Most acute low back pain can be treated with a pain reliever, gentle exercises, cold and hot compresses, and one to two days of bed rest (for severe pain). Most patients with back pain recover without a loss of function. In some cases, surgery may be needed. If you try self-care of your back pain and it is not better after 72 hours, call your health care provider.
Several prescription drugs and over-the-counter (OTC) drugs are available for pain relief. Be sure to check with your health care provider before taking OTC drugs for pain relief because some are unsafe during pregnancy, may interact with other medications you take, and may cause side effects, including drowsiness, or may lead to liver damage. These are common OTC pain relievers:
- Non-steroidal anti-inflammatory drugs, such as aspirin, naproxen and ibuprofen. These reduce stiffness, swelling and inflammation, and ease mild to moderate low back pain.
- Creams, ointments or sprays, which are applied to the skin over the painful areas. These products can stimulate the nerve endings in the skin to provide feelings of warmth or cold to dull the sense of pain.
- Other creams or sprays, which can reduce inflammation and stimulate blood flow. Many of these compounds contain salicylates, the same ingredient found in oral pain medications that include aspirin.
Prescription drugs that offer pain relief include anti-seizure drugs; certain antidepressants, such as amitriptyline and desipramine, which relieve pain and help with sleep; and opioids, such as codeine, oxycodone, hydrocodone and morphine, which are for short-term use to treat severe acute and chronic back pain.
Exercises prescribed by your health care provider or a physical therapist may be the most effective way to speed recovery from low back pain and help strengthen back and abdominal muscles.
You should resume your activities as soon as possible. Only people with severe back pain should rest in bed -- and then only for one or two days. Studies have shown that people who continue their activities without bed rest after an episode of low back pain recover more quickly and suffer fewer complications, such as depression, decreased muscle tone and blood clots in the legs.
Alternating ice and heat treatments may help reduce pain and inflammation. The NINDS says that you should apply a cold pack or cold compress as soon as possible after an injury. A cold compress can be a bag of ice or a bag of frozen vegetables wrapped in a towel. Apply the cold to the tender spot several times a day for up to 20 minutes at a time. After two to three days of cold treatment, apply a heating lamp or hot pad for brief periods to relax muscles and increase blood flow. A warm bath may also help relax muscles. Don't sleep on a heating pad, which can cause burns and lead to additional tissue damage.
Sleep on your side with a pillow between your knees.
If these measures don’t relieve pain, your health care provider may suggest other treatments. Medications that block the transmission of pain impulses from nerves to the brain can be injected into the painful area. Ultrasound therapy can help muscles relax. Transcutaneous electrical nerve stimulation (TENS) blocks pain signals to the brain by sending a mild electric pulse sent along nerve fibers.
If your back pain is caused by poor physical conditioning or improper body mechanics, you can help prevent injuries by regularly doing a combination of exercises that don't jolt or strain the back, maintaining correct posture, and learning how to lift objects properly. Activities that include stretching exercises, swimming, walking and movement therapy can improve coordination and develop proper posture and muscle balance, the NINDS says. Yoga helps stretch and strengthen muscles and improve posture. Always talk to your health care provider before beginning an exercise program to make sure it is the right thing to do.
Although some people use a wide elastic belt to support back and abdominal muscles when lifting heavy objects, studies have not proved that such belts are beneficial. Don’t use these belts as a substitute for physical conditioning and proper lifting techniques.
Here are some general tips on how to maintain a healthy back and avoid causes of low back pain:
Get regular exercise
You should do some type of exercise on most days of the week. Low-impact aerobic exercises, such as speed walking, swimming or stationary bike riding for 30 to 60 minutes a day can increase muscle strength and flexibility and help maintain a healthy weight. A weightlifting program designed by a physical therapist or professional trainer can build strength and improve posture. Stretching and flexibility exercises maintain posture and prevent injury and falls.
Maintain good posture
- When standing, keep your weight balanced on your feet, with your ears, shoulders and hips in a straight line, and your stomach pulled in. If you stand for long periods, try to elevate one foot or shift your weight often. Women should avoid wearing high heels; instead, they should wear low-heeled shoes with good cushioning and arch support.
- Sit in a chair with a straight back and good lumbar support. Keep your shoulders back and your knees slightly higher than your hips. To do this, you may need to adjust your chair height or use a footstool.
- Don't slouch over your desk or lean your head forward. Slouching requires greater muscular effort and creates more tension in your back.
- To do close work, move your chair in. Get up every hour or so and stretch. Also, to keep moving, fidget when you are sitting.
- Move the car seat forward enough so your knees and hips are at the same level and you don't have to stretch your legs to reach the pedals. Sit in an upright position; don't recline the back of your seat. On long drives, take frequent rest stops so you can get out and stretch.
Eat a nutritious diet
A nutritious diet can help you lose extra pounds, especially weight around the waist. Your body mass index should be between 18.5 and 24.9. Make sure you get enough calcium, phosphorus and vitamin D each day to promote new bone growth. For more information on a healthy diet, go to http://mypyramid.gov/.
Learn how to lift
Learn and practice proper lifting techniques. Do not lift things that are too heavy for you. Don’t lift by bending over; instead, bend your knees and squat to pick up the object. Before you lift, tighten your stomach muscles by pulling them in; keep your back straight so the weight is pushed onto your knees, keep your head down and in line with your straight back. Keep the object close to your body. Do not twist when lifting. To move heavy objects, push rather than pull.
Sleep on a firm mattress
Sleep on your side with a pillow between your knees, if needed to relieve back aches.