Tulane Medical Center - April 20, 2021

I threw my back out! What do I do?

It can happen any time. We get overly ambitious with yard work, lift something too heavy, twist funny and then we feel it – that sudden, sharp, suck-in-your-breath pain that signals a “thrown-out back.” Most of the time, this is caused by a back-muscle strain, sprain or spasm, and will eventually go away by itself or with at-home treatment. But sometimes back pain may mean something else. Learn what to do when your back goes out, and when you may need to see the doctor.

Back pain basics

Back pain is one of the most common reasons for doctor visits and missed work. About 80 percent of adults experience low back pain at some point in their lives. Back pain is either chronic – ongoing for longer than three months – or acute, pain that comes on quickly and then goes away after a few days or a week, says Mathew Cyriac, an orthopedic surgeon specializing in spin and back pain. According to Dr. Cyriac, about 95 percent of back pain is muscle-related and will get better by itself or with self-treatment.

What causes a backache?

Aside from the obvious suspects of accidents, exercise, lifting, etc., sometimes the cause of back pain isn’t known. Causes can range from lifestyle triggers – sitting too much and too long, excess weight – to wear and tear on the spine as we age, congenital conditions or previous surgeries, says Dr. Cyriac. According to Dr. Cyriac, back pain causes can include:

Muscle strains or sprains

When you’ve lifted something, twisted funny or done a strenuous activity your body isn’t used to, you can stretch or even tear your muscles or ligaments causing pain.

Herniated or slipped discs

Wear and tear can cause the soft tissue from the discs between your joints to bulge or rupture and press on the nerves in your lower back or hips.

Complications from degenerative disc disease

The discs can wear down or shrink with age, causing the bones to rub together, resulting in other painful problems.


As we age, osteoarthritis in the spine can lead to a narrowing of the spinal canal, which can add painful pressure to spine and nerves.

Skeletal irregularities

Conditions such as severe scoliosis (curvature of the spine) can sometimes cause back pain.

What can trigger back pain?

Back pain can come on suddenly, even without a history of problems or issues, or occur over time. Risk factors that can make you more prone to back problems include:

  • Being overweight
  • Excessive sitting
  • Growing older
  • Lack of exercise
  • Smoking
  • Habitual poor lifting
  • Psychological conditions such as depression and anxiety
  • Previous back surgeries

What can I do about a backache?

In the majority of cases, back pain is caused by muscle injuries and there are some things you can do to relieve the pain:


Try to lie down in a “back-neutral” position where your spine is aligned. Lie on your back with a pillow under your head and your knees bent.


Apply ice packs 20 minutes at a time to help with inflammation. Wrap ice or ice packs in a towel, don’t apply directly to skin.


Over-the-counter medicines such as ibuprofen or aspirin can help.


After the first day or two, switch from ice to heat, applying for 20 minutes at a time. Wrap the heat source in a towel to avoid direct contact with your skin.

Physical Therapy

If you have had pain for a few weeks, physical therapy may help restore mobility and flexibility. But if the therapy causes pain – as opposed to a mild ache when stretching or trying something new – stop and talk with your therapist and doctor.

Use it or lose it

Once the immediate acute pain has subsided, it’s important to get moving again. Gentle exercises and stretching are a good start. If you don’t use these important back muscles, they quickly begin to weaken and you start to use other muscles to compensate, says Dr. Cyriac. This causes furthering weakening and can lead to chronic back pain.

When it’s time to seek care

If your back pain doesn’t go away after a few weeks, see your doctor. If the pain is continuous and not helped by rest, or is accompanied by any of the following, you should immediately seek emergency care:

  • Fever
  • Weakness, numbness or tingling in one or both legs
  • Confusion, slurred speech or inability to speak, vision loss
  • Loss of bladder or bowel control
  • Pain down one or both legs, especially if it extends below the knee

Back pain may indicate a more serious issue in people with certain conditions. If you have severe or chronic lower back pain and have any of these medical conditions, you should be seen as soon as possible.

  • History of cancer
  • Recent immunosuppression, either from surgery or prescribed drugs
  • Any recent injury or trauma, especially if you’re elderly
  • Long-term steroid use
  • Intravenous drug use

When back pain is chronic

When back pain becomes long-lasting, your doctor may refer you to a specialist. According to Dr. Cyriac, procedures such as spinal cord stimulation which sends low-level electrical impulses to keep pain signals from reaching the brain, and targeted drug delivery (pain pump), offer non-invasive and non-pharmaceutical options to relieve pain.

Plus, Dr. Cyriac adds, when the pain is gone, physical therapy can often help get your back in the proper alignment with muscles and joints “doing their job,” providing long-term relief.

Put your back into it

It’s never too early or late to work on keeping your back muscles strong to minimize your chances of injury or pain.

  • Maintain a healthy weight.
  • Get moving with a regimen of low-impact aerobic activities.
  • Be a yogi to strengthen your core and improve flexibility.
  • Standing up straight helps reduce the stress on back muscles.
  • Sit smart and spend the money on a good chair with lower back support, armrests and a swivel base. If you’re at a desk all day, get up and move, or at least change positions every half-hour.
  • Let your legs, not your back do the heavy lifting.

We’ve got your back

Tulane Health System offers comprehensive spine and back care options. The Tulane Neuroscience Center features board-certified neurosurgeons, along with chronic pain experts to develop a customized plan for relief from chronic pain.

Tulane Health System’s orthopedic clinics and Tulane Institute of Sports Medicine have orthopedic surgeons, sports medicine physicians, physical therapists and others offers care for back problems and other sports injuries.


tags: back pain