Back Pain Treatment

Self-Care at Home

General recommendations are to resume normal, or near normal, activity as soon as possible. Stretching or activities that place additional strain on the back are discouraged, however.

• 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.
• Nonprescription medications may provide relief from pain.
  • Ibuprofen (such as 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 (such as 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 legs, 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. Others are of more questionable use.

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 (back pain going down the leg) may benefit from 2-4 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.

If back pain is associated with sudden loss of bladder or bowel control, it is important to seek immediate medical attention.