If you have occasional flare-ups of back pain, these six steps can prevent it from becoming a chronic problem.

With changes in the aging spine, occasional backaches may grow more frequent and blossom into a chronic and disabling pain condition. It doesn't have to happen to you. To maintain the best back health possible, you have to address both the body and the mind, says Dr. Zacharia Isaac, a physical medicine and rehabilitation doctor at Harvard-affiliated Brigham and Women's Hospital.

"Cardiovascular and strength training are good basic prevention to keep your back healthy," Dr. Isaac says. "Because of the brain's involvement with back pain, maintaining a good sleep cycle and good emotional state are also very important."

1 Don't baby your back

It's important to respond to back pain constructively. "Acute back pain flare-ups are so painful that most people start to baby their backs," Dr. Isaac says. "If people tend to shrink too much from their daily activity level, they get deconditioned."

In turn, deconditioning can lead to worse pain and disability. "Neurological changes happen that sensitize you to the pain," Dr. Isaac says. "That feeds into a cycle of more avoidance of activity and more deconditioning."

When you have a sore back, avoid extended bed rest. Slowly transition back to your usual activities. "It's important to maintain normalcy," Dr. Isaac says. "Get up and walk around the house. Try to do light tasks. Maintain moderate activity."

2 Strengthen your core

Strengthen the muscles that support the lower spine as an insurance policy. "Moderate exercise is very helpful," Dr. Isaac says. "Many people who are moderate exercisers have fewer musculoskeletal problems."

Ask your doctor to suggest daily back exercises appropriate to your condition, or ask for a referral to a physical therapist to teach you the most effective exercises to prevent back pain.

3 Stay limber

If the muscles that support the lower spine become tight, it can make pain worse. Trouble generally develops in the muscles and ligaments of the pelvic girdle, which allow you to bend and twist at the waist. "When the hip girdle is unbalanced, you have more flare-ups of back pain," Dr. Isaac says.

Learn some stretches to keep your pelvic girdle limber. Some of the same exercises often recommended for routine back pain will help, but
a physical therapist can carefully assess your specific musculoskeletal issues and prescribe stretches to release the tension.

4 Straighten up

Poor posture can put stress on the back and trigger back pain. Don't slouch when you sit. If you are slouching or leaning because of ongoing pain, loosening the hip girdle with stretching exercises may help. "That allows you to stand more upright and put less mechanical strain on the low back," Dr. Isaac says.

5 Get some sleep

Getting restful sleep is essential for anyone with back problems because sleep deprivation sensitizes you to pain. "When you have poor sleep, it also alters brain chemistry and you are more prone to developing a chronic pain state," Dr. Isaac says.

6 Stay positive and relax

People who are depressed and anxious tend to have worse back problems. And of course back pain itself can get you down. Like sleep deprivation, blue moods and anxiety can make you more sensitive to pain.

Relaxing deep-breathing exercises can help to relieve the stress of a back pain flare-up. If you are getting depressed, anxious, or hopeless about your condition, ask for more help from your doctor. Think of the flare-up as a temporary setback and focus on what you will be able to do in the future to make back pain a less frequent companion in your life.

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