Ask the Expert – “What Should I Do About Back Pain?”

As a Physical Therapist I am often asked many questions but above all, ”I have back pain, what should I do about it?” is the most common.

According to the U.S. National Library of Medicine, “….back pain is one of the most common medical problems, affecting 8 out of 10 people at some point during their lives.”

So, what can you do about it? To begin with, back pain can come from many sources.  As a Physical Therapist, I would first begin to determine the cause.  I can evaluate your spine by going through a medical screening as well as musculoskeletal evaluation to determine your functional deficits and therefore get a better idea of what is actually happening with your specific pain.

Often, back pain is the result of poor posture; poor flexibility, improper sitting mechanics, and improper lifting mechanics but it can also stem from systemic diseases or be referred from internal organs. Many people sit all day at work and this in itself can create stress to the back. Proper sitting posture should display sitting with your knees and hips level, with a small arch in your low back. I would suggest lowering your chair or placing a small box or book under your feet to establish this position. You can also place a small towel under the back half of your buttocks to create a bit of a wedge preventing your pelvis from rolling and losing your low back arch.

Sitting throughout the day can also create tightness in the muscles that surround the pelvis and legs. Your hamstrings, located on the back of your thighs, can become shortened from prolonged sitting and this alone will create back pain. Your hip flexors, located in the front of your hips, can also become restricted from prolonged sitting and if not stretched, can also lead to back pain. These muscles can easily be stretched with proper instruction and can often alleviate your problems.

If lifting is the cause, a Physical Therapist would recommend you assess the weight of the object you are planning to move.  Consider strongly if you need assistance but once you have established that the weight is appropriate for you, be sure to lift with your legs. Proper lifting involves bending your knees and hips while “sticking your buttocks out” as you reach forward. Remember to keep the object close to your center of gravity, use your legs and keep an arch in your low back.

Many systemic diseases as well as internal organs can replicate common back pain which further encourages the need for assessment by a trained health care practitioner.

Prevention is truly the best medicine and with careful, methodical and purposeful movements, you might just be one of the 20% who won’t have back pain at all.


Renee Midgett, PT, DPT began her career in physical therapy in 1986 when she graduated from Virginia Commonwealth University’s Medical College of Virginia.

She then became a certified Sports Medicine Trainer with the American College of Sports Medicine, B.O.C. and was the trainer for Atlantic Shores Christian School from 1999- 2010 while working also in an outpatient orthopedic clinic. Today she is the Clinical Director of Tidewater Physical Therapy’s Battlefield clinic in Chesapeake.

Her 25 years of experience includes working with many professional athletes in football, hockey and soccer in addition to being one of the LPGA tour trainers in 2003.

While Renee’s expertise has been in orthopedics and sports medicine, she has also had many years of treating general musculoskeletal diagnoses resulting from disease processes, injuries and surgeries.