reatment for lower back pain depends upon the patient's history and the type and severity of pain. The vast majority of lower back pain cases get better within six weeks without surgery, and lower back pain exercises are almost always part of a treatment plan.
Over-the-counter pain relievers and the use of heat or ice might be all you need. Bed rest isn't recommended but you can stop activities for few days.
Continue your activities as much as you can tolerate. Try light activity, such as walking and activities of daily living. Stop activity that increases pain, but don't avoid activity out of fear of pain. If home treatments aren't working after several weeks, your doctor might suggest stronger medications or other therapies.
Ceasing activity for a few days allows injured tissue and even nerve roots to begin to heal, which in turn will help relieve lower back pain. However, more than a few days of rest can lead to a weakening of the muscles, and weak muscles have to struggle to adequately support the spine. Patients who do not regularly exercise to build strength and flexibility are more likely to experience recurrent or prolonged lower back pain.
Heat and Ice Packs.
Heat and/or cold therapy helps relieve most types of low back pain by reducing inflammation. Often patients use ice, but some prefer heat. Both may be used alternately.
Depending on the type of back pain you have, your doctor might recommend the following:
Over-the-counter (OTC) pain relievers. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), might relieve acute back pain. Take these medications as directed by your doctor, because overuse can cause serious side effects.
If OTC pain relievers don't relieve your pain, your doctor might suggest prescription NSAIDs.
Muscle relaxants. If mild to moderate back pain doesn't improve with OTC pain relievers, your doctor may also prescribe a muscle relaxant. Muscle relaxants can make you dizzy and sleepy.
Topical pain relievers. These are creams, salves or ointments you rub into your skin at the site of your pain.
Narcotics. Certain drugs, such as codeine or hydrocodone, may be used for a short time with close supervision by your doctor.
Antidepressants. Low doses of certain types of antidepressants — particularly tricyclic antidepressants, such as amitriptyline — have been shown to relieve some types of chronic back pain, independent of their effect on depression.
Injections. If other measures don't relieve your pain and if your pain radiates down your leg, your doctor may inject cortisone — an anti-inflammatory medication — or numbing medication into the space around your spinal cord (epidural space). A cortisone injection helps decrease inflammation around the nerve roots, but the pain relief usually lasts less than a few months.
Physical therapy is the cornerstone of back pain treatment. A physical therapist can apply a variety of treatments, such as heat, ultrasound, electrical stimulation and muscle-release techniques, to your back muscles and soft tissues to reduce pain.
As pain improves, the therapist can teach you exercises that can increase your flexibility, strengthen your back and abdominal muscles, and improve your posture. Regular use of these techniques can help prevent pain from returning.
You may be able to avoid back pain or prevent its recurrence by improving your physical condition and learning and practicing proper body mechanics.
How keep your back healthy and strong:
Exercise. Regular low-impact aerobic activities — those that don't strain or jolt your back — can increase strength and endurance in your back and allow your muscles to function better. Walking and swimming are good choices. Talk with your doctor about which activities are best for you.
Build muscle strength and flexibility. Abdominal and back muscle exercises (core-strengthening exercises) help condition these muscles so that they work together like a natural corset for your back. Flexibility in your hips and upper legs aligns your pelvic bones to improve how your back feels. Your doctor or physical therapist can tell which exercises are right for you.
Maintain a healthy weight. Being overweight strains back muscles. If you're overweight, trimming down can prevent back pain.
How to use proper body mechanics:
Stand smart. Maintain a neutral pelvic position. If you must stand for long periods, place one foot on a low footstool to take some of the load off your lower back. Alternate feet. Good posture can reduce the stress on back muscles.
Sit smart. Choose a seat with good lower back support, armrests and a swivel base. Consider placing a pillow or rolled towel in the small of your back to maintain its normal curve. Keep your knees and hips level. Change your position frequently, at least every half-hour.