Treatment At Home
General recommendations are to resume normal, or near normal, activity as soon as possible. However, stretching or activities that place additional strain on the back are discouraged.
- Sleeping with a pillow between the knees while lying on one side may increase comfort. Some doctors recommend lying on your back with a pillow under your knees.
- No specific back exercises were found that improved pain or increased functional ability in people with acute back pain. Exercise, however, may be useful for people with chronic back pain to help them return to normal activities and work. These exercises usually involve stretching maneuvers.
- Nonprescription medications may provide relief from pain.
- Ibuprofen (Advil, Nuprin, or Motrin), available over the counter, is an excellent medication for the short-term treatment of low back pain. Because of the risk of ulcers and gastrointestinal bleeding, talk with your doctor about using this medication for a long time.
- Acetaminophen (Tylenol) has been shown to be as effective as ibuprofen in relieving pain.
- Topical agents such as deep-heating rubs have not been shown to be effective.
- Some people seem to benefit from the use of ice or heat. Their use, although not proven effective, is not considered to be harmful. Take care: Do not use a heating pad on “high” or place ice directly on the skin.
- Most experts agree that prolonged bed rest is associated with a longer recovery period. Further, people on bed rest are more likely to develop depression, blood clots in the leg, and decreased muscle tone. Very few experts recommend more than a 48-hour period of decreased activity or bed rest. In other words, get up and get moving to the extent you can.
Medical Treatment
Initial treatment of low back pain is based on the assumption that the pain in about 90% of people will go away on its own in about a month. Many different treatment options are available. Some of them have been proven to work while others are of more questionable use. You should discuss all remedies you tried with your health-care provider.
Home care is recommended for the initial treatment of low back pain. Bed rest remains of unproven value, and most experts recommend no more than two days of bed rest or decreased activity. Some people with sciatica may benefit from two to fours days of rest. Application of local ice and heat provide relief for some people and should be tried. Acetaminophen and ibuprofen are useful for controlling pain.
- Many studies have called into question the usefulness of our present treatment of back pain. For any given person, it is not known if a particular therapy will provide benefit until it is tried. Your doctor may try treatments known to be helpful in the past.
Pain in the lower back or low back pain is a common concern, affecting up to 80% of Americans at some point in their lifetime. Many will have more than one episode. Low back pain is not a specific disease, rather it is a symptom that may occur from a variety of different processes. In up to 85% of people with low back pain, despite a thorough medical examination, no specific cause of the pain can be identified.
What Causes Back Pain?
Back pain can have many underlying reasons, but often no specific cause will be found and the pain will stop. This chapter will review many of the causes of back pain and proper evaluation and diagnosis. Please be sure to discuss your individual symptoms as well as the suggested treatments with your health-care professional to determine the appropriate diagnostic and treatment plan for your circumstances.
- Low back pain is second only to the common cold as a cause of lost days at work. It is also one of the most common reasons to visit a doctor’s office or a hospital’s emergency department. It is the second most common neurologic complaint in the United States, second only to headache.
- For most people, even those with nerve root irritation, their symptoms will improve within two months no matter what treatment is used, even if no treatment is given.
- Doctors usually refer to back pain as acute if it has been present for less than a month and chronic if it lasts for a longer period of time.