Frequent low back pain in a 22 years old caregiver

Dear Ask The Doctor: I am a 22 year old girl and fairly active. I go hiking and try to take the stairs any chance I get! I'm also a caregiver and have been on my feet ever day at work for the past four years. I have heard that back pain can sometimes be caused by sitting too often so I wanted to rule that out immediately. I have always had mild discomfort in my back for as long as I can remember but in the past year or so it seems to have gotten worse. The only way I can think to describe it is it feels like the vertebrae in my spine are grinding on top of each other and my entire back is almost always stiff. And increasingly I am start to experience sharp shooting pains in random parts of my back that get worse when I move but if I hold perfectly still for about a minute it goes away. I have gotten them in my lower spine, upper spine, and even in my shoulder blades. I don't know if this is related or not but I also have a tendency to get migraines from time to time and recently have been having trouble sleeping for long periods of time and I know I toss and turn in my sleep frequently because its hard for me to comfortable due to my back hurting even though I almost always tired. Is it serious? Should I see my doctor? ((I have no medical insurance)) or are there at home remedies I can do? Thank you!

Dear Amanda: Mechanical low back pain (LBP) is the second most common reason for seeing a physician in the United States. Of the US population, 85% will experience an episode of mechanical LBP at some point during their lifetime. Fortunately, the LBP resolves for the vast majority within 2-4 weeks. Sometimes it may complicate with a persistent muscle contracture and/or a sciatic nerve inflammation and the healing process takes a little longer. The suggested conservative treatment would be: a physical therapy program aimed to: control the pain and the inflammatory process, relative rest, flexion and extension exercises of the spine to reduce the nerve tension, exercises that improve the muscular strength and endurance of lumbar muscles. The main goal of physical therapy in persons with post-traumatic acute back pain is not to increase strength but to achieve adequate pain control. Acetaminophen (“Tylenol”) remains one of the best first-line treatments of acute LBP. It is generally well tolerated, has few adverse effects or drug reactions with other medications, and is inexpensive. You can also try anti inflammatory drugs (“Aleve”) or the one that you are actually taken “Celebrex”. Also, try avoiding all the activities that produce pain or discomfort, such as weight lifting, keep a good posture at all times and sleeping with a pillow between the knees while lying on one side may increase comfort. Some doctors recommend lying on your back with a pillow under your knees. The back pain will improve within several days. Do not be discouraged if you don't get a fast improvement. Almost everyone gets better within a month of onset of the pain if it is an uncomplicated mechanical lower back pain.