Your relationship with your back can be a complicated one. Sometimes it does exactly what you want, whether that’s supporting you through a heavy lift or helping you carry groceries in from the car. Then again, your back can be a royal pain, acting up just when you need it most. Unfortunately, most of us have experienced some form of back pain, whether it’s a passing ache or a long-term problem. We’ll help you conquer chronic back pain so you and your back can be happy together at last.

What’s the Trouble?

Your back is separated into three sections: the cervical spine (neck), the thoracic spine (upper back), and the lumbar spine (lower back). The spine is an intricate structure, made up of a variety of joints, ligaments, and nerves, all of which work together to support, strengthen, and move the rest of your body. Because there are so many moving parts, the lower back has a high risk of injury. More than 31 million Americans experience lower-back pain at any given time, according to the American Chiropractic Association.

And while working out keeps you healthy in general, it can put your back at risk for injury if you’re not careful. Failing to warm up properly, subjecting your spine to repetitive high-impact activities, or simply using poor form can all lead to back trouble. “Muscles can’t function at their fullest capacity if they’re not stretched or warmed up. And impact activities like running put force on the spine and joints,” explains Jeffrey A. Goldstein, M.D., an orthopedic spine surgeon at NYU Langone Health in New York

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Lifting heavy weights or doing symmetrical exercises like deadlifts and squats can lead to injury if your form is off. “These activities can potentially cause compression on the spine, so it’s crucial to have ideal mechanics while doing them,” says Erica Meloe, a physical therapist in private practice in New York. Past injuries can also haunt your back by throwing off your form. “I’ve seen many patients with old ankle sprains or a history of an ankle fracture—when they squat they’ll shift their weight to one side and wind up hurting their backs in the process,” adds Meloe.

And a lack of flexibility and mobility can create additional problems. “Most people are very tight and weak in their ankles, hips, upper back, and shoulders,” says Ashleigh Gass, C.S.N., C.S.C.S., who is based in Clearwater, FL. “If you only focus on traditional strength training and ignore joint mobility, flexibility, and core training, your chances of injury will increase.”

Injury Watch

How can you tell whether your back pain is just the aftereffect of a heavy training day or something more serious? Pain that lasts longer than two days or feels dull or sharp and starts in the center or sides of the lower back and moves into your glutes is often an indicator of a potentially bigger injury.

“Be aware of any numbness, tingling, weakness, or pain in the legs or of bowel or bladder problems, since these can be signs of neurologic injuries requiring urgent attention,” warns Goldstein.

The first steps for treating back pain are rest, ice, and anti-inflammatories. But don’t rest too long, cautions Meloe. “It’s fine to take a day to rest from an acute injury, but be sure to move around soon after that to avoid getting too stiff,” says Meloe. When you’re ready, try foam-rolling or hanging from a bar to help loosen up your back and decompress your spine.

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Pain from an acute injury should resolve in a few days or weeks. But lingering discomfort after a couple of months means it may be time to seek medical advice. Left untreated, you will start to compensate in other areas of your body, cautions Meloe. “With each recurrence, recovery time becomes longer, and rate of reinjury will rise,” she says.

Preventative Practices

While back injuries remain prevalent, that doesn’t mean you have to be the one at risk. To make sure you stay healthy, incorporate the following recommendations into your routine.

1. Vary your positions.

Avoid using the same muscles in the same way, says Meloe. That extends beyond the gym. “If you sit all day, make sure your cardio or warmup consists of standing exercises, like the elliptical or running; if you stand all day, try the bike.” The same advice applies to the workplace, especially if you have a desk job. Try using standing desks that allow you to change positions during the day, she notes, and keep your monitor at a good level so your neck isn’t in a strained position for extended periods of time.

2. Address discrepancies.

“Imbalances that often lead to back pain include weak or tight hamstrings and hips and poor spine mobility,” says Gass. “Incorporate strength moves like back extensions, Gymnastics Bodies Jefferson Curls [holding a light barbell, legs straight, roll down through spine’s full range of motion; roll up to start], and planks to strengthen the core,” she says. Also, do stretches that help decompress the spine and increase flexibility; several yoga poses are especially helpful. (Check out some stretches here.)

3. Start slow.

If you’re just starting out with a fitness plan or returning after a long layoff, ramp up gradually. “Doing CrossFit, where you’re swinging heavy kettlebells, or taking boot camp classes without a foundation in strength can potentiate back injury,” adds Meloe, so “see a physical therapist for a baseline evaluation beforehand.”

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