• Wearing a back brace
• Not lifting heavy objects
• Avoiding bending at the waist
• To consult with a physical therapist as you reintroduce exercise into your routine

The usual age of onset of severe low back pain is between 30 and 50 years of age. The most likely reason is that the degenerative process has begun, and individuals in that age range are still active enough to stress their bodies and place somewhat degenerative discs at risk for injury. It is also common in this age group for individuals to be very preoccupied with their life and occupation and in turn not take as good care of themselves as when they were younger. This leads to increased stress on the discs predisposing them to injury. The incidence of low back pain is equal between males and females. It is not uncommon for adolescents to experience low back pain. While this was previously thought to be a sign of severe potential problems, it is now recognized as common entity and usually not dangerous. Fortunately, it is often self-limiting as adolescents learn good body mechanics and participate in proper strengthening and conditioning for their spine and overall body.

A spinal disc is the ligamentous structure that attaches one vertebra to the next adjacent vertebra. The purpose of the disc is to allow for motion of the spine. Many people consider the disc to be a “shock absorber” between the bones of the spine. This is just one purpose of the disc. Another important function of the disc is to allow for motion in the spine. The disc is a very tough ligament that allows the spine to move in multiple directions, i.e., flexion, extension, side-bending to the right or left, rotation to the right or left, and distraction and compression along the axis of the spine. A healthy disc has a soft central portion, which is often likened to a jelly-like center. The outer portion of the disc consists of very tough ligaments arranged circumferentially. It is made of multiple layers crisscrossing as they encompass the jelly-like center. This very tough outer ligamentous portion allows the spine to move in multiple directions. The disc itself lacks any specific blood supply or nerves within the disc. However, the outside of the disc is richly innervated with nerve fibers. These nerve fibers on the outside of the disc if stimulated or irritated can cause severe back pain. Learn more about spine anatomy.

A physical therapist will determine whether you will need special equipment to keep you safe and comfortable. The therapist will let the team know what equipment may be necessary and place the order with a medical equipment provider. The equipment either will be delivered to Mount Sinai or to your home or rehabilitation facility on the day of your discharge.

If pain is progressive, severe, and disabling, surgery is strongly considered. Numbness, tingling, and weakness are all possible signs of nerve compression and may indicate a need for surgery before nerve damage becomes permanent. Pressure on the spinal cord can be very dangerous and may require surgery. Surgery may be preventative if the spinal cord is at risk of being damaged. Surgery may also be needed if there is significant deformity of the spine.