There are many steps that people can take to help reduce the risk of back pain. These include strengthening the back and abdominal muscles through exercise and learning new ways to sit and stand.

People who have suffered a back injury also can prevent additional damage to their back by increasing strength and flexibility. Patients should work with their physician and other experts, such as a physical therapist or a personal trainer, to help create a safe and effective program that includes the following elements:

• Aerobic exercise. Helps increase the strength and endurance of the lower back. It is best to engage in regular aerobic exercise that does not strain or jolt the back, such as walking, swimming or biking.
  
  
• Strength and flexibility training. Proper weight training can help strengthen abdominal and back muscles, allowing them to serve as a natural corset for the back. Stretching, yoga, tai chi and other exercises can increase flexibility in the hips and upper legs, which allows for proper pelvic bone alignment.
  
  
• Maintaining a healthy weight. Excess weight strains the back muscles and increases back pain.
  
  
• Quitting smoking. Smoking reduces the level of oxygen that reaches spinal tissue, thereby hindering the healing process when back muscles are strained or injured.
  
  
• Taking precautions against trauma pain. Measures such as using seatbelts and not diving into shallow water can reduce the risk of back pain.
  
  
• Nutritious diet. Adequate intake of nutrients including vitamin D, calcium and magnesium may reduce the risk of osteoporotic fractures. Several recent studies suggest that carotenoids (found in orange and yellow vegetables and fruits) and certain enzymes in cruciferous vegetables (the broccoli and cabbage family) could protect the joints and help stave off arthritis. Some research indicates the mineral selenium, found in foods including seafood and meat, may help in preventing osteoarthritis.

The risk of injuring the back can also be reduced by such simple changes as learning to lift heavy items properly and maintaining good posture. Correct posture and ergonomics include:

• Lifting from the knees, not the back. When lifting heavy objects, keep the back straight and the load close to the body. Do not twist the back while lifting. Bending from the waist to pick up even lightweight objects from the floor can strain the back. If an object is heavy or awkward, do not lift it without a partner’s help.
  
  
• Using proper posture when standing and sitting. When standing, maintain the pelvis in neutral position. People who stand for long periods of time should alternate placing each foot on a footstool. This can take some of the pressure off of the back. When sitting, choose a seat with good lower back support, arm rests and a swivel base. A rolled-up towel or pillow in the small of the back (lumbar area) can help maintain its normal curve. Individuals should also try to keep their knees and hips level.
  
  
• Sleeping on a medium-firm mattress. Recent studies indicate that sleeping on such a mattress is better for the back than sleeping on a firm mattress. Pillows can offer good support, but only if they do not force the neck up at a severe angle.

In some cases preventive medications are recommended to avert sources of back pain. For example, patients requiring long-term corticosteroid therapy may be prescribed bisphosphonates to reduce their risk of osteoporosis and vertebral fractures.