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Neurology Now:
Department: Ask the Expert

Your Questions Answered

Roaf, Elizabeth M.D.

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Elizabeth Roaf, M.D., is a specialist in physical medicine, spinal cord injury and internal medicine at the Fairlawn Rehabilitation Hospital in Worcester, Mass.

Q I've had low-back pain since lifting something heavy. How long should I rest in bed before trying to resume normal activities?

DR. ELIZABETH ROAF ADVISES:

A Bed rest, although once recommended for back injury, is no longer the treatment of choice. In fact, doctors now recommend physical activity after a back injury.

To avoid making the pain worse early on, limit lifting, pushing or pulling and avoid twisting or repeated bending of the lower back. Gentle stretching exercises should begin in one to two days — as long as there are no signs of a serious problem.

Call your doctor if you experience any of the following signs of a serious problem: pain when lying flat, severe or persistent pain, fever, weakness in the legs or arms, numbness and tingling in the legs or groin, or changes in bowel or bladder function.

Common causes of low-back pain after lifting include muscle strain, herniated disc and stress fracture due to thinning of the bones. Muscle strains from lifting generally cause an aching or burning pain. If the pain shoots into the legs, a herniated disc may be the cause. Stress fractures may cause pain over the midline of the back.

In treating patients for back strain, I recommend 20 minutes of heat or ice followed by slow, gentle stretches. Heat works better with stretches than ice. Physical therapy, massage or acupuncture also may help. Popular drugstore remedies include creams and heated wraps. And simple analgesics may decrease inflammation as well as pain.

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©2006 American Academy of Neurology

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