Help for Back Pain

Posted: April 1, 2004

Ice and heat
As soon as possible following trauma, apply a cold pack or a cold compress (such as a bag of ice or bag of frozen vegetables wrapped in a towel) to the tender spot several times a day for up to 20 minutes. After two to three days of cold treatment, apply heat (such as a heating lamp or hot pad) for brief periods to relax muscles and increase blood flow. Warm baths may also help relax muscles. Patients should avoid sleeping on a heating pad, which can cause burns and lead to additional tissue damage.

You should contact a doctor if there is not a noticeable reduction in pain and inflammation after 72 hours of self-care.

Bed rest
Bed rest should last only one to two days. Studies suggest that bed rest alone may make back pain worse and can lead to secondary complications such as depression, decreased muscle tone, and blood clots in the legs. At night or during rest, lie on one side, with a pillow between the knees (some doctors suggest resting on the back and putting a pillow beneath the knees).

Exercise
This may be the most effective way to speed recovery from low back pain and help strengthen back and abdominal muscles. Your doctor can provide a list of gentle exercises that help keep muscles moving and speed the recovery process.

A routine of back-healthy activities may include stretching exercises, swimming, walking, and movement therapy to improve coordination and develop proper posture and muscle balance. Yoga is another way to gently stretch muscles and ease pain. Any mild discomfort felt at the start of these exercises should disappear as muscles become stronger. But if pain is more than mild and lasts more than 15 minutes during exercise, you should stop exercising and contact a doctor.

Medications
Effective pain relief may involve a combination of prescription drugs and over-the-counter remedies. Patients should always check with a doctor before taking pain relievers.

Interventional therapy
This therapy can ease chronic pain by blocking nerve conduction between specific areas of the body and the brain. Approaches range from injections of local anesthetics, steroids, or narcotics into affected soft tissues, joints, or nerve roots to more complex nerve blocks and spinal cord stimulation. When extreme pain is involved, low doses of drugs may be administered by catheter directly into the spinal cord. However, chronic use of steroid injections may lead to increased functional impairment.

Transcutaneous electrical nerve stimulation (TENS)
TENS is administered by a battery-powered device that sends mild electric pulses along nerve fibers to block pain signals to the brain. Small electrodes placed on the skin at or near the site of pain generate nerve impulses that block incoming pain signals from the peripheral nerves. TENS may also help stimulate the brain’s production of endorphins (chemicals that have pain-relieving properties).

Ultrasound
This noninvasive therapy is used to warm the body’s internal tissues, which causes muscles to relax. Sound waves pass through the skin and into the injured muscles and other soft tissues.

Other treatment options
Some patients find relief from back pain through spinal manipulation, acupuncture and biofeedback.

Surgery
In the most serious cases, when the condition does not respond to other therapies, surgery may relieve pain caused by back problems or serious injuries. Some surgical procedures may be performed in a doctor’s office under local anesthesia, while others require hospitalization. It may be months following surgery before the patient is fully healed, and he or she may suffer permanent loss of flexibility.

Source: National Institute of Neurological Disorders and Stroke

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