What can I do to ease back pain?

Dr. Mike Clark, DPT
First, if pain is severe talk your health care professional and receive a proper diagnosis. Often, a program of inhibiting overactive muscles, lengthening tight muscles, activating weak muscles and integrating small and large muscles into a coordinated movement pattern will help alleviate back pain. In the case of back pain, it is generally caused by imbalances in the muscles surrounding your hips. Specific muscle tightness in the hip flexors (muscles that flex the hip) hip rotators (hip muscles that work with your glutes) and hamstrings (muscles on the back of your thigh) often leads to misalignment of the hips and spine. As a consequence, or sometimes the cause, muscles that stabilize your spine like the deep abdominals (the transversus abdominis and small muscles of your spine) and glutes become weak. The cascade effect can lead to inefficient loading of the spine when you move, and poor distribution of forces throughout the body. This equates to increased poor posture, imbalanced movement, compensation and eventually, pain.
Back pain can be excruciating and interfere with every part of your life. Sometimes, alternative therapy is used for back pain, such as steroid epidural injections or physical therapy. Your physician may also be able to recommend specific exercises for you to do to strengthen the muscles in your back.
One of the most important things you can do to help yourself recover from back pain is to stay mobile. A day or two of bed rest is fine if you're really hurting, but after that, muscles begin to atrophy, which will make your back muscles weaker and make future injuries and pain more likely. So try to stay mobile, even if you just take short walks while you recover. Here are some treatments that may help you get around more comfortably:
  • Hot and cold therapy: Cold packs can help reduce swelling and inflammation if used the first day or two after injury. After that, the warmth of heating pads or hot water bottles can help relieve muscle tension and spasms.
  • Pain medications: Over-the-counter acetaminophen, ibuprofen, naproxen, or aspirin can help provide short-term relief of back pain. But don't exceed the dosing instructions. And see your doctor if your situation does not improve.
  • Rub-on relief: Pain-relieving ointments, gels, creams, and salves are applied directly to the skin and may help reduce stiffness and muscle soreness.The good news is that about 90 percent of people with acute low back pain get better within 4 to 6 weeks.
Brian Yee
Physical Medicine & Rehabilitation
Accurate diagnosis of the sources of back pain will indicate the type of treatment you should receive. However, after structural reasons of back pain have been ruled out (such as a herniated disc), the majority of patients are diagnosed with 'non-specific low back pain'.

What we find clinically is that traditional interventions such as medications and injections, although perhaps needed and based on a physician's recommendation, provide short-term relief.

There is growing research and clinical attention on trying to diagnose or sub-group 'non-specific low back pain'. This can include movement dysfunction, fascial restrictions, muscle control dysfunction, myofascial trigger points, psychosocial variables, pelvic pain, nerve referred pain, or internal/systemic issues such as referred pain from internal organs or hormonal/vitamin deficiencies.

It is important to find a clinician that is able to differentially diagnose the various contributing factors of back pain, and then be able to provide effective treatment for those sources -- and then coordinate with other practitioners that can address other needed areas. Especially in chronic low back pain management, a multi-disciplinary team of health practitioners is usually needed.
Ways to ease back pain include:
  • apply moist heat twice daily to affected area (or bathe in a warm tub of water or use a Jacuzzi)
  • do neck, hip, and back exercises
  • focus on stretching and strengthening muscles
  • do crunches to strengthen abdominal muscles
  • swim to strengthen muscles, increase endurance and end fatigue (start slowly and increase gradually over time)
  • work on quality of sleep and stress control
  • lose weight
  • talk to your doctor if medications are needed
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Diet for a Pain-Free Life: A Revolutionary Plan to Lose Weight, Stop Pain, Sleep Better and Feel Great in 21 Days

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Rick Olderman
Physical Therapy
Back pain treatment is dependent on the causes. Not all back pain is caused by the same thing. You must be individually assessed for your back pain and given a plan of treatment according to the issues that are found causing it.
The primary treatment for most back pain is non-opioid analgesics. These include nonsteroidal anti-inflammatory drugs, like aspirin and ibuprofen, along with other over-the-counter painkillers like acetaminophen. Bedrest is not recommended beyond a day or two, but it may be necessary for you to avoid activities that caused the injury. Exercise and physical therapy can be useful, especially in chronic cases. Gradual training will help increase flexibility and improve posture. Depending on the cause of the pain, doctors may prescribe a variety of different treatments, including opioid analgesics, corticosteroid injections, antibiotics, anticonvulsants, surgery, tricyclic antidepressants, or alternative treatments like acupuncture.
To ease back pain, your doctor will review the information gathered in your medical history and physical exam and may provide a range of treatments. The most common treatments include:
  • Education and activity recommendations. Your doctor will talk with you about many of the same things presented in this handout, including avoiding bed rest, staying active, and practicing good body mechanics.
  • Medications for pain relief. Your doctor may recommend over-the-counter or prescription strength anti-inflammatories (such as ibuprofen or naproxen) or acetaminophen. For more severe cases, your doctor may recommend a short course of muscle relaxers to help reduce muscle tension and increase ability to move. Acute back pain rarely requires treatment with steroids or narcotics.
  • Referral to a physical therapist. A physical therapist can create and supervise an individual program of exercises to increase your flexibility and strength. So if your doctor refers you to physical therapy, don’t delay your visit. Early treatment tends to produce better results than later treatment. (If your insurance doesn’t cover physical therapy, ask your doctor for exercise recommendations.)
You can get relief from over-the-counter anti-inflammatory medications, and by avoiding activities that aggravate the back pain, and by resting for a day or two. You should listen to your body and anything that aggravates the pain, is probably best to be avoided. If the pain improves, it is more likely to be a benign condition and nothing that serious. However, if the pain is really severe and does not improve, you should consult your physician.
Matthew F. McCarty, MD

Most back pain is caused from muscle spasm but can have underlying causes which might prolong the course. NSAIDs like ibuprofen, massage, ice or heat packs coupled with stretching can usually ease most back pain. If the pain persists over a week then a doctor’s visit with a prescription for muscle relaxants and physical therapy could be beneficial. If the pain persists beyond 6 weeks then further investigation by a pain physician would be helpful. After a thorough history and physical your pain physician will review imaging to look for potential underlying causes. If surgically correctable problems are identified then a referral is made. If not then an individualized treatment plan which could include injections and/or medications would be recommended to try to limit the pains impact on your daily living.

Continue Learning about Back Pain

Back Pain

Back Pain

Just about everyone has experienced some level of back pain. It is one of the most common ailments brought on by disease, injury, or misalignment of the spine. It can be a dull muscle ache in the lower back or a severe, sharp pain ...

in that affects your ability to bend over or stand up straight. Most often back pain results from strained muscles and ligaments that surround the spine, but it can also be caused by structural problems with the bones of the spine. There are treatment options for back pain, and understanding the causes and symptoms is key to preventing it in the first place.

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.