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Frequently Asked Questions

Who is most likely to develop low back pain?
Nearly everyone has low back pain (LBP) at some time. Men and women are equally affected. LBP occurs most often between ages 30 and 50, due in part to the aging process but also as a result of inactive lifestyles with too little exercise.

Is back pain serious?
Most of the time, low back pain is not serious and is not the result of a back/spine injury. Back pain is a symptom, not a disease. Very serious low back problems are rare. Although on occasion someone will be able to pinpoint when their back started to hurt or ache, most people don't actually remember hurting their back. Your spine and the body parts that work with it are very strong, so it's difficult to have a serious back injury.

What causes low back pain?
The exact cause of low back pain can be hard to pinpoint at times. Maybe you helped your neighbor move and used your back more than you are used to or possibly you lifted something the wrong way. You may have stood or sat too long in one position so now the muscles are stiff and sore. If you work out for the first time in a while and do a lot of push-ups, you expect your upper arm muscles to be sore the next day. The same goes for your back muscles.

Your back pain may have come on gradually during the day or you may have noticed it during the night or when you woke up. Your back may feel stiff and sore or you may have sharp or burning pain. Sometimes people have tingling, or a "pins-and-needles" feeling. Up to 85 percent of people will experience back pain at some time in their lives – it is that common! The good news is it usually only lasts for a few days or weeks. Every now and then, it lasts a bit longer, up to four or six weeks, but that's less common. Back pain that lasts 12 weeks or less is considered “acute” pain. When it lasts longer than 12 weeks, back pain is considered “chronic.”

What are my options if I hurt my back?
Actions you can take:

  • Most back pain resulting from minor strains can be resolved with over-the-counter medicines and simple self-treatment.
  • If the pain gets better as time passes, or the pain is not the result of a serious injury, then successful self-treatment is possible.
  • Avoid bed rest and prolonged inactivity.
  • Use the exercises in this program to build strength in your back, stomach, and abdomen.
  • Stay active and keep moving.

When should I see a doctor for pain?
In most cases, it is not necessary to see a doctor for back pain because the pain usually goes away with or without treatment. However, a trip to the doctor is probably a good idea if you have numbness or tingling, if your pain is severe and doesn't improve with medications and rest, or if you have pain after a fall or an injury. If you continue to have episodes of back pain without cause, you should seek care from a physical therapist. Recurrent back pain is often the result of muscles that stabilize the back getting weak – even in people that exercise regularly. Specific stabilization exercises can decrease your chances of recurrent back pain from 84% to 30%.

It is also important to see your doctor if you have pain along with any of the following problems:

  • Trouble urinating
  • Weakness
  • Pain or numbness in your legs
  • Fever
  • Unintentional weight loss

Such symptoms could signal a serious problem that requires treatment soon.

Seek immediate attention from your healthcare provider if you have any of the following with back pain:

  • Difficulty controlling your bladder or bowels
  • Loss of sensation in the groin area or between your legs
  • Pain following a fall or impact to the back
  • Severe leg pain, weakness, tingling, numbness, or inability to move
  • Pain that is steadily increasing over several hours
  • Chills, fever, or night sweats
  • Difficulty with balance or coordination

Which type of doctor should I see?
Many different types of providers treat back pain, from family physicians to doctors who specialize in disorders of the nerves and musculoskeletal system. In most cases, it is best to see your primary care physician first. In many cases, he or she can treat the problem. In other cases, your provider may refer you to an appropriate specialist.

How is back pain treated?
Treatment involves using analgesics, reducing inflammation, restoring proper function and strength to the back, and preventing recurrence of the injury. Most low back pain can be treated without surgery. Most patients with back pain recover without residual functional loss.

What are symptoms of common joint injuries?
Symptoms often related to common joint injuries can include pain, swelling, redness, and warmth.

Be sure to contact your provider if you experience any of the following:

  • You have severe pain and cannot put any weight on the injured joint.
  • The injured area looks crooked or has lumps and bumps (other than swelling) that you do not see on the opposite, uninjured joint.
  • You cannot move the injured joint.
  • Your limb buckles or gives way when you try to use the joint.
  • You have numbness in any part of the injured area.
  • You see redness or red streaks spreading out from the injury.
  • You injure an area that has been injured several times before.
  • You have pain, swelling, or redness over a bony part of your foot.
  • You are in doubt about the seriousness of the injury or how to care for it.

When should I use ice on an injury?
Immediately after an injury, fluid leaks from blood vessels into the injured area. Applying ice to the injured tissues helps limit the leakage of fluid from the blood vessels by causing them to constrict or become smaller. This reduces swelling and limits the amount of inflammation that will occur. In contrast, applying heat causes the blood vessels to dilate or enlarge. This dilation can increase the amount of fluid that leaks into the injured tissue. This increased leakage leads to increased swelling and worsening of inflammation.

Ice is most effective when applied immediately following an injury and during the first 48 to 72 hours after the injury has occurred. An easy way to properly apply ice is to use crushed ice in a plastic bag covered with a moistened towel. Such an application of ice easily conforms to the shape of the injured body part. Alternatively, a bag of frozen vegetables such as peas can be used in the same way. The cold pack should be applied over a moist towel on the injured body part. Apply for 20 minutes and remove for at least 20 to 40 minutes so that the skin is not injured from the icing. Your provider may recommend applications only a few times a day or throughout the day depending on the injury or condition. Do not use ice if the injured area has decreased sensation, poor circulation, or an open wound. In these cases, seek medical attention.

When should I use heat on an injury?
Heat is not usually recommended during the first 48 to 72 hours following an injury. The use of heat during that time can dilate or enlarge the blood vessels leading to increased fluid leakage into the area. This fluid results in increased pain and swelling. After the first 48 to 72 hours, heat applications can be helpful, especially prior to recovery exercise workouts. The heat can improve blood flow to the area and aid in the recovery process. Heat provides an additional benefit by relaxing the muscles of the injured area so that workouts can occur as safely as possible.

It’s important to keep in mind that heat can injure the tissues if it is used excessively. It can actually "cook" the skin, causing discoloration. Heat should only be applied for 20 minutes and should not be painful. Your provider may recommend heat application several times a day depending on the situation. Never sleep on a heating pad, as this is a common cause of skin burning. Moist heat by heating pad or direct moisture from hot whirlpool can be effective depending on the injury or disease involved and overall condition of the patient. The elderly should be especially cautious about using a whirlpool for therapeutic purposes, and a provider’s advice is recommended.

How do I tell the difference between a sprain and a fracture?
Because sprains and fractures often share many of the same symptoms, it is sometimes difficult to tell the difference between a sprain and a fracture. Your provider may need to x-ray the affected area or conduct other tests to accurately diagnose the injury.

Should I continue to exercise if I have pain?
Pain is often an indicator from your body that it is injured. In many cases, minor discomfort is not a cause for alarm, but if the pain is sharp, severe, increases, or persists, be sure to contact your provider. Continuing to exercise with an injury can worsen the injury and delay recovery or lead to permanent damage.

What causes carpal tunnel syndrome?
Carpal tunnel syndrome is often the result of a combination of factors that increase pressure on the median nerve and tendons in the carpal tunnel, rather than a problem with the nerve itself. Some people are born with a small carpal tunnel. This makes them more susceptible to developing carpal tunnel syndrome. Other contributing factors include trauma or injury to the wrist that causes swelling, such as a sprain or fracture; over-activity of the pituitary gland; hypothyroidism; rheumatoid arthritis; mechanical problems in the wrist joint; work stress; repeated use of vibrating hand tools; fluid retention during pregnancy or menopause; or the development of a cyst or tumor in the canal. In some cases no specific cause can be identified.

There is little clinical data to prove whether repetitive and forceful movements of the hand and wrist during work or leisure activities can cause carpal tunnel syndrome. However, repeated motions performed in the course of normal work or other daily activities can result in repetitive motion disorders such as bursitis and tendinitis.

What is a recommended treatment for minor orthopedic injuries?
The treatment plan for an orthopedic injury will vary based on the degree of damage to the injured area. Most minor injuries are initially treated with a strategy known as P.R.I.C.E., which stands for protect, rest, ice, compression, and elevation.

Will I need physical therapy for rehabilitation?
Your provider can best determine if physical therapy is right for your treatment. While many injuries can be handled by self-care, if you are not improving or are plateauing, you should seek care from a physical therapist. If surgery is required, the physical therapist will work with you before and after surgery to guide you through a program designed to increase your strength and regain your range of motion. Physical therapy can play an important role to your recovery.

What can I do to prevent an injury?
The key to preventing injury is to maintain good strength, muscle balance, hydration, nutrition, sleep, and flexibility. Here are a few tips that you may find valuable:

  • Warm up before doing exercises, playing sports, or participating in any vigorous activities. Your warm-up should cause you to have a light sweat.
  • Participate in a conditioning program to build muscle strength.
  • Develop a daily ritual of stretching exercises.
  • Listen to your body. Never run if you experience pain in the foot, ankle or knee, or if you feel fatigued.
  • Pay attention to walking, running, or working surfaces. The harder/firmer the surface, the more stress on your body.
  • Wear protective equipment appropriate for the sport or activity that you’re engaged in.
  • Replace your athletic shoes as soon as the tread or heel wears out. Typically, you should replace your shoes every six months, more frequently if you are in a wet/humid climate.
  • Be sure that all of your shoes fit properly.
  • Repetitive motion injuries can be avoided through rest breaks, exercise, proper posture, correct technique, use of protective equipment, and properly designed working environments.
  • Ensure you get enough quality sleep each night. This is where you reap the benefits of exercise, and it is when your body repairs damage.
  • Ensure proper hydration. The most common reason for a poor performance with an athletic event is inadequate hydration the day PRIOR.
  • Eat a well balanced diet.

Are there exercises I can do to prevent or help heal an injury?
There are a variety of exercises such as strengthening, isometric, isotonic, and proprioception techniques. Check with your provider to see which of these exercises are appropriate for you to prevent or help heal an injury. Instructions for a number of exercises are contained within this program.

What is rheumatoid arthritis?
Rheumatoid arthritis is an autoimmune disease that causes chronic joint inflammation. Rheumatoid arthritis can occur when your immune system, which normally protects your body from infection, attacks your body’s own tissues.