Initial Treatment

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Harvard Medical School

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Initial Treatment

Low Back Pain
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Initial Treatment
Initial Treatment
htmSensibleApproachLBP
Rest, stretching and alternative therapies.
339552
InteliHealth
2009-04-02
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InteliHealth/Harvard Medical Content
2011-04-02

Reviewed by the Faculty of Harvard Medical School

Initial Treatment

Low back pain will often improve with simple measures that don't require drugs: rest, stretching, application of heat (or cold if pain followed an injury) and massage, for example. These measures often provide enough relief so that you can tolerate the pain until it gets better, or at least improves, on its own. Other options may also help relieve your pain:

Change your daily routine. Examining your daily routine may provide additional clues that will help you find effective treatments. For example, many people with low back pain can benefit from stretching before and after exercise, using a chair at work that better supports the back or placing a lumbar (lower back) support pillow in the car. If you're overweight, losing those extra pounds can help relieve back pain.

Keep your brain busy. Distraction, too, can be a powerful pain reliever. Many people say their pain increases at night; this is probably because the day's distractions fall away when they are trying to get to sleep, and the pain can then demand attention. Focusing on aspects of your life other than the pain, such as family or hobbies, can help, regardless of the cause of your pain or the treatments you use.

Let the pain run its course. In the end, once evaluation rules out a life-threatening cause of low back pain, some people elect to do nothing. They decide not to change their routine. They simply tolerate the problem because it is a mild, minor annoyance rather than a disabling symptom. There is nothing wrong with this approach, as long as your health-care provider agrees that skipping treatment will not cause your low back pain to get worse. Because you are the one putting up with the pain, it's your decision whether to pursue any treatment or intervention.

Stay active. Years ago, severe back pain was routinely treated with a week or more of strict bed rest. Recent studies, however, have shown that bed rest is not particularly helpful, and bed rest longer than two days may even slow recovery. Returning to work and other activities with the necessary accommodations, such as avoiding heavy lifting, is usually preferable to a prolonged absence from work.

Consider drug treatment. Some people have no choice — their pain is so severe that they have to rest. For these people, balancing periods of rest (on a firm mattress) and activity makes the most sense. With this type of pain, drug treatment may be worthwhile; acetaminophen or an anti-inflammatory drug (such as over-the-counter doses of aspirin, ibuprofen or naproxen) is a reasonable next step. Check with your health-care provider to be sure you have no medical reasons, such as ulcer disease, to avoid these drugs.

Seek alternative treatments. For people who want to avoid drug treatment, chiropractic care, acupuncture, massage therapy and electrical stimulation (also called transcutaneous electrical nerve stimulation, or TENS ) may provide relief. Be sure to have an evaluation to rule out serious or even life-threatening conditions before embarking on these therapies.

 

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Last updated July 08, 2013


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