That’s precisely how most back pain happens: one moment you’re doing something you’ve done countless times before, the next you’re frozen, with pain radiating in your back or legs, a muscle spasm and maybe numbness in your legs. It simply hurts to stand or sit. For Peter, as with most back-pain sufferers, there was no serious underlying cause – such as a tumour or arthritis – and the pain went away after a few weeks. But Peter decided to lower the risk that back pain would ever sideline him again. Since that incident, he has learned and adjusted to healthy lifestyle habits that include good posture and regular exercise.

Dr. Hamilton Hall, medical director of CBI Health in Toronto, blames most common backaches on the wear and tear and natural aging of the spine, coupled with poor posture. Problems typically begin in the mid-20s and peak at middle age, says Hall, who is also director of spine services at the Orthopedic and Arthritic Institute at Sunnybrook and Women’s College Health Sciences Centre in Toronto, as well as a professor in the department of surgery at the University of Toronto.

Here’s what happens. Joints and discs, which act as shock absorbers between the bones in the spine, wear out over time. The discs – imagine doughnuts filled with squishy fluid – become less resilient and sometimes herniate (experts also use the words rupture, crack and fracture). The discs swell and press on nerves, causing inflammation, irritation and pain.

Sciatica occurs when a pinched nerve in the back causes leg-dominant pain. Although muscles are rarely a primary cause of back pain unless they sustain a direct injury, you can count on them to tense up as a natural reaction and share the overall pain, says Hall.

“But I didn’t do anything wrong!” you say. Well, that’s often the way it seems. A 1998 Canadian Back Institute study of 11,000 people showed that two-thirds of back pain happens for no particular reason. This is because the major contributors to back pain have a gradual, cumulative effect. For example, stress can trigger back pain. So can improper lifting, excess exertion, poor posture, pregnancy, injuries, obesity, lack of exercise, carrying heavy objects – even menstrual periods (increased blood volume and fluid retention can increase the pressure on discs).

Deidre Pretlove, a physiotherapist at Personal Best Physiotherapy in Toronto, says a growing number of teenagers are turning up with back and neck pain caused by sitting in front of computers and television sets for too long. The heavy backpacks that many kids lug to and from school can also cause problems. Others at risk include tall people who spend most of their day in flexion, overweight people who carry an extra – and not always balanced – load and anyone whose job requires a great deal of lifting.

Very few back problems – just one and a half to two per cent – require surgery, says Hall. Surgery is performed either to remove a piece of the disc or bone that is pushing on the nerve, or to fuse discs to stabilize sections of spine that may be rubbing together. Otherwise, health practitioners may suggest such noninvasive treatments as physiotherapy, applying ice packs or heating pads, exercises to restore joint mobility, massage for muscle spasms, chiropractic adjustment, ultrasound for inflammation and spasm, transcutaneous electrical nerve stimulation (TENS) or analgesics to relieve the pain.

Most specialists who treat back pain recommend an active approach to the problem rather than complete bed rest. And they all emphasize that once you’re past the acute phase, it’s really up to you to keep your back healthy. Here are some of the latest and greatest healthy back-care techniques.

Strengthen the back muscle, or perispinals. The back muscles, along with the abdominals, are core muscles that work together to support your spine. There is equipment, such as the ergonomic Roman chair, that is specially designed to isolate and tone the perispinals, and there are effective exercises you can do at home. It’s not strength you’re after, says Hall, but rather endurance. The more endurance your back muscles have, the better chance there is that you will avoid significant back pain.

Try Pilates classes. Interned at the outbreak of the First World War, Joseph Pilates taught his fellow PoWs to keep fit using a series of controlled movements that stretch and strengthen muscles. The New York dance community has since adopted the technique for conditioning. Pilates classes are becoming a hot exercise trend in Canada, and there are a growing number of clinics today that offer them.

Get flexible. Noninvasive activities allow for gentle, gradual motion and stretching of the tissue, says Cory Ross, a Toronto chiropractor who is also dean of clinical affairs at the Canadian College of Naturopathic Medicine in Toronto and coauthor of The Complete Idiot’s Guide to Healing Back Pain for Canadians. For example, yoga and T’ai Chi use deliberate breathing and movement to help develop flexibility. Another great exercise is swimming; working against the gentle resistance of warm water enhances blood flow.

Keep active. Aerobic activities such as walking and fitness classes help keep the back limber and help maintain healthy weight. Healthy adults should aim for three to four 20- to 30-minute sessions of aerobic activity every week. However, take note: rowing puts a lot of pressure on the back, as does cycling (even on stationary bikes, though upright handlebars can help). Stretch before and after any exercise, paying special attention to hamstring muscles – if these muscles are tight, they can cause back pain.

Eat sensibly. Follow Canada’s Food Guide to Healthy Eating and be sure to load up on calcium-rich foods such as milk, yogurt and cheese to promote strong, healthy bones. Drink plenty of water each day; besides being good for your overall health, it helps keep everything – including discs – lubricated.

Consider taking glucosamine sulfate, but talk to your health-care provider first. Saifa Sidi, a chiropractor at Wynford Chiropractic and Rehabilitation Clinic in Toronto, says that this supplement is one of the building blocks of cartilage and helps nourish joints.

Sit up straight (Yes, your mother was right.) Sitting incorrectly exerts pressure on discs and is worse for back health than bending or lifting, says Pretlove. To the rescue: an ergonomic chair; a back- and lumbar-support product such as an Obus Forme, which fits on your chair; or a McKenzie roll, which tucks into your back against the back of a chair. The best position for sitting is to plant both feet firmly on the floor, with shoulders back, knees and hips at a 90-degree angle and hips slightly higher than your knees. A kneeling chair with no back is recommended as a second chair, as long as you don’t have knee problems.

Avoid standing or sitting in any position for long periods of time. Gravity compacts the spine, says Ross, so give your back a break by getting up or changing positions every 20 to 30 minutes. Movement helps nourish joints by carrying blood and nutrients to the back and other parts of your body.

Back off. Never overdo weekend activities, whether you’re working around the house, gardening or playing a sport. When lifting, bend at your knees instead of at your back, and hold the load close to your body. Keep your back straight and avoid lifting anything too heavy. Balance any load in both arms (don’t lug a baby around on your hip, for example). If you’re travelling with luggage, get a suitcase with wheels.

Slow down and relax. Try such stress-management techniques as yoga-style breathing (take in a slow, deep breath, hold it for 10 seconds and then breathe out slowly) or meditation with a visualization tape (envision your healthy back).

Take an extra pillow to bed. Peter McKinnon often goes to sleep on his back or his side with a pillow tucked beneath his knees to help keep the curve in his back properly aligned. And speaking of sleep, is a hard or a soft mattress better for back health? While some people find a hard bed more comfortable than a soft one, says Hall, it’s a personal choice. He emphasizes that, like many other health matters, it’s important to listen to your own body – and then do what it tells you.