Low back pain can make you miserable and cost you money. It is the most common cause of job-related disability in the U.S. and one of the leading causes of missed work—and it soaks up tens of billions of dollars in treatment costs. While most low back pain goes away within a few days, some bouts last much longer—or permanently. The symptoms might be muscle ache, shooting or stabbing pain, limited flexibility and/or range of motion, or an inability to stand straight. Sometimes pain felt in one part of the body radiates elsewhere in the body.

The main point is: you don’t want it. Here are some suggestions for avoiding it—

  • Have a regular routine of low-impact exercises that will increase muscle strength and flexibility—for example, 30 minutes a day of speed walking, swimming, or stationary bike riding. Yoga can also help stretch and strengthen muscles and improve posture. Your doctor should be able to suggest low-impact exercises appropriate for your age and designed to strengthen lower back and abdominal muscles.
  • Always stretch before exercise or other strenuous physical activity.
  • Don’t slouch when standing or sitting. When standing, keep your weight balanced on your feet. Your back supports weight most easily when curvature is reduced.
  • At home or work, make sure your work surface is at a comfortable height for you.
  • Sit in a chair with good lumbar support and proper position and height for the task. Keep your shoulders back. Switch sitting positions often and periodically walk around the office or gently stretch muscles to relieve tension. A pillow or rolled-up towel placed behind the small of your back can provide some lumbar support. If you must sit for a long period of time, rest your feet on a low stool or a stack of books.
  • Wear comfortable, low-heeled shoes.
  • Sleep on your side to reduce any curve in your spine. Always sleep on a firm surface.
  • Ask for help when transferring an ill or injured family member from a reclining to a sitting position or when moving the patient from a chair to a bed.
  • Don’t try to lift objects that are too heavy for you. Lift with your knees, pull in your stomach muscles, and keep your head down and in line with your straight back. Keep the object close to your body. Don’t twist when lifting.
  • Keep your weight down, especially weight around the waistline that puts a load on lower back muscles. A diet with sufficient daily intake of calcium, phosphorus, and vitamin D helps to promote new bone growth.
  • If you smoke, quit. Smoking reduces blood flow to the lower spine and causes the spinal discs to degenerate.

If you have a flare-up, don’t expect to get rid of it by going to bed. A 1996 Finnish study found that patients who continued their activities without bed rest following the start of low back pain appeared to have better back flexibility than those who rested in bed for a week. Other studies suggest that bed rest alone may make back pain worse and can lead to complications like depression, decreased muscle tone, and blood clots in the legs. When you are in bed, it is best to lie on one side, with a pillow between the knees (some doctors suggest resting on the back and putting a pillow beneath the knees).