
  Age also makes a difference.  As we age, so do our spines.  Activities that require speed and strength become harder to do.  This happens to many people by age 30, to most people by age 40, and to nearly everyone by age 50.  Consider your age as you plan your daily tasks when recovering from a back problem. 
  You can ease your discomfort safely.  Your clinician will suggest safe ways for you to be more comfortable as you recover.  But staying in bed is usually not the best thing.  More than a few days in bed actually weakens your back and could cause your symptoms to last longer.  Neither bed rest, medications, or any other remedies should be expected to do away with all the discomfort.  It is important to be up and around as much as possible even if you are uncomfortable.  The sooner you return to normal daily activities, the sooner your symptoms will disappear. 
  You may need to make changes in your daily activities.  Sitting may not be comfortable.  Sitting is not dangerous, but it puts more stress on the back than standing.  While recovering, try to spend less time sitting.  To make sitting easier, support the curve of your lower back with a towel or small pillow.  If possible, use a chair or other seat with a slightly reclining back. 
  Lifting.  Keep anything you must lift close to the belly button. Lifting a carton of milk or orange juice at arm's length can stress your back more than lifting 30 pounds held close to the body.  So try to limit bending forward, twisting, or reaching while lifting when possible. 
  Exercising can help your back.  Your health care provider may suggest safe activities such as walking, swimming, or riding a stationary bike.  These exercises do not stress the back any more than does sitting on the side of your bed (which is not dangerous).  Exercise keeps your back muscles from becoming weakened by not enough activity.  In addition, exercise is good for your general health, can speed your recovery, and may help protect you from future back problems.  As your symptoms lessen, daily exercise will make it easier for you to resume your normal activities. 
Points to remember: 
-   There is no hint of a serious problem. 
-   Your back symptoms are the kind that usually are under control within days to a few weeks.  
-   No medications or other treatments, including home remedies, can be expected to relieve all the discomfort immediately. 
-   If you change some daily activities to keep from irritating your back, add enough active to keep from weakening your muscles. 
-   If you are one of the few who is slow to recover, your clinician will look for the reason. Even if you are slow to recover, there is little chance of a serious reason for your back problem. 
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