Johns Hopkins Health Alerts Back Pain and Osteoporosis Self-Treatment for Back Pain

It is often difficult to pinpoint the exact cause of back pain because so many different structures can be affected. Fortunately, most cases of back pain do not need to have the cause identified and do not require medical attention. Fewer than 5% of people with back pain have a major medical problem that requires either intensive care or surgery.

Because about 90% of back pain episodes clear up within six weeks with little or no treatment, people suffering from back pain can safely try self-treatment as long as they are not experiencing severe pain, or symptoms of a dangerous condition (such as cancer, infection, cauda equina syndrome, or an abdominal aortic aneurysm).

Those with severe back pain should visit a doctor if the pain is not relieved after a couple of days of bed rest, it recurs, or it is accompanied by pain, numbness, or tingling that radiates into the buttocks or legs.

In general, back pain due to muscle injury will abate completely in about six to eight weeks. Back pain lasting longer than this is usually due to spinal column changes and merits a visit to a physician.

Self-Treatment Techniques for Back Pain
Back relaxation exercises—which involve gentle stretching to relax back muscles, lengthen the spine, and relieve compression of the vertebrae—are useful for alleviating stress and strain on the back. Ask your doctor for instructions or a referral to a physical therapist. In addition, several steps can be taken at home to help ease back pain.

• Rest. Lying down takes pressure off the spine and usually lessens the back pain. The best postures in bed are lying in the fetal position with a pillow between the knees or on the back with knees flexed, using a pillow to support the legs.

  Most experts advise limiting bed rest to one or two days. The inactivity associated with longer periods of bed rest may do more harm than good by weakening muscles and prolonging the time to recovery. It is better to get out of bed and move around as soon as you can do so with reasonable comfort, even if some pain persists. Until the back pain disappears, however, you should avoid lifting, vigorous exercise, bending, or other activities that place stress on the back.

  Although it may seem counterintuitive to move around while still experiencing back pain, a growing body of research supports a limit to bed rest. One recent study found that people with acute back pain who continued ordinary activities recovered more rapidly than those for whom bed rest was prescribed. In fact, within one week, just 20% of the normal-activity group were still absent from work, compared with 41% of those placed on bed rest. After three months, people in the bed-rest group accumulated 9.2 sick days, on average, compared with 4.7 sick days in the normal-activity group.

• Ice. Immediate application of ice can alleviate back pain after a sudden back injury that causes localized pain. In addition to relieving back pain, ice reduces internal bleeding and swelling by decreasing blood flow. An ice bag, commercial cold pack, or even a package of frozen vegetables should be used for 10 to 20 minutes every two waking hours for 48 hours. The 20-minute limit is important to avoid the risk of frostbite. Another approach to relieving back pain is to massage the painful area with an ice cube.

• Heat. It is best to wait for 48 hours after an acute back injury before applying heat. However, chronic back pain or a more widespread backache that starts some time after a back injury may be eased by relaxing muscles with a hot bath or shower, heating pad, heat lamp, or hot, moist compresses.

• Over-the-counter medications. Nonsteroidal anti-inflammatory drugs (NSAIDs)—such as Advil, Motrin, Aleve or Orudis—or the pain reliever Tylenol may help alleviate discomfort, reduce inflammation, or both.

• Traction, corsets, and braces. Little evidence supports the use of traction or corsets for relief of back pain, although temporary use of a corset with built-in supports may be helpful when recovering from surgery or for allowing essential activities despite continued symptoms. Whether back braces help in treating back pain is unclear, and seemingly contradictory findings continue to be published.

For more Back Pain and Osteoporosis articles, please visit the Back Pain and Osteoporosis Topic Page

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Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer

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Posted in Back Pain and Osteoporosis on February 7, 2006
Reviewed May 2007