Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.


Nearly 80 percent of adults have low back pain at times.

Normally with good self-care, low back pain symptoms improve within 4 to 6 weeks. In many cases, the pain returns later. 

Studies show that back pain flare-ups are related to:

  • Weak stomach and back muscles.
  • Lack of flexibility in the legs. 

Fortunately, you can actively prevent pain flare-ups by:

  • Using proper positions and movements for daily activities.
  • Exercising regularly, including core muscles strengthening, back stretches, and aerobics.
  • Taking care of your overall health.

Talk with us about your back symptoms before you start exercising. We’ll create a program for your specific condition and adjust it as needed. 

Even one exercise session can help you feel better. By exercising daily for the rest of your life, you’ll dramatically improve your back health.

Back Anatomy

Bones in the back are called vertebrae.

Joints form where the vertebrae meet. 

Discs sit between the vertebrae. Discs are:

  • Made of layers of fibrous cartilage with a soft center called a nucleus.
  • Able to carry pressure, like a shock absorber. 

Nerves carry messages to the brain and muscles. Spinal nerves branch out from the spinal cord.

Muscles support the back and allow you to move. 

Ligaments are strong bands that hold the bones together. Ligaments allow joints to move properly. 

Most back pain results from injury or irritation, commonly caused by:

  • Pulling or twisting when lifting.
  • Repetitive bending or stooping.
  • Sitting too long, slouching, and other posture problems.
  • Changes due to aging, especially in joints and discs.

Exercises and Recovery

When your back hurts, it’s tempting not to move at all. But studies show that more than 3 days of bed rest delays recovery. Immobile muscles get stiff, which can make your pain worse.

We’ll recommend exercises to reduce back pain and help you heal. These will include:

Self-traction exercises to take pressure off your back (unload) and help you feel better.

  • Do self-traction exercises sittting, standing, or lying down.
  • Unload your back often (even every hour) throughout the day.
  • Gently hold each position for 10 to 15 seconds.
  • Repeat as needed for pain relief.

Low-back exercises to strengthen and stretch spinal muscles. This lessens pain by:

  • Reducing swelling. 
  • Relaxing stiff muscles.
  • Preventing further injury.

Together, we’ll review your daily activities and lifestyle choices and decide on needed changes.

Your Role in Physical Therapy

When you start physical therapy, you’re joining a partnership with us. The success of your therapy depends a lot on your commitment to the program we design for you. Your active participation is necessary for you to regain normal function.  

We’ll help you learn to:

  • Adjust your daily activities to reduce pain.
  • Change behavior that makes your injury or condition worse.

We encourage you to do your exercises every day, or as recommended by your therapist. Continue your exercises and lifestyle adjustments after our therapy sessions end. This is the best way to maintain a good quality of life and prevent pain from returning. 

As you stick with your physical therapy program, you’ll gain more benefits over time.

Manage Back Pain Flare-Ups

Take these steps at home to reduce your back pain:

Use relative rest 

If your back pain returns, we recommend “relative rest” for a few days. Continue your normal activities, but rest if your pain level increases. Plan your activities ahead of time and take frequent breaks.

Apply ice or heat 

Place an ice pack or heating pad on your lower back for 10 to 15 minutes. 

  • Place a thin cloth layer between your skin and the ice or heat.
  • Use this treatment as often as needed.
  • Alternate between heat and ice, if helpful.

Posture and Body Mechanics

Good posture eases muscle tension in your lower back.

Avoid sitting too long  

  • Sit in one position for no more than 30 minutes. Then stand, walk, or stretch.
  • Maintain good posture.
  • Place a rolled towel between the chair and your lower back.

Bending and lifting 

  • Bend and lift from your hips and knees, not your waist.
  • Keep your neck and back aligned.
  • Keep the load close to your body.
  • Get help with large or awkward loads.
  • Don’t lift if you have new or severe symptoms.
  • Stop if you feel pain.
Additional References:

Lifestyle Changes

These recommendations can help your back heal and improve your overall health.

Exercise safely  

Aerobic exercise can feel good and help reduce pain. Studies show that consistent exercise – even easy activities – can help prevent back pain flare-ups. 

Try walking, if it doesn’t make your symptoms worse:

  • Take 5 to 10 minute walks throughout the day.
  • Keep your back in a neutral position.
  • Limit step length to avoid back tension.
  • Wear athletic shoes with good arch support.  

Cycling and swimming are also good choices.

Lose weight if needed. Being overweight strains your body. Our programs can help you reach and maintain a healthy weight.

Get enough sleep. Studies show that this reduces pain. Avoid lying on your stomach, as this strains the neck.

Quit Smoking. People who smoke have more joint problems and slower recovery. Smoking interferes with blood flow and tissue healing. 

Quitting smoking is one of the best things you can do to improve your health. Use our resources to help you quit.

Manage Stress

When you’re under extra stress, the muscles in your back, neck, and shoulders can tighten up. This can cause back pain. Try these methods to ease stress:

  • Walking
  • Deep breathing
  • Relaxation exercises
  • Guided imagery, using body awareness and visualization of pleasant images
  • Meditation
  • Gentle yoga stretching 
  • Self-hypnosis

When to Call Your Doctor

Please call us if you have:

  • Loss of bladder or bowel control, or difficulty in starting or stopping urination.
  • Weakness in the legs and/or numbness in the genital or rectal area.
  • Worsening back pain symptoms.
  • Pain that spreads down one or both legs.
  • Weakness or numbness that prevents you from standing or walking comfortably.

Your Care with Me

If you are having symptoms in your back that concern you, your first contact will typically be with your personal physician or other specialist, who will evaluate your health and symptoms.

If physical therapy is needed, your doctor will refer you to our department. Your needs and schedule will be considered when we make and appointment for you in our department.

I will review your medical history prior to your appointment. On your first visit, I will ask you a variety of questions and perform a physical therapy assessment. The assessment may include:

Observation. I will observe how your back is affected by the way you walk, stand, or perform other activites. 
Palpation. I may touch the area that is causing pain to assess the injury or condition.
Movement and strength testing. I may perform additional tests to establish your muscle strength and range of motion.
Functional assessment. I will consider how your injury or condition is affecting your ability to function normally.

We will discuss the results of your exam. I will recommend a treatment plan, educate you about your back, and together we will decide the best course of rehabilitation for your condition. Individualized exercises will always be a major part of your program.

Your care may also include:

  • Manual therapy (hands-on stretching or mobilization)
  • Self-care instructions

We may schedule a number of visits so that you can learn how to do your exercises correctly and feel confident about continuing them by yourself at home.

If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.

If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line, available 24 hours a day, 7 days a week. You will be connected with a nurse who can give you immediate advice.

If you are experiencing an emergency, call 911 or go to the nearest Emergency Room.

Coordinating Your Care

Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.

Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate.

When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.

If you call the Appointment and Advice line
  • Our call centers are open every day of the year around the clock. If you need advice, we will transfer you to one of our skilled advice nurses (RNs). They can help you determine when you need to be seen and in what location.
  • The advice nurse can often start your treatment by telephone depending on the situation, and has access to your electronic medical record.
If you come to an office visit
  • At the beginning of your visit, you will receive information about when you are due for your next test, screening, or immunization.
  • At the end of your visit, you may receive a document called the “After Visit Summary” that will summarize the issues we discussed during your visit. You can also view it online under Past Visits.
  • To help you prepare for your visit, please see additional details under Office Visit.

Convenient Resources for You

As your specialist, I have a goal to provide high quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.

My Doctor Online is available at any time that is most convenient for you. From my home page you can:

Manage your care securely
  • View and compose secure e-mail messages.
  • Manage any prescriptions.
  • View your past visits and test results.
  • View your preventive services to see whether you are due for a routine screening or updated immunization.
  • Manage your family’s health by setting up access to act on their behalf. Learn how to coordinate care for the ones you love.
Learn more about your condition
  • Read about causes, symptoms, treatments and procedures.
  • Find interactive health tools, videos, and podcasts to help you manage your condition.
  • View programs to help you decide on or prepare for a surgery or procedure.
Stay healthy
  • Locate health education classes and support groups offered at every medical center.
  • Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
  • View your Preventive Services to see whether you are due for a routine screening or updated immunization.

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If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder. This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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