Your family doctor will first do a careful physical examination. If your doctor does not find a serious problem causing your low back pain, he or she may tell you to rest for a few days, do certain exercises and take medication for pain.
Medicine often helps relieve low back symptoms. The type of medicine that your doctor recommends depends on your symptoms and how uncomfortable you are. If your symptoms are mild to moderate, you may get the relief you need from an over-the-counter (nonprescription) medicine such as acetaminophen, aspirin, or ibuprofen. These medicines usually have fewer side effects than prescription medicines and are less expensive. If your symptoms are severe, your health care provider may recommend a prescription medicine.
Heat or cold applied to the back. Within the first 48 hours after your back symptoms start, you may want to apply a cold pack (or a bag of ice) to the painful area for 5 to 10 minutes at a time. If your symptoms last longer than 48 hours, you may find that a heating pad or hot shower or bath helps relieve your symptoms.
Spinal manipulation. This treatment (using the hands to apply force to the back to adjust the spine) can be helpful for some people in the first month of low back symptoms. It should only be done by a professional with experience in manipulation. You should go back to your health care provider if your symptoms have not responded to spinal manipulation within 4 weeks.
A number of other treatments are sometimes used for low back symptoms. While these treatments may give relief for a short time, none have been found to speed recovery or keep acute back problems from returning. They may also be expensive. Such treatments include: Traction, TENS (transcutaneous electrical nerve stimulation), Massage, Biofeedback, Acupuncture, Injections into the back, Back corsets, Ultrasound.
About Surgery: Even having a lot of back pain does not by itself mean you need surgery. Surgery has been found to be helpful in only 1 in 100 cases of low back problems. In some people, surgery can even cause more problems. This is especially true if your only symptom is back pain. People with certain nerve problems or conditions such as fractures or dislocations have the best chance of being helped by surgery. In most cases, however, decisions about surgery do not have to be made right away. Most back surgery can wait for several weeks without making the condition worse. If your health care provider recommends surgery, be sure to ask about the reason for the surgery and about the risks and benefits you might expect. You may also want to get a second opinion.
f you develop low back pain, the first thing to do is to avoid any heavy lifting or bending. Bed rest is usually not necessary, although your doctor may recommend resting for a day or two. Your doctor can give you information about exercises you can do at home to strengthen your back. Gently massaging sore muscles may help them to relax. Over-the-counter pain medications like aspirin or acetaminophen (Tylenol) may relieve some of your discomfort.
The most important goal is for you to return to your normal activities as soon as it is safe. Your family doctor and (if you work) your employer can help you decide how much you are able to do safely at work. Your schedule can be gradually increased as your back improves. If your symptoms are severe, your family physician may recommend a short period of bed rest. However, bed rest should be limited to 2 or 3 days. Lying down for longer periods may weaken muscles and bones and actually slow your recovery. If you feel that you must lie down, be sure to get up every few hours and walk around--even if it hurts. Feeling a little discomfort as you return to normal activity is common and does not mean that you are hurting yourself. Back problems take time to get better. If your job or your normal daily activities (These included (1) heavy physical work, (2) lifting and forceful movements, (3) bending and twisting (awkward postures), (4) whole-body vibration) make your back pain worse, it is important to communicate this to your family, supervisor, and coworkers. Put your energy into doing those things at work and at home that you are able to do comfortably. Be productive, but be clear about those tasks that you are not able to do.
Things You Can Do Now: Wear comfortable, low-heeled shoes. Make sure your work surface is at a comfortable height for you. Use a chair with a good lower back support that may recline slightly. If you must sit for long periods of time, try resting your feet on the floor or on a low stool, whichever is more comfortable. If you must stand for long periods of time, try resting one foot on a low stool. If you must drive long distances, try using a pillow or rolled-up towel behind the small of your back. Also, be sure to stop often and walk around for a few minutes. If you have trouble sleeping, try sleeping on your back with a pillow under your knees, or sleep on your side with your knees bent and a pillow between your knees.
Exercise: A gradual return to normal activities, including exercise, is recommended. Exercise is important to your overall health and can help you to lose body fat (if needed). Even if you have mild to moderate low back symptoms, the following things can be done without putting much stress on your back: walking short distances, using a stationary bicycle, swimming. It is important to start any exercise program slowly and to gradually build up the speed and length of time that you do the exercise. At first, you may find that your symptoms get a little worse when you exercise or become more active. Usually, this is nothing to worry about. However, if your pain becomes severe, contact your health care provider. Once you are able to return to normal activities comfortably, your health care provider may recommend further aerobic and back exercises.
Special tests: Your health care provider will examine your back again and may talk to you about getting some special tests. These may include x-rays, blood tests, or other special studies such as an MRI or CT can of your back. These tests may help your health care provider understand why you are not getting better. Your health care provider may also want to refer you to a specialist.
Certain things, such as stress (extra pressure at home or work), personal or emotional problems, depression, or a problem with drug or alcohol use can slow recovery or make back symptoms seem worse. If you have any of these problems, tell your health care provider.
When Low Back Symptoms Return: More than half of the people who recover from a first episode of acute low back symptoms will have another episode within a few years. Unless your back symptoms are very different from the first episode, or you have a new medical condition, you can expect to recover quickly and fully from each episode.