Complications
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Prognosis
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Treatment|
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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.
Rest.
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.
Medications
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.
Physiotherapy
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.
Surgery
Few people need
surgery for back pain. If you have unrelenting pain associated with radiating
leg pain or progressive muscle weakness caused by nerve compression, you may
benefit from surgery. Otherwise, surgery usually is reserved for pain related to
structural problems, such as narrowing of the spine (spinal stenosis) or a
herniated disk, that hasn't responded to other therapy.
Prevention|
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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.
Lift smart. Avoid heavy lifting,
if possible, but if you must lift something heavy, let your legs do the work.
Keep your back straight — no twisting — and bend only at the knees. Hold the
load close to your body. Find a lifting partner if the object is heavy or
awkward.
