The most frustrating aspect in the treatment of back pain is that there is no “magic bullet.” Most individuals recover completely by simply avoiding strain to their spine. Patients often find help from ice, heat, and medications. If the basic treatments for back pain do not relieve your symptoms, the next step is to seek medical evaluation. Depending on the symptoms and the length of the problem, your physician can properly organize a treatment schedule.
- Nonsurgical options are usually the first step in treatment of back pain conditions. Rest, ice, heat, exercises, medications, and other treatments may all be useful in relieving your symptoms.
- Alternative treatments are popular and often as successful as traditional medical treatments for many types of back pain. These treatments are often safe and as effective as medicines used for treatment of back pain.
- Spine surgery is usually reserved for treatment of back pain that does not resolve with simple steps. However, there are some conditions where surgery may be necessary. Your doctor can help you determine when surgery may be an appropriate treatment for your condition.
Pain can usually be addressed with OTC (over-the-counter, no prescription required) painkillers. Resting is helpful, but should not usually last more than a couple of days – too much rest may actually be counterproductive.
- Medication – back pain that does not respond well to OTC painkillers may require a prescription. Codeine or hydrocodone – narcotics – may also be prescribed for short periods; they require close monitoring by the doctor. Some tricyclic antidepressants, such as amitriptyline, have been shown to alleviate the symptoms of back pain, regardless of whether or not the patient has depression.
- Physical Therapy- the application of heat, ice, ultrasound and electrical stimulation, as well as some muscle-release techniques to the back muscles and soft tissues may help alleviate pain. As the pain subsides the physical therapist may introduce some flexibility and strength exercises for the back and abdominal muscles. Techniques on improving posture may also help. The patient will be encouraged to practice the techniques regularly, even after the pain has gone, to prevent back pain recurrence.
- Cortisone injections – if the above-mentioned therapies are not effective enough, or if the pain reaches down to the patient’s legs, cortisone may be injected into the epidural space (space around the spinal cord). Cortisone is an anti-inflammatory drug; it helps reduce inflammation around the nerve roots.
Steps to lower the risk of developing back pain:
- Exercise – regular exercise helps build strength as well as keeping your body weight down. Experts say that low-impact aerobic activities are best; activities that do not strain or jerk the back.
- Smoking – a significantly higher percentage of smokers have back pain incidences compared to non-smokers of the same age, height and weight.
- Body weight – the fatter you are the greater your risk of developing back pain. The difference in back pain risk between obese and normal-weight individuals is considerable.
- Posture when standing – make sure you have a neutral pelvic position. Stand upright, head facing forward, back straight, and balance your weight evenly on both feet – keep your legs straight.
- Posture when sitting – a good seat should have good back support, arm rests and a swivel base (for working). When sitting try to keep your knees and hips level and keep your feet flat on the floor – if you can’t, use a footstool. You should ideally be able to sit upright with support in the small of your back. If you are using a keyboard, make sure your elbows are at right-angles and that your forearms are horizontal.
- Lifting things – the secret for protecting your back when lifting things is to think “legs not back”. In other words, use your legs to do the lifting, more than your back. Keep your back as straight as you can, keep your feet apart with one leg slightly forward so you can maintain balance, bend only at the knees, hold the weight close to your body, and straighten the legs while changing the position of your back as little as possible. Bending your back initially is unavoidable, when you bend your back try not to stoop or squat, tighten your stomach muscles so that your pelvis is pulled in. Most important, do not straighten your legs before lifting; otherwise you will be using your back for most of the work.
- Moving things – remember that it is better for your back to push things across the floor, rather than pulling them.
- Shoes – flat shoes place less of a strain on the back.
- Driving – it is important to have proper support for your back. Make sure the wing mirrors are properly positioned so you do not need to twist. The pedals should be squarely in front of your feet. If you are on a long journey, have plenty of breaks – get out of the car and walk around.
- Your bed – you should have a mattress that keeps your spine straight, while at the same time supporting the weight of your shoulders and buttocks. Use a pillow, but not one that forces your neck into a steep angle.