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NON-SURGICAL TREATMENT

 

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Back Pain Medication

A wide range of treatment is available for low back pain, depending on what is causing the pain and how long it lasts. Most people find that their low back pain improves within a few weeks. Chances are good that your pain will go away soon with some basic self-care.

As you consider treatment for your low back pain, keep these things in mind:

  • If you have recently developed low back pain, stay active and consider taking over-the-counter pain medicines such as acetaminophen (Tylenol, for example) or non-steroidal anti-inflammatory drugs (NSAIDs). Examples of NSAIDs are ibuprofen (Advil or Motrin) and naproxen (Aleve or Naprosyn). Staying active is better for you than bed rest. In fact, staying in bed more than 1 or 2 days can actually make your pain worse and lead to other problems such as stiff joints and muscle weakness.
  • People who understand their low back pain are more satisfied. Be sure to ask your doctor or physical therapist if you have questions about your symptoms, how to manage your back pain, or activities you can do or should not do.
  • If your low back pain has lasted longer than 3 months, you will probably benefit from more intensive treatment. Programs that combine strengthening exercises with education and activities to help you increase your function and manage your pain are often effective.
  • Surgery is rarely needed for low back pain. Even if you have a herniated disc or nerve damage, you are likely to improve without surgery.
  • After you have had low back pain once, the pain is likely to come back. To avoid further problems, keep your back and stomach muscles strong, use good posture, learn the safest way to lift heavy objects, and learn to manage stress.

Treatment for acute low back pain

Acute low back pain is pain that has lasted less than 3 months. If you have recently started to have low back pain, there's a good chance that it will get better within a few weeks. Most low back pain will improve if you take the following steps:

  • For the first day or two, rest in a comfortable position. Try lying on your side with a pillow between your knees. Or lie on your back on the floor with a pillow under your knees. Do not stay in one position for too long, though. Every 2 or 3 hours, take a short walk (about 10 to 20 minutes), then find a comfortable position to rest again.
  • Take pain medicine if needed, such as acetaminophen (Tylenol) or medicines that reduce pain, swelling, and irritation, including ibuprofen (such as Advil or Motrin) or naproxen (such as Aleve or Naprosyn). For some people, these medicines work best if taken on a regular schedule.
  • Try using a heating pad on a low or medium setting for 15 to 20 minutes every 2 or 3 hours. Try a warm shower in place of one session with the heating pad. You can also buy single-use heat wraps that last up to 8 hours. You can also try an ice pack for 10 to 15 minutes every 2 to 3 hours. There is not strong evidence that either heat or ice will help. But you can try them to see if they help. You may also want to try switching between heat and cold.
  • As soon as possible, get back to your normal activities. Movement helps your muscles stay strong. Staying in bed for more than 1 or 2 days can actually make your problem worse.

Walking is the simplest and perhaps the best exercise for the low back. Your doctor or a physical therapist can recommend more specific exercises to help your back muscles get stronger. These may include a series of simple exercises called core stabilization. The muscles of your trunk, or core, support your spine. Strengthening these muscles can improve your posture, keep your body in better balance, and decrease your chance of injury.

Treatment for chronic low back pain

Chronic low back pain is pain that has lasted longer than 3 months. As low back pain continues beyond 3 months, it becomes vitally important that you develop skills for managing and coping with chronic pain so you can avoid getting into a cycle of sleeplessness, inactivity, irritability, depression, and more pain.

Chronic pain often requires both psychological counseling and medical treatment, because pain has a wearing effect on both the mind and the body. Seek out a cognitive-behavioral therapist who can teach you stress management and pain control skills. Look for a "back school" program and at least one type of health professional who specializes in spinal care. Some programs combine exercise, activities to increase your function, and techniques to help you manage pain.

Treatment if low back pain gets worse or comes back

See your doctor if you have moderate to severe low back pain that lasts more than a couple of days, if you have back or leg symptoms that have gotten worse, if your symptoms have not gone away after 2 weeks of home treatment, or if improved symptoms flare up again. A physical exam and possibly an imaging test may produce new information about your condition and help direct your treatment decisions.

  • If no serious cause of mild to moderate low back pain is apparent (as in most cases), your doctor will probably advise you to continue with home treatment. Consider seeing a physical therapist for back-healthy exercises to use every day, as long as they don't make your symptoms worse. A medicine to reduce pain, moist heat application, massage, cognitive-behavioral therapy, learning how to best use your back in a "back school" program, chiropractic therapy (also called spinal manipulation), or biofeedback may also help prevent your symptoms from becoming chronic.
  • If your pain is severe, your doctor may recommend short-term use of an opiate painkiller, epidural steroid injection, or muscle relaxant. These medicines have potential harms and side effects, but these may be balanced out if the medicines help you. Epidural steroid injections are usually used only for people with symptoms from a herniated disc, such as pain in the buttocks and down into the leg. Talk with your doctor about the expected benefits and side effects of any medicine.
  • If your pain is caused by another health problem, such as a herniated disc, spinal stenosis, ankylosing spondylitis, osteoarthritis, cancer, or infection, your doctor will make specific treatment recommendations.

If you have a herniated disc, your doctor may recommend surgery. Most doctors will wait to consider surgery until after you have tried nonsurgical treatment for 1 to 3 months without improvement (but usually before more than 6 months have gone by). Most people who have a herniated disc never need surgery.

 

   

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