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The question

I threw out my back last week - I'm a 42-year-old guy and in very good shape, if I do say. What can I do to stay active during this time? (I've been on the couch for five days..)

The answer

The back is made up of intricate connections of vertebrae, muscles, tendons, ligaments, nerves and disks (cushion between vertebral bones). Back pain can be due to a strain or damage to any of these parts and in your case, due to heavy lifting, a sudden awkward movement or degenerative changes that have developed over time such as those related to - yes, even at 42 - arthritis.

When your back is out, wanting to rest and allow the body to heal is common. While this is a natural response, prolonged bed rest has been found to potentially increase back pain and reduce flexibility and muscle strength. Several studies have shown that bed rest is strongly associated with more days off work, increased intensity of pain and disability related to low back pain. In the minority of cases, if the back pain is severe or associated with radiating pain down to the ankle, a short period of rest may be helpful but generally no longer than 1-2 days at most.

While it may seem counterintuitive, increasing mobility of the spine by remaining active is one of the best things you can do for your back. Moving helps to bring nutrients to help heal the spine and also helps to increase flexibility and improves muscle tone.

For uncomplicated back pain, (pain that's not radiating below the knee in a healthy person under 50), I recommend low impact activities such as stretching, yoga, swimming, and walking. If these activities trigger pain, listen to your body and stop and try another gentle exercise. Avoid high impact activities or those that involve twisting or bending.

The key to keeping your back healthy is prevention. Regular exercise, good posture, using safe lifting techniques (knees bent and abdominal muscles tightened) and maintaining a healthy weight can reduce the risk of back injury.

Smoking is thought to age the spine and increase the risk of injury, so decreasing or quitting smoking may be helpful. Avoid activities that involve repetitive bending or twisting and high-impact activities that increase stress on the spine.

The reassuring news is that for the vast majority of patients, uncomplicated back pain is not serious and you'll make a full recovery within 4-6 weeks. If your pain is prolonged, affecting your function or you are experiencing any alarming symptoms - bowel or bladder dysfunction, leg weakness, pain associated with fever or unexplained weight loss - seek medical attention to rule out the rarer but serious causes of back pain.

Send family doctor Sheila Wijayasinghe your questions at She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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