Q: I'm recovering from an episode of low back pain. How quickly (or slowly) should I resume my normal activities? I don't want to reinjure my back.
A: You're right: It's a balancing act. Too rapid a return may precipitate a relapse, but too timid a return can delay -- or even prevent -- recovery.
I can't give you a definitive answer because I don't know the details of your condition. But here's some general advice.
• Pain is a warning sign. Let your symptoms be your guide. Avoid doing anything that hurts. If you feel pain, stop the offending activity.
• Avoid twisting your trunk or making sudden off-balance movements. Try to rid your house of clutter that can trip you up. Slippery surfaces and throw rugs are notorious for causing falls. Lifting objects while your body is in an awkward position can also cause problems.
• Exercise regularly. After an episode of low back pain, resume exercise. Do it at a much lower level of intensity and duration than what you were doing before your injury. Many conditions that cause low back pain are made worse by exercises that jar the spine, such as jogging. Exercises that don't jar the spine -- swimming, walking or bicycle riding (either stationary or regular) -- should become part of your regular exercise routine.
Why exercise? Most often, low back pain is caused by conditions of the spine and the muscles around it. The muscles that lie along the spine, and muscles in the wall of your abdomen, protect your spine. Build strength in those muscles.
Do it slowly over several months. Stretching exercises also are important. A common cause of low back pain is muscles that have not been strengthened and stretched by regular exercise. When those muscles are challenged by some activity -- like carrying a heavy object -- they are easily injured.
Stretching and strengthening exercises that target both your back muscles and abdominal muscles not only will help treat any existing low back pain; they will also help prevent a recurrence of the problem.
(On my website, AskDoctorK.com, I've put descriptions and illustrations of several back-strengthening exercises.) Stop the exercises if you experience any pain.
• Hold on to good habits. During your episode of low back pain, you may have found yourself instinctively moving more cautiously: bending your knees when picking something up, carrying objects close to your body to minimize leverage on your back, and sitting down and getting up more carefully.
Try to turn these back-saving maneuvers into lifelong habits. Practices such as these can help keep your back injury-free.
Fortunately, I've had only one episode of low back pain in my life, but it really knocked me out of action. I was fairly young and feeling invincible. I wasn't exercising regularly at the time, and I never did any stretching exercises.
One day I picked up a heavy object and carried it way out in front of my body, instead of holding it against my body.
Pow! Never again: I learned an ergonomic lesson.
• Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com.