About the Back and Back Problems: Pain Relief

Getting Relief

A number of medicines and other treatments help with low back symptoms. The good news is that most people start feeling better soon.

Drugs Can Work but …

Medicine often helps relieve low back symptoms. The type of medicine that your health care provider recommends depends on your symptoms and how uncomfortable you are.

If your symptoms are mild to moderate, you may get the relief you need from an over-the-counter (nonprescription) medicine such as acetaminophen, aspirin, or ibuprofen. These medicines usually have fewer side effects than prescription medicines and are less expensive. If your symptoms are severe, your health care provider may recommend a prescription medicine.

For most people, medicine works well to control pain and discomfort. But any medicine can have side effects. For example, some people cannot take aspirin or ibuprofen because it can cause stomach irritation and even ulcers. Many medicines prescribed for low back pain can make people feel drowsy. These medicines should not be taken if you need to drive or use heavy equipment. Talk to your health care provider about the benefits and risks of any medicine recommended. If you develop side effects (such as nausea, vomiting, rash, dizziness), stop taking the medicine, and tell your health care provider right away.

Non Drug Alternatives

Your health care provider may recommend one or more of the following to be used alone or along with medicine to help relieve your symptoms

Heat or cold packs applied to the back.

• Within the first 48 hours after your back symptoms start, you may want to apply a cold pack to the painful area for 5 to 10 minutes at a time.
• If your symptoms last longer than 48 hours, you may find that a heat pack or hot shower or bath helps relieve your symptoms.

 

Our recommended source for Hot and Cold packs

 

Spinal manipulation.

• This treatment (using the hands to apply force to the back to adjust the spine) can be helpful for some people in the first month of low back symptoms.
• It should only be done by a professional with experience in manipulation.
• You should go back to your health care provider if your symptoms have not responded to spinal manipulation within 4 weeks.

Keep in mind that everyone is different. You will have to find what works best to relieve your own back symptoms.

Other treatments

A number of other treatments are sometimes used for low back symptoms. While these treatments may give relief for a short time, none have been found to speed recovery or keep acute back problems from returning. They may also be expensive. Such treatments include:

• Traction.
• TENS (transcutaneous electrical nerve stimulation).
• Massage.
• Acupuncture.
• Injections into the back.
• Back corsets.
• Ultrasound.

Physical Activity

Your health care provider will want to know about the physical demands of your life (your job or daily activities). Until you feel better, your health care provider may need to recommend some changes in your activities. You will want to talk to your health care provider about your own personal situation. In general, when pain is severe, you should avoid:

• Heavy lifting.
• Lifting when twisting, bending forward, and reaching.
• Sitting for long periods of time.

The most important goal is for you to return to your normal activities as soon as it is safe. Your health care provider and (if you work) your employer can help you decide how much you are able to do safely at work. Your schedule can be gradually increased as your back improves.

Bed Rest

If your symptoms are severe, your health care provider may recommend a short period of bed rest. However, bed rest should be limited to 2 or 3 days. Lying down for longer periods may weaken muscles and bones and actually slow your recovery. If you feel that you must lie down, be sure to get up every few hours and walk around–even if it hurts. Feeling a little discomfort as you return to normal activity is common and does not mean that you are hurting yourself.

About Work and Family

Back problems take time to get better. If your job or your normal daily activities make your back pain worse, it is important to communicate this to your family, supervisor, and coworkers. Put your energy into doing those things at work and at home that you are able to do comfortably. Be productive, but be clear about those tasks that you are not able to do.

Things You Can Do Now

While waiting for your back to improve, you may be able to make yourself more comfortable if you:

• Wear comfortable, low-heeled shoes.
• Make sure your work surface is at a comfortable height for you.
• Use a chair with a good lower back support that may recline slightly.
• If you must sit for long periods of time, try resting your feet on the floor or on a low stool, whichever is more comfortable.
• If you must stand for long periods of time, try resting one foot on a low stool.
• If you must drive long distances, try using a pillow or rolled-up towel behind the small of your back.
• Also, be sure to stop often and walk around for a few minutes.
• If you have trouble sleeping, try sleeping on your back with a pillow under your knees, or sleep on your side with your knees bent and a pillow between your knees.

Exercise

A gradual return to normal activities, including exercise, is recommended. Exercise is important to your overall health and can help you to lose body fat (if needed). Even if you have mild to moderate low back symptoms, the following things can be done without putting much stress on your back:

• Walking short distances.
• Using a stationary bicycle.
• Swimming.

It is important to start any exercise program slowly and to gradually build up the speed and length of time that you do the exercise. At first, you may find that your symptoms get a little worse when you exercise or become more active. Usually, this is nothing to worry about. However, if your pain becomes severe, contact your health care provider. Once you are able to return to normal activities comfortably, your health care provider may recommend further aerobic and back exercises.

 

This information was based on the Clinical Practice Guideline, Acute Low Back Problems in Adults.

 

The Guideline was developed by a non-Federal panel of experts sponsored by the Agency for Health Care Policy and Research.