To avoid back pain, you must reduce excess stresses and strains on your back and ensure that your back is strong and supple.

If you have recurring bouts of back pain, the following advice may be useful:

• Lose any excess weight – you can use the healthy weight body mass index BMI calculator to find out whether you are a healthy weight for your height.
• Wear flat shoes with cushioned soles, as these can reduce the stress on your back.
• Avoid sudden movements or muscle strain.
• Try to reduce any stress, anxiety and tension.

Posture

How you sit, stand and lie down can have an important effect on your back. The following tips should help you maintain a good posture.

Standing

Stand upright, with your head facing forward and your back straight. Balance your weight evenly on both feet and keep your legs straight.

Sitting

You should be able sit upright with support in the small of your back. Your knees and hips should be level and your feet should be flat on the floor (use a footstool if necessary). Some people find it useful to use a small cushion or rolled-up towel to support the small of the back.

If you use a keyboard, make sure that your forearms are horizontal and your elbows are at right angles.

Driving

Make sure that your lower back is properly supported. Correctly positioning your wing mirrors will prevent you from having to twist around. Foot controls should be squarely in front of your feet. If driving long distances, take regular breaks so that you can stretch your legs.

Sleeping

Your mattress should be firm enough to support your body while supporting the weight of your shoulders and buttocks, keeping your spine straight. If your mattress is too soft, place a firm board – ideally 2cm thick – on top of the base of your bed and under the mattress. Support your head with a pillow, but make sure that your neck is not forced up at a steep angle.

Exercise

Exercise is both an excellent way of preventing back pain and reducing any back pain you might have. However, if you have chronic back pain (back pain that has lasted more than three months), consult your doctor before starting any exercise program.

Exercises, such as walking or swimming, strengthen the muscles that support your back without putting any strain on it or subjecting it to a sudden jolt.

Activities such as yoga or pilates can improve the flexibility and the strength of your back muscles. It is important that you carry out these activities under the guidance of a properly qualified instructor.

There are also a number of simple exercises you can do in your own home to help prevent or relieve back pain.

• Wall slides – stand with your back against a wall with your feet shoulder-width apart. Slide down into a crouch so that your knees are bent to about 90 degrees. Count to five, then slide back up the wall. Repeat five times.
• Leg raises – lie flat on your back on the floor. Lift each heel in turn just off the floor while keeping your legs straight. Repeat five times.
• Bottom lifts – lie flat on your back on the floor. Bend your knees so that your feet are flat on the floor. Then lift your bottom in the air by tightening your stomach muscles while keeping your back straight. Repeat five times.

At first, do these exercises once or twice a day, then gradually increase to six times a day, as your back allows.

These exercises are also useful for 'warming up' your back. Many people injure their back when doing everyday chores at home or work, such as lifting, gardening or using a vacuum cleaner. 'Warming up' your back before you start these chores can help to prevent injury.

Lifting and handling

One of the biggest causes of back injury, especially at work, is lifting or handling objects incorrectly. Learning and following the correct method for lifting and handling objects can help to prevent back pain.

• Think before you lift – can you manage the lift? Are there any handling aids you can use? Where is the load going?
• Start in a good position – your feet should be apart, with one leg slightly forward to maintain balance. When lifting, let your legs take the strain – bend your back, knees and hips slightly, but do not stoop or squat. Tighten your stomach muscles to pull your pelvis in. Do not straighten your legs before lifting as you may strain your back on the way up.
• Keep the load close to your waist – keep the load as close to your body for as long as possible with the heaviest end nearest to you.
• Avoid twisting your back or leaning sideways, especially when your back is bent. Your shoulders should be level and facing in the same direction as your hips. Turning by moving your feet is better than lifting and twisting at the same time.
• Keep your head up – once you have the load secure, look ahead, not down at the load.
• Know your limits – there is a big difference between what you can lift and what you can safely lift. If in doubt, get help.
• Push rather than pull – if you have to move a heavy object across the floor, it is better to push it rather than pull it.
• Distribute the weight evenly – if you are carrying shopping bags or luggage, try to distribute the weight evenly on both sides of your body.

Source: NHS Choices, UK (Preventing back pain)