Louise Chang, MD
If you got up this morning and thought, “Ugh, my back hurts,” you’re not alone. About one in five Americans reports having experienced back pain at least once during the previous month.
So, should you go to the doctor? Not necessarily. Most low back pain resolves on its own within about four to six weeks, with or without medical treatment. In many cases, you can manage your back pain at home.
First, you should know when it’s a bad idea to handle your back pain yourself. If you have significant back pain accompanied by any of the following symptoms, see a doctor:
Without any of those symptoms or history, here are some options for easing your back pain on your own, without the intervention of a doctor.
First, you should rest your back. This doesn’t mean weeks of bed rest, as was once thought. “That’s the worst thing you can do,” says Jae Jung, MD, associate professor of orthopaedics at the David Geffen School of Medicine at the University of California-Los Angeles.
Jung suggests resting your back for about 48 hours after an injury or after the first time you notice significant pain. After that, you can slowly increase your activity level. Getting up and moving as soon as spasms and sharp pains subside can help ease pain and stiffness.
Applying ice or heat directly to the area of low back pain can help to decrease swelling and inflammation, and ease your discomfort. Studies have found that heat may be more beneficial than ice, but both have been shown to alleviate low back pain.
Heat works by dilating blood vessels. That increases the oxygen supply to the back and helps reduce muscle spasms. Cold works by possibly decreasing the size of the blood vessels and the blood flow to the area. That may reduce inflammation. Although it may feel painful at first, it can ease deep pain.
If you want to use heat, there are a number of options, including heating pads and disposable heat wraps. For ice, says Jung, it’s just as easy to use a package of frozen vegetables as to buy a commercially prepared ice pack. “You can get the ice on your back without having to run out of the house, if you’re really in pain.”
Over-the-counter medications, such as acetaminophen (Tylenol) or a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Advil) and naproxen (Aleve), have been found to improve pain for people with low back pain. It’s unclear whether acetaminophen or NSAIDs are more effective.
One thing that might help make your decision easier is the potential side effects of medications.
The side effects of NSAIDs include gastrointestinal problems and kidney problems, while acetaminophen primarily can cause damage to the liver. In most cases, you’d need to take large doses of the medications over a long period of time to cause any damage.
Topical creams and gels that contain ingredients like capsaicin, salicylate, camphor, eucalyptus oil, and menthol also may be soothing for pain. These include products such as Aspercreme, Bengay, Icy Hot, and Zostrix.
Although no specific exercises have been found to be particularly effective in alleviating back pain, exercise in general is important for many people with back pain to maintain mobility.
If you've had physical therapy in the past and know what to do, then start with a gentle exercise program. If you're not sure which exercises to do, then talk with your doctor or have a physical therapist show you.
A physical therapist may have you do exercises to help widen the spaces between the vertebrae, reducing pressure on the nerves. Exercises to stretch back and hip muscles and strengthen abdominal muscles may also be recommended. You may also do stretching exercises to ease stiffness and increase range of motion. You may be encouraged to do aerobic exercise for overall fitness.
You may also do extension exercises which involve bending backward -- such as with leg lifts. These exercises may help minimize radiating pain. You may also do stretching exercises to ease stiffness and increase range of motion. You may be encouraged to do aerobic exercise for overall fitness.
“Exercise is always a good baseline treatment to do at home,” says Jung. However, exercising when your back is in spasm can be counterproductive. Instead, wait for spasms to subside, then slowly start stretching your muscles.
SOURCES: Kinkade, S. American Family Physician, April 15, 2007; vol 75: pp 1181-1188.Jae Jung, MD, assistant professor of orthopedics, David Geffen School of Medicine at UCLA, Los Angeles.National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health: “Handout on Health Back Pain.”FamilyDoctor.org: “Low Back Pain."Cherkin, D. Archives of Internal Medicine, 2001; vol 161: pp 1081-1088.
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