Thelma Lucas walked almost daily until hip pain made it difficult for her to put one foot in front of the other.

"It came out of nowhere," says Lucas, 65, of the "toothache-like" pain that traveled down her sides and lasted for days at a time. "I'd be going along just fine, go to get up, and there it was."

When the frequency and intensity increased, Lucas saw a doctor, who diagnosed her hip pain as a back problem, a condition that plagues millions.

Most adults will experience back pain resulting from a degenerative spine, injury, muscle strain or wear and tear on the body, says Miriam Nelson, author of "Strong Women, Strong Backs." A doctor's diagnosis often is required to rule out other causes, such as tumors or fractures.

Women are more susceptible to back problems because their backs and abdomens are weaker, causing more strain on the spine. Childbearing, heavy purses and housework also add to the potential for pain, as do brittle bones from a lack of calcium in elderly women.

"The good news is that there are a number of very easy strategies that help with back pain," Nelson says.

Rest, over-the-counter muscle relaxers, pain pills and anti-inflammatories can treat back soreness that lasts a few days. Prolonged pain might require physical therapy, epidurals (spinal injections) or alternative remedies such as chiropractic care, which targets spinal alignment.

But when pain leads to nerve damage and numbness in the legs, surgery is the most viable option to remedy the problem, but not always the pain.

"I don't know if you ever get a cure," says Patricia Baumann, a physician at Emory School of Medicine in Atlanta. "Even with surgery, it's (still) pain management."

Baumann performs one of the latest procedures for chronic back pain, spinal cord stimulation. Electrical impulses are used to block pain from being perceived in the brain, so instead of pain, the patient feels a mild tingling.

After decades of chronic back pain, Covington, Ga., resident Pricilla Brooks received the procedure as a last resort.

"It's not a cure, but it gives me relief," says Brooks, 69, who still takes some medication but now can perform basic chores and sleep better.

EXERCISES FOR A STRONG BACK

Although it's best to get a customized exercise program to prevent back pain, these exercises can provide a starting point to improve the flexibility of your spine and strength of the smaller muscles that support your spine. If you already have back pain or have been diagnosed with a spinal condition, get your doctor's permission to do any exercise.

SHELL STRETCH: Start on all fours with hands shoulder-width apart and knees hip-width apart. Slowly move your hips back toward your heels as far as you can, comfortably, rounding your spine over your thighs. Relax your upper back, shoulders, neck and head. Breathe deeply through your nose. Hold 20-30 seconds. Repeat two to three times.

SWAN DIVE: Lie on your stomach, with legs hip-width apart and rotated outward so your toes point out. Rest your hands on the mat, just wider than your shoulders, with forehead hovering over the mat. Exhale as you pull your bellybutton toward your spine. Press lightly into your hands to lift and lengthen your spine. Rise only as high as you feel you can keep good form and there is no discomfort in your lower back. Inhale once you have reached the top, holding the lifted position. Exhale and slowly lower your body back to start position, keeping your abdominals tight to support your spine. Repeat three to eight times.

SWIMMING: Lie on your stomach with legs hip-width apart, arms stretched out in front of you, shoulder-width apart, forehead resting on the mat. Exhale as you tighten your abs, pulling your bellybutton off the mat toward your spine. Lift your left arm and right leg 2 to 3 inches off the mat. Inhale as you lower your arm and leg. Exhale as you repeat with opposite arm and leg. Do five to 10 repetitions each side.

AB PREP: Lie on your back with knees bent, feet hip-width apart and arms at your sides. Keep collarbones wide — not rounded forward. Your lower back should have a slight, comfortable arch and your tailbone should be heavy on the mat. Slightly nod your chin to feel a lengthening of the back of your neck. Exhale as you draw your bellybutton to the spine to flatten and widen abdominals, use your abs to slide your ribs toward your pelvis, rounding your upper back slightly to lift your head and shoulder blades off the mat.Inhale as you hold this lifted position. Exhale to lower shoulders and head to the mat. Repeat 10 times.

GETTING RELIEF

• Massage. Helps relieve muscle spasms or tension.

• Physical therapy. Includes stretching and strengthening exercises for the back muscles.

• Chiropractic care. Works on spinal alignment.

• Anti-inflammatories. Reduce swelling and inflammation around tissues.

• Prescription steroids. More powerful than anti-inflammatories.

• Epidural. Numbs area and helps a patient become more comfortable; injected in weekly or monthly intervals.

• Surgery. When a patient is getting weaker in the legs or has bowel or bladder problems, surgery is often recommended. Procedures often include spinal fusion, discectomy, laminectomy or spinal cord stimulation. They are appropriate for patients with herniated or degenerated discs, spinal fractures, spinal cancer, narrowing of the spinal column, severe cases of spinal infection, curvature of the spine and forward slipping of the spine.

AN OUNCE

OF PREVENTION

• Develop good nutrition habits. Helps keep tissues healthy.

• Maintain proper weight. Extra pounds put more pressure on knees and spine.

• Lift properly. Bend from the knees and not the back.

• Maintain good posture. Sitting and standing correctly helps with spinal alignment.

• Establish good ergonomics. Keep chair at correct height.

• Strengthen your back and abdomen. Increase muscles that support your spine.

• Manage stress. It can cause upper back and neck problems and future back problems.

• Stop smoking. Studies show that smokers experience more back problems.

— Source: Vicki Barnett, director of surgical services,Northside Hospital, Atlanta

DO-IT-YOURSELF RELIEF

At the onset of pain, try these steps first:

• Take it easy. Avoid heavy lifting and physical activities such as exercise or sports.

• Get up and stand. Walk or move around, especially if you're at work, at least 10 minutes each hour.

• Ice and heat. Put ice on the painful area for the first 24 hours. Then, alternate ice and heat.

• Self-medicate. Take an over-the-counter pain reliever or muscle relaxer, but don't exceed recommended dose. If pain persists or intensifies, or you develop fever, weakness or numbness in one or both legs or lose bladder or bowel control, call your doctor.

— Source: "Living Well With Back Pain" by Robert Winter and Marilyn Bach

CHIROPRACTIC CARE

If you choose a chiropractor, here is what you should expect:

• Joint manipulation. Manipulating or "adjusting" the joints frees restrictions and often helps pain.

• Adjunctive treatments. You may also receive heat, electrical stimulation, ice or ultrasound.

• X-rays. Repetitive X-rays will assess your progress.

Caution: No treatment works for every problem. If the treatment is helping, you should feel improvement and/or your activities will improve in weeks.

— Source: Craig Castanet, Backstrong Non-surgical Rehabilitation Center, Atlanta

What to avoid:

• Nutrition advice. Chiropractors should not dispense particular diets or supplements.

• Preventive treatment. You need alignment only to alleviate pain, not prevent pain.

• Anti-medical sentiment. Chiropractic care should be part of a holistic approach, along with standard medical treatment.

Refer to the American Chiropractic Association for a qualified chiropractor.

— Source: "Strong Women, Strong Backs" by Miriam Nelson