When you experience back pain, the goal of treatment is to make you feel better and allow you to move freely and easily again.
Your choice of treatment will depend on the location of your pain and whether the pain is acute—severe and sudden, caused by something—or chronic—for more than 6 months, and may occur after the injury or illness has healed. It’s not going.
Diagnosis and testing
Unless you cannot move at all due to an injury, your doctor may test your range of motion, check how your nerves work, and press your back to zero in the problem area. You may have blood and urine tests to rule out other problems, such as infections or kidney stones.
Doctors usually use imaging tests to check for persistent pain, whether something has been hit in the back, whether you have a fever, or whether there are nerve problems, such as weakness or numbness in the arms or legs:
- X-rays can help pinpoint fractures or other spinal problems. They can sometimes help find problems in connective tissue.
- An MRI or CT scan can show your doctor about soft tissue damage (such as a herniated disc).
- Electromyography (EMG) helps to find nerve and muscle damage.
But there is not always a direct link between the results of these tests and the degree of injury.
When you first experience back pain or your back pain is due to your overuse, imaging tests are usually not performed. Most back pain starts in the back, not the real spine. Because it is usually related to the back muscles, it is usually impossible to find the specific cause through imaging studies.
Your diagnosis will help your doctor decide what to do next.
Treatment at home
The basic way to relieve stress or minor injuries is to relax for 24 to 72 hours. Use ice packs and over-the-counter pain relievers, such as acetaminophen, aspirin, ibuprofen, or naproxen. After the inflammation subsides, a heating pad or heating pack can help soothe muscles and connective tissues.
If you have chronic back pain, sleep on a medium firm mattress. It may be more comfortable to put a pillow between your knees when lying on your side. Some doctors recommend lying on your back with a pillow under your knees.
Some other tips to try:
Maintain a good posture. Do this all day. Be sure to listen to your body. If you feel sore or stiff, change your posture and body mechanics.
Sit up straight. It feels better and puts minimal pressure on your back. If you feel stiffness, arch your back 5 to 10 times. This includes when you are driving.
Rest awhile. If you are doing hobbies such as quilting, sewing, and scrapbooking, don’t bow your head for a long time without taking a break. Change your position and stretch in the opposite direction about every 20 minutes. Kneel or squat down when gardening or cleaning.
Stretch regularly. This leads to a good posture, and you can maintain the posture effortlessly. Try these stretching exercises at home or at your desk:
- Shoulder roll, backward, 10 times
- Scapula squeeze, 10 times
- Chin, 10 times
- Slowly stretch your head with the chin back, 10 times
- Turn your head over your shoulders, 10 times in each direction
- Standing back bending stretch, 10 reps
Exercise and physical therapy
Bed rest, once recommended by doctors to treat back pain, may do more harm than good. It may slow down your recovery and cause new problems.
For acute pain, you should be able to start normal, relaxing activities, such as walking, within a few days. Afterwards, gradually return to your usual exercise level.
Strengthening the abdominal and back muscles helps stabilize the spine. Pilates exercises can exercise these core muscles. You can help prevent further back injuries by learning and doing gentle stretching exercises and correct weightlifting.
Exercising in the water is especially safe for back pain. Water can support part of your body weight, make you feel more comfortable, and provide gentle resistance, thereby enhancing your strength. Hydrotherapy can make you more flexible and relieve the pain of chronic low back problems.
Yoga can help you improve flexibility, strength and balance. This helps relieve stress and it will also help you cope with pain.
Physical therapy (PT) focuses on managing or preventing injury or disability. PT helps relieve pain, promote healing, and restore function and movement.
Your treatment plan may involve visiting a specialist called a physical therapist. They focus on pain relief through passive or active treatment. Examples of passive physical therapy include:
- Manual therapy
- Hot compress or ice pack
- Electrical stimulation
- Dry needle
Examples of active physical therapy include:
- Exercise-based activities, including stretching and range of motion exercises
- Specific strengthening exercises
- Exercises to relieve pain
- Low-impact aerobic conditioning
Remember, everyone may respond differently to treatment. People have different types of bodies, different exercise methods and different habits. Physical therapists and their well-trained staff can try to correct incorrect habits and exercise patterns.
Over-the-counter pain relievers such as Tylenol, aspirin, or non-steroidal anti-inflammatory drugs (such as ibuprofen and naproxen) may be helpful. If you have trouble getting through a normal day, your doctor may prescribe stronger painkillers or muscle relaxants. But you must be careful. Some of these prescription drugs can make you drowsy. You may also rely on hydrocodone/acetaminophen (Vicodin), oxycodone/acetaminophen (Percocet), or other opioid-containing drugs.
The antidepressant duloxetine (Cymbalta) may help treat arthritis and chronic low back pain. Doctors sometimes prescribe antidepressants and anticonvulsants to treat pain related to irritated nerves. It is generally not recommended to use swallowed steroids for acute low back pain.
If your attending doctor cannot help you manage the pain, they may refer you to a back specialist or pain specialist who may inject steroids or other medications directly into your back to help control the pain.
Injections and surgery in and around the spine usually only provide temporary relief. However, when other methods fail, they may be important in helping diagnose the structural causes of pain and helping the body recover. Injections are expensive and have potential side effects, which should be discussed in detail before starting. Usually, pain specialists or back specialists also use the rehabilitation and counseling services of non-physicians (such as therapists, counselors, and patient educators).
Chiropractic and osteopathy
Chiropractic can treat acute low back pain, but may not be effective for chronic low back pain.
Chiropractic adjustments immediately after a back injury may prevent chronic problems in the future.
Osteopaths usually combine medical treatment with spinal massage or traction, followed by physical therapy and exercise.
This ancient Chinese treatment method can bring relief to patients with chronic low back pain. Gently inserting a thin, dry needle into the skin at a specific point may trigger the release of endorphins, which are your body’s natural painkillers, or it may change your brain’s chemical reactions and give you a higher pain tolerance sex. You should use it with other treatments.
These treatments are suitable for long-term back pain and nerve damage.
Radiofrequency ablation electrically stimulates specific nerves, making them less sensitive to pain. It can also stimulate the nerve to destroy it and prevent further pain.
TENS or transcutaneous electrical nerve stimulation may help block pain signals or trigger your body to produce endorphins. A small battery-powered device sends signals through electrodes attached to your skin, making you feel tingling.
Intradiscal electrothermal therapy (IDET)
The intervertebral disc acts as a cushion between the vertebrae. Sometimes, the intervertebral disc can be damaged and cause pain. IDET uses heat to change the nerve fibers of the intervertebral disc and destroy the pain receptors in that area. During this process, a wire called a heating catheter is placed through the incision in the intervertebral disc. Electric current passes through the wires to heat a small part of the intervertebral disc to a temperature of 90°C externally. IDET is done as an outpatient procedure when you are awake and under local anesthesia.
Early research suggests that some people may have sustained pain relief for 6 months or more. But more research is needed to compare this treatment with standard therapies and surgery and placebo.
Radiofrequency disc nucleoplasty
Radiofrequency disc nucleoplasty is a relatively new procedure that uses radiofrequency probes instead of heating wires to break down a small portion of the central disc material. The result is partial decompression of the intervertebral disc, which may help relieve the pain caused by the compression of the nearby spinal nerve root by the herniated disc.
Cognitive behavioral therapy (CBT) can often reduce back pain, change your perception of pain and disability, and even relieve depression. People have been able to reduce medication while improving their outlook.
If your lower back pain is related to muscle tension or cramps, biofeedback can help you train your muscles to better cope with stress and exercise. It may reduce the intensity of pain and the need for medication.
For most chronic back pain, this is the last resort. When you have a herniated disc or compressed spinal nerves, you may need surgery.
Nerve radiculotomy—surgery to cut nerves—stops it from sending pain signals to your brain. Surgery can repair symptoms caused by severely damaged nerves and spine joints friction surfaces, but it cannot solve other problems, such as a herniated disc.