Back pain treatment varies with the severity, cause and associated factors. Some of the treatments and therapies that may be tried for back pain may be outlined as follows.
Management of acute or short term back pain
This is commonly seen in most individuals with back pain. The pain lasts no longer than six weeks and can be treated with pain relievers that are available over-the-counter or without prescription at a pharmacy and home treatments.
Of the pain relievers Paracetamol (Acetaminophen) is commonly used successfully. Some people find anti-inflammatory drugs such as ibuprofen more effective.
Stronger pain killers like codeine may be taken for more severe pain along with paracetamol.
Those with muscle spasms may be prescribed a muscle relaxant like diazepam along with a pain reliever.
Pain relievers may also be applied as creams, ointments or sprays over the affected area.
Hot and cold compresses
Heat with the use of a hot bath, hot water bottle or heated pad may provide relief from back pain in some individuals. In yet others application of ice packs or a bag of frozen vegetables over the pain may ease the pain. Ice packs, however, should not be applied directly over the back as this may cause cold burns. Some persons also benefit by alternating hot and cold using ice packs and hot compression packs.
- Sleeping posture – Sleeping posture and mattress may be contributing to the back pain. By changing the sleeping position and/or mattress the pain may be eased or prevented. Patient is advised to sleep on their side and draw their legs up slightly towards their chest and pillow is put between their legs. For those who sleep on their backs, a pillow may be placed under the knees to maintain the normal curve of the lower back.
- Relaxing muscle tensions – this can be achieved by deep breathing and conscious relaxation of back muscles before retiring to bed each day.
- Maintaining regular physical activity – Long periods of inactivity is bad for the back. People who remain active are likely to recover more quickly. Earlier those with back pain were advised bed rest. These days they are advised to walk or perform their daily activities to prevent immobility of the back.
- Weight loss – Being overweight and obese is a risk factor for back pain. Having a healthy and balanced diet along with regular exercise helps in keeping excess weight in check.
- Reduction of stress
- Regular exercise and being active and physically fit – This may be achieved by walking, swimming, yoga and pilates. These help in maintaining the flexibility and strength of the back muscles and prevent recurrence of back pain
Management of long term or chronic back pain
Back pain lasting over six weeks is called chronic back pain
- A more intensive exercise programme is prescribed. This is usually up to eight sessions over a period of up to 12 weeks. It will usually be a group class supervised by a qualified instructor. These exercises help to strengthen the muscles and improve posture. There are aerobic and stretching exercises as well.
- Manual therapy is prescribed and this includes manipulation, mobilisation and massage. This is performed by chiropractors, osteopaths or physiotherapists. These are usually for up to nine sessions over a period of up to 12 weeks.
- Acupuncture may be tried as a treatment modality as well. These may include up to 10 sessions over a period of up to 12 weeks.
- Some patients may suffer from concurrent depression due to their back pain. These patients require antidepressant medications, counselling and cognitive behavioral therapy as well.
- Surgery is usually only recommended as a treatment option when all else has failed. A common procedure is spinal fusion surgery. This involves fusion or joining up of the joint that is causing pain to prevent it moving.
- Other therapies include low level laser therapy. In this low energy lasers are focused on the back to reduce the inflammation.
- Ultrasound waves may also be used to accelerate healing and encourage tissue repair
- Interferential therapy (IFT) is performed by a device that passes an electrical current through the back to improve healing.
- Transcutaneous electrical nerve stimulation (TENS) – This is delivered by a machine that provides small electrical pulses to the back through electrodes that are placed on the skin. This helps to reduce the pain signals from the back.
- Mechanical measures – This includes lumbar supports like cushions, pillows and braces, traction devices for the spine.
- Drugs – Pain killers and steroids may be directly injected into the affected joints to reduce inflammation and pain.
Warning signs of back pain and when to see the physician
In most cases a few days of rest and adequate mobility may help in recovery from back pain. However, some symptoms may indicate a deeper problem and mandates a visit to the doctor. These symptoms include:
- Weight loss that is unexplained
- Swelling and immobility of the back
- Pain in the limbs
- Worsening pain at night
- Numbness of the lower limbs or other parts of the body including genitals
- Loss of bladder or bowel control
- Unsteadiness when standing