O.K. it is Saturday morning. Your regular group has an 8:30 tee time at your favorite course. You worked hard over the last few days at the driving range to get your swing under control. When you went to bed last night, you were convinced that today was going to be the day that you would shoot a new low. Somewhere in your brain, you imagined your friends congratulating you for your heroic performance as you finally conquered the game of golf. Then, you roll in bed and feel the pain. Your back is hurting. You get up, do some exercises that help your friend treat his back and things only get worse. You get dressed, hoping that things quiet down. You take your Tylenol, Ibuprofen, get to the course and almost collapse on the first tee.

Or, you may be someone who has chronic pain and stiffness. By about the 4th or 5th hole, you might be moving better. You might be worse. If this sounds familiar, read on.

Back pain is a common problem. It effects an overwhelming majority of all people including golfers. There are as many different causes of back pain as there are golf swings. Understanding your back and your limitations are very important to successful treatment, and your enjoyment of the game.

Probably, the most common cause of back pain is wear and tear arthritis involving the joints of the spine. These are common findings in all people who are mature enough to remember the days when Roadrunner cartoons were considered the cutting edge violence and too much for your youth.

Symptoms that go along with this wear and tear arthritis include an aching type pain in the back and possibly the buttocks, but rarely, if ever, into the legs. The pain is usually worse with activity such as the take away and follow through of a golf swing. It is also worse when someone bends forward at the waist to lift a ball out of a cup, tee up a ball or carry a golf bag.

More disabling causes of back pain can also include leg pain. This can be caused by a compressed or pinched nerve in the back. Between every pair of back bones, two nerve roots exit from the spinal cord. These nerve roots pass out of the spine through windows between the bones. They then travel down to the buttock and legs. Compression of these nerve roots, can result in severe burning pain, tingling, numbness and even weakness of the legs.

This is a more serious condition. Playing with a plain backache due to wear and tear type arthritis usually does not result in significant long term deficits such as weakness. On the other hand, continuing to play through the pain associated with compressed or pinched nerve roots can.

With regard to the regular run of the mill backache, there are several structures that can generate pain in the back and the pelvis. The treatment for each of these "generators of pain" can be different. Some of the universal treatments for back pain that can get you back on the tee box include the following:

Standard doses of Tylenol before, during and after the round. If you have no medical problems such as kidney disease or stomach ulcers, the use of medications like Ibuprofen can also help a great deal. These medications could be taken before, during and after a round. If you are already taking other medications in the same category of Ibuprofen, such as Bextra, Celebrex or Vioxx, you should not mix these medications.

The application of an ice pack before and after the round can also help a great deal. The ice is usually applied for 20 minutes and then removed for at least 40 before it is reapplied.

One of the most universal concepts that can help all people with backaches include increasing your flexibility.

When someone has restricted movements of their spine, between two arthritic joints, the take away and follow through, during a golf game can still take place. Instead of sharing the burden of motion evenly, among all the joints of the spine, extra stress is put upon the joints that are most able to move. This can cause problems as these joints are asked to contribute more than they are able.

Stretching before, during and after a round can help greatly. A safe and effective way to stretch includes sitting on the chair and maintaining good posture. Place your right hand at the outside of the left knee and use your shoulders to rotate to your left, keeping your buttocks and thighs as still as possible, (sounds like a golf swing). Move slowly to the left and then slowly back to the midline. Then, place your left hand over the outside of your right knee and rotate your shoulders to the right.

A good golf turn results in a 90 degree rotation of the shoulders to the right. This can be simulated and enhanced by this exercise.

There are many effective treatments for back pain and for nerve root compression or radicular pain in the legs. It would be impossible for anyone to recommend specific and effective treatment without examining the individual golfer.

1. Try to stretch, before, during and after a round.
2. Use Tylenol and occasional medications like Ibuprofen as long as there are no medical reasons to avoid these medicines (see above).
3. Ice before and after a round.
4. If your problems include pain shooting down to the legs or feet, this can indicate a more serious problem that needs to be evaluated by a physician.

If you feel limited by your back or leg pain, see your doctor. It is more likely than not that you can enjoy the game again, either pain free or with greatly reduced pain. No one can guarantee that you will be carried off the 18th green on your partner's shoulders, as the club house admires your record setting performance. However, playing a round without pain can be almost as rewarding.