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General Medical Questions
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Question : My husband is getting severe back spasms in his lower back, possibly as a result of twisting wrong while doing sit-ups. He is getting no relief from ibuprofen. Is there an over-the-counter alternative?
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The Trusted Source
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Howard LeWine, M.D.

Robert H. Shmerling, M.D. is associate physician at Beth Israel Deaconess Medical Center and associate professor at Harvard Medical School. He has been a practicing rheumatologist for over 20 years at Beth Israel Deaconess Medical Center. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program.

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December 05, 2012
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A:

Did your husband’s back pain developed after doing sit-ups? Then it is likely due to muscle injury or spasm.

Still, there are many other causes of back pain. They range from the common and benign (such as overuse or osteoarthritis) to more serious causes (including osteoporosis with fracture or a bone infection).

If his symptoms do not improve quickly or if new symptoms develop (such as fever or leg weakness), he should see his doctor promptly.

There are a number of over-the-counter treatments for back pain. These include:

  • Topical treatments. For example, IcyHot, Bengay and Aspercreme may help.
  • Pain relievers. Acetaminophen (as in Tylenol and many other products) is the most popular example.
  • Anti-inflammatory medications. If ibuprofen has not helped, he may improve with naproxen or aspirin.

Non-drug treatments can also help. These include:

  • Bed rest. This should be limited to a day or two, as longer periods of bed rest may be counterproductive. This should be followed by a gradual return to normal activities, while avoiding lifting, sit-ups or other stress to the back.
  • Physical therapy, massage or chiropractic care.
  • A heating pad or cold compress.

You asked about over-the-counter options. But prescription drugs can be quite helpful for back pain. These include higher doses of ibuprofen or naproxen, muscle relaxants and more powerful pain relievers.

Finally, it’s worth emphasizing that there are better exercises for the abdominal muscles than traditional sit-ups. Core exercises, such as push-ups and leg lifts, may accomplish more with less pain and risk of injury.

If your husband continues to experience back problems, he could consider an exercise program designed by an experienced trainer or physical therapist. It’s ilikely a safer bet than slogging through a routine of sit-ups.

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