During my last twenty years of caring for people with back problems, I have seen and heard an amazing variety of tips and suggestions for relieving back pain. Here are a few of the ideas you should avoid:

1. Rest in bed until you feel better. This is one of the surest ways to turn a short-lived back problem into a chronic problem. Although bed rest has frequently been recommended by some physicians for back pain, it has been shown to slow recovery.

Bed rest has been found to be problematic for back pain sufferers by multiple studies. In fact, the federal government determined after a decade-long assessment of proposed solutions for back pain that prolonged bed rest was a leading cause of disability.

2. Sleep with a moist heating pad. I know you have heard that advice. Patients often tell me they have been sleeping on a heating pad for a week (or longer) hoping their back would get better. When I ask them to discontinue the heat, they look at me with wide eyes. “But that is the only way I get any relief!” they protest.

The results of using heat can be confusing. In fact the soothing comfort of the heat pad can be downright seductive. The heat does often relieve pain, help relax muscles and create the impression that it is helping. That is why it is often recommended. The kicker is that within a few hours your body’s inflammatory response may be elevated and the result will likely be more swelling and more pain. You rationally conclude, “Wow my back is killing me again, that heat felt good so I will put the heating pad back on.” The next thing you know you are experiencing a repetitive cycle of worsening pain and spasm.

I know I will hear from some readers telling me that they get welcome relief from their beloved heating pad. I don’t disagree. Sometimes it works great. But in many cases the heat will lead to a worsening problem. Application of a cold pack, although not as soothing initially, can be much more effective in resolving the problem.

3. “Crack” your own back or have your brother-in-law do it for you. Years ago I happened to be speaking with a lady that mentioned she had back pain. I told her that government studies show that spinal manipulation can be very effective and asked if she had ever had chiropractic care. “Oh no,” she replied. “I couldn’t go to a chiropractor. That scares me. Sometimes I let my husband crack my back and that feels good, though.” Intrigued, I asked what her husband did for a living. “He’s an electrician,” she told me.

4. Buy an ultra-firm mattress. Although a worn or poorly made mattress can result in back pain, contrary to the myth, super firm mattresses are not really better for backs. Although a person’s back pain may be worse in the morning, that does not mean their mattress is the culprit. Improving the function of the spinal joints, doing appropriate rehab exercises, and being aware of postures and activities that can cause back pain will likely help sufficiently so that you can keep your mattress.

5. Start a new set of exercises that you find in a magazine. Think about it this way: You are hurt. Tissue damage is causing significant pain. Is this really the best time to start doing any kind of exercises?

For acute episodes of back pain, exercises are not advised unless specifically recommended by your chiropractor, medical doctor or therapist. Although some forms of light gentle movement exercises may be helpful, the wrong approach to exercise can be damaging.

For chronic back pain, rehab exercises are very important. However, the exercise plan should be custom-designed to fit your unique needs by a specialist knowledgeable about rehabilitation.

Trying the wrong things to help an aching back can lead to a chronic disability that could be avoided with proper care. A successful solution depends not only on doing the right things, but also recognizing and avoiding bad ideas.