Back pain affects eight out of 10 Americans, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. The causes and severity vary widely, although aging, obesity and sedentary  lifestyles take some of the blame.

“There has been a steady increase in time lost from work and the number of spinal surgeries performed over the last two decades,” says Dr. Michael Chabot, an orthopedic surgeon with Orthopedic Specialists and on staff at Des Peres Hospital. Beyond a genetic propensity toward age-related spinal degeneration, which can’t be changed, “lack of exercise diminishes the integrity of the spinal support structures and reduces the dynamic protection healthy muscle and associated tissues offer to the spine,” he adds.

Yet while exercise can be a key element in back pain management, individuals must take care to practice proper technique when lifting weights or performing other types of weight-bearing exercise. Ironically, acute injuries that occur due to incorrect form cause a fair share of back pain.

While injury often strikes with acute pain, back pain hits many with no warning and quickly becomes a chronic or recurrent problem. Spasms or muscular irritation often cause this type of chronic condition, says Dr. Fred Buckhold, a SLUCare physician specializing in internal medicine. And in some instances, back pain may have more to do with other health issues than with the spine itself.

“Problems with the heart can produce pain along the back of the chest, as well as the front, which is more typical,” Chabot says. “Abdominal aneurysms can refer pain along the upper and lower lumbar spine, intestinal problems can refer pain to the low back, and anyone who has ever experienced a kidney infection or stone can readily describe the terrible back pain they experienced.”

When back pain strikes, the initial response may be to get on the couch and stay there. However, that’s not the best approach. “Often, that makes the pain worse or prolonged as it causes the surrounding muscles to tighten up more,” Buckhold says. “I often recommend exercises to maintain or improve the range of motion of the back without doing strenuous or repetitive motions in the back. I also recommend either Tylenol or extra-strength ibuprofen (Advil) or naproxen (Aleve).”

Chabot expands on these recovery recommendations: “A progressive program of stretching, tissue massage, moist heat or ice, and gradual advancement of activities can usually lead to a minimum amount of down time. A general rule is that during the recovery process, if certain activities or stretches hurt too much, then back off a bit and start the process over where you were comfortable.”

Chronic back pain also may respond to chiropractic treatments, physical therapy, yoga or acupuncture. However, pain that doesn’t resolve within a month or symptoms that extend to the legs should be assessed by a physician.

Buckhold reminds patients that most back pain episodes improve after a few weeks and almost all improve within six months. And if you’re pain-free, increase your chances of staying that way with good posture, regular exercise, healthy weight maintenance and stress management.