Low back pain - acute - Treatment

Treatment:

To get better quickly, take the right steps when you first get pain.

Here are some tips for how to handle pain early on:

• Stop normal physical activity for the first few days. This helps calm your symptoms and reduce any swelling in the area of the pain.
• Apply heat or ice to the painful area. One good method is to use ice for the first 48-72 hours, then use heat.
• Take over-the-counter pain relievers such as ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol).

While sleeping, try lying in a curled-up, fetal position with a pillow between your legs. If you usually sleep on your back, place a pillow or rolled towel under your knees to relieve pressure.

A common misbelief about back pain is that you need to rest and avoid activity for a long time. In fact, bed rest is NOT recommended.

If you have no sign of a serious cause for your back pain (such as loss of bowel or bladder control, weakness, weight loss, or fever), then you should stay as active as possible.

You may want to reduce your activity only for the first couple of days. Then, slowly start your usual activities after that. Do not perform activities that involve heavy lifting or twisting of your back for the first 6 weeks after the pain begins. After 2 - 3 weeks, you should gradually resume exercise. See: Taking care of your back at home

Begin with light cardiovascular training. Walking, riding a stationary bicycle, and swimming are great examples. Such aerobic activities can help blood flow to your back and promote healing. They also strengthen muscles in your stomach and back.

Stretching and strengthening exercises are important in the long run. However, starting these exercises too soon after an injury can make your pain worse. A physical therapist can help you determine when to begin stretching and strengthening exercises and how to do so.

Many people benefit from physical therapy. Your health care provider will determine whether you need to see a physical therapist and can refer you to one in your area. The physical therapist will begin by using methods to reduce your pain. Then, the therapist will teach you ways to prevent getting back pain again.

If your pain lasts longer than one month, your primary care health care provider may send you to see either an orthopedist (bone specialist) or neurologist (nerve specialist).

If your pain has not improved after use of medicines, physical therapy, and other treatments, your doctor may recommend an epidural injection.

You may also see a massage therapist, someone who performs acupuncture, or someone who does spinal manipulation (a chiropractor, osteopathic doctor, or physical therapist). Sometimes a few visits to these specialists will help back pain.

Expectations (prognosis):

Many people will feel better within 1 week after the start of back pain. After another 4 - 6 weeks, the back pain will likely be completely gone.

Calling your health care provider:

Call your health care provider right away if you have:

• Back pain after a severe blow or fall
• Burning with urination or blood in your urine
• History of cancer
• Loss of control over urine or stool (incontinence)
• Pain traveling down your legs below the knee
• Pain that is worse when you lie down or that wakes you up at night
• Redness or swelling on the back or spine
• Severe pain that does not allow you to get comfortable
• Unexplained fever with back pain
• Weakness or numbness in your buttocks, thigh, leg, or pelvis

Also call if:

• You have been losing weight unintentionally
• You use steroids or intravenous drugs.
• You have had back pain before, but this episode is different and feels worse.
• This episode of back pain has lasted longer than 4 weeks.