45 years old back tired consider and exercise to muscle strain, osteophytes, osteoporosis, etc., can oral anti-inflammatory, pain relief, anti-osteoporosis drugs, calcium, etc.. Excessive exercise or inappropriate exercise, mattress inappropriate, etc. lead to back muscle strain, osteophytes lead to back tendon aseptic inflammation, can appear back fatigue, you can take non-steroidal anti-inflammatory pain medication (diclofenac sodium delayed-release tablets, ibuprofen capsule) and swelling medication (Panlong seven tablets, dioxymethamphetamine tablets), should also be moderate rest. Osteoporosis can also cause back fatigue, which can be treated with oral anti-osteoporosis medication (zoledronic acid sodium), as well as calcium supplements (calcium carbonate) and vitamin D, etc. There may be other causes of back strain at age 45, so it is recommended to consult a physician for timely treatment under the guidance of a physician.