Whether it’s sudden intense pain or a longstanding ache, back pain can be debilitating. The question is, what can you do to make it go away?

Dr. Joerg Ermann, a rheumatologist in the Division of Rheumatology, Inflammation, and Immunity at Harvard-affiliated Brigham and Women’s Hospital, says that there are several strategies that can help you get back up and moving. Choosing the right ones largely depend on what type of back pain you have. The first question you need to answer, he says, is duration: Are you experiencing a short-term (acute) problem? Or is your pain chronic — lasting for months or even years?

"It’s important to distinguish between the two scenarios, because it has a huge impact on what could be driving this pain, and affects its management," says Dr. Ermann.

What to do for acute pain

If you’ve got what doctors refer to as an acute episode of back pain, it typically comes on suddenly and often goes away within a few days or weeks. This type of back pain is very common.

"Almost everyone — 80% of people — will experience this in their lifetime at some point," says Dr. Ermann. "With most common causes of back pain, we often don’t really know why it hurts."

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A classic scenario occurs when someone shovels snow or does some other unusual physical activity, and — later in the day or on the following day — develops severe back pain. "This is usually due to muscle strain or ligament sprain in the back," says Dr. Ermann.

If this sounds like you, and you’re otherwise fit and healthy, you can likely wait a few days to see if the pain starts to go away before you pay a visit to the doctor. In the meantime, there are several pain management strategies that are often helpful.

Medication and heat. Taking an over-the-counter nonsteroidal anti-inflammatory drug, such as ibuprofen or naproxen, can help to reduce pain. Also, try applying heat to the affected area.

Move as much as you are able. While you may be tempted to lie flat on your back until the pain goes away, movement may actually help get you back to normal more quickly. "The general approach these days is that, if at all possible, people experiencing back pain should keep moving. We don’t treat back pain with immobilization," says Dr. Ermann. The exception to this rule is a fracture or other condition that makes movement inadvisable.

Stay positive. Most episodes of acute back pain resolve on their own within a few days or weeks. "People almost always get back to the status they had before," he says. Other than staying active, no particular strategy has been shown to more quickly resolve pain and stiffness.

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See your doctor. There are some instances where back pain warrants immediate medical attention. Signs that you should call your doctor include the following:

Your pain is debilitating and getting worse. It prevents you from performing your daily activities.

You have additional symptoms, such as fever, weakness in the legs, difficulty walking, or urinary incontinence.

You have an existing disease — for example, you are undergoing cancer treatment or you are on immunosuppressant medications. "Sudden severe back pain in this context may indicate a more serious problem, such as a fracture or infection," says Dr. Ermann.

Is your back pain a sign of an overlooked condition?

Sometimes chronic back pain is caused by conditions that aren’t very common. One to consider is axial spondyloarthritis, also known as ankylosing spondylitis. It’s a chronic inflammatory condition triggered by a problem with your immune system. It leads to back pain, stiffness, and other symptoms.

"Axial spondyloarthritis used to be considered a male disease, but that view has changed over the past 10 years. We now have better ways to identify these patients, and have since realized that the disease is as common in women as it is in men," says Dr. Joerg Ermann, a rheumatologist at Brigham and Women’s Hospital. Doctors used to think that it was more prevalent in men because males tend to have more severe disease that progresses rapidly, so it’s visible on an x-ray, he says.

Signs that you might have axial spondyloarthritis include back pain and stiffness that are worse in the morning and improve with exercise. This condition should also be on your radar if someone else in your family has it because it has a strong hereditary component.

What to do for chronic back pain

Chronic back pain, defined in the medical literature as pain that lasts three months or longer, typically needs different management strategies than acute back pain does.

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"If you are experiencing back pain that has lingered past the three-month mark, is interfering with your life, and requires medications to treat it, it is worthwhile to talk to your doctor about it," says Dr. Ermann. A good starting point might be to mention it at your annual wellness visit. Your doctor might recommend any of the following strategies.

Work with a physical therapist. Getting guidance from a specialist as well as performing regular exercise at home can often help. Core strengthening exercises are especially important, says Dr. Ermann. If the spine is better supported by strong core muscles, it can reduce some of the pressure and pain on your back. "This can be helpful in relieving symptoms," he says. At home, try plank holds (either in a push-up position or using a modified version on your knees). Regular exercise can also help you lose weight, which may alleviate some of the pressure on the back.

Adjust your posture. In some situations, lasting back pain may be aggravated by poor posture, such as slouching.

"If you are experiencing pain, look at how you sit at your desk. Relatively simple changes sometimes bring a big benefit," says Dr. Ermann. This might include getting up every few hours to stretch your back.

"I had a patient who started having back pain when working from home. It disappeared when he went back to the office. He realized that at home he was working from his couch. At the office he was sitting at a desk, which improved his posture," he says.

Try, try again. People with chronic back pain may experience pain sensitization, meaning that changes in the brain cause the body to overreact to pain signals. "Chronic pain may take on a life of its own," Dr. Ermann says. This can be addressed with specific medications, such as certain antidepressants.

"Unfortunately, we cannot really predict which medications will work for an individual, so it often becomes a matter of trial and error to find an appropriate medication or combination of medications that work," he says.

Be patient. "If you are someone who has had chronic back pain for five or 10 years, you can’t expect it to go away overnight," says Dr. Ermann. Sometimes it takes time for interventions such as medication or physical therapy to make a difference. Most treatment plans won’t work instantly.

Consider alternatives. "Many patients of mine also see a chiropractor," says Dr. Ermann. This do­esn’t work for everyone, but it is certainly something worth trying. "I personally prefer a more active approach, such as physical therapy, where you empower the muscles and help the back get stronger. Chiropractic medicine is a more passive approach. Nevertheless, I do hear from some patients that they feel better doing it," he says.

Document your progress. Keep a record of all the interventions that you have tried and write down what works and what doesn’t. Having a record can be helpful down the road. Also, be certain to keep copies of the reports and the actual digital images. "It’s important for a back pain specialist to see the images directly rather than reading a report."

Get a second opinion. Surgery may be necessary for some back problems, particularly those that are causing neurological symptoms, such as numbness or weakness in the extremities. It may also be used to address a tumor or for certain types of fractures. But surgery is not a cure for many back conditions, and it is not uncommon for back pain to persist after surgery. For this reason, if your doctor recommends surgery, consider getting a second opinion, says Dr. Ermann

Move over, "Quarantine 15." That term, coined for pandemic-era weight gain, isn’t the only catchy phrase from this challenging time. Now there’s "pandemic posture," referring to poor posture from slouching at a desk or on a couch during time at home — and it brings lots of back pain complaints with it.

We asked Dr. David Binder, a physiatrist and director of innovation at Harvard-affiliated Spaulding Rehabilitation Hospital, about this phenomenon and what to do if you’re experiencing it.

Q. Is "pandemic posture" real?

Dr. Binder: Yes, we have seen increased complaints of neck and lower back pain in the last year, often in the context of sitting for extended periods of time with increased work at home.

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Science has proven that chronic, low-grade inflammation can turn into a silent killer that contributes to cardiovas­cular disease, cancer, type 2 diabetes and other conditions. Get simple tips to fight inflammation and stay healthy -- from Harvard Medical School experts.

Many people don’t have the same facilities or workstations that they have in an office setting, which has created poor posture.

Or maybe they’re spending too much time in a comfortable chair or on the couch.

Q. Why does poor posture cause back pain?

Dr. Binder: Holding any posture for a long period of time, whether it’s standing or sitting, sometimes increases discomfort because of muscle spasms or muscle fatigue.

Having poor posture may also put increased pressure on certain joints or produce an imbalance on one side of your body that bears an increased load compared with the opposite side.

Additionally, poor posture can result in nerve irritation at pressure points such as the buttocks or tailbone, which can be painful.

Q. What do you recommend for people who want to reduce back pain from poor posture?

Dr. Binder: It’s helpful to exercise every day with a well-rounded routine that includes a warm-up, aerobic exercise, a cool-down, and general muscle stretching. This will keep your muscles strong and flexible.

Sometimes working with a physical therapist is useful as well. A therapist can help you understand the mechanics of how to sit up straight, with your back arched and your shoulders back and down. The therapist can also train you to strengthen and stretch the muscles that help you sit up straight. Those include your abdominal, back, shoulder, neck, and chest muscles.

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(Note: If you have medical conditions, check with your doctor before starting a physical exercise program.)

Get on your hands and knees. Keep your hands flat on the floor in front of you, exhale, then lower your buttocks backward until they rest on your heels and feet. Lower your forehead to the floor and extend your arms in front of you, hands still flat on the floor. Hold, then inhale as you come back up.

Q. Would improving a home workstation also help?

Dr. Binder: Absolutely. Use a chair with lots of cushioning for the buttocks and support for your lower back. Sometimes using a footrest helps you feel more comfortable and takes a little load off your back. A footrest is especially helpful for people who are a bit shorter, so they can keep their knees at an optimal angle — approximately 90°.

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Other workstation tips would be raising your computer monitor to eye level, so you won’t have to look down all the time and put pressure on your neck, and using an ergonomic mouse and wrist pad to cut down on wrist, arm, and shoulder discomfort — which can lead to pain in the shoulder, shoulder blade, or neck. But watch out if you use a standing desk, which allows you to stand while working. Standing for long periods can worsen back pain.

Q. What else helps?

Dr. Binder: Set a timer to get up from your desk — or couch or chair — and move around every 20 minutes. This will keep you from being in one position for extended periods of time. Getting up will also give your spine a break from the pressure of sitting and keep your muscles from getting too tight. And of course, staying active throughout the day is also important for many other aspects of health; sitting too much is associated with chronic disease and even premature death.