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Treatments for low back pain
A number of medicines and other treatments help with low back symptoms,
and most people start feeling better soon. But keep in mind that everyone
is different; you will have to find what works best to relieve your
own back symptoms.
The type of medicine that your health care provider 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 a 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.
For most people, medicine works well to control pain and discomfort.
But any medicine can have side effects; some people cannot take aspirin
or ibuprofen because it can cause stomach irritation and even ulcers.
Many medicines prescribed for low back pain can make people feel drowsy.
You should not take these if you need to drive or use heavy equipment.
If you develop side effects like nausea, vomiting, rash, dizziness,
stop taking the medicine and tell your health care provider right away.
Your health care provider may recommend one or more of the following
to be used alone or along with medicine to help relieve your symptoms.
• 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.
• 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 be done only by a
professional with experience in manipulation. Go back to your health
care provider if your symptoms have not responded to spinal manipulation
within 4 weeks .
Other treatments
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, and ultrasound.
Physical Activity, Bed Rest and Exercise
Your health care provider will want to know about the physical demands
of your life (your job or daily activities). Until you feel better,
your health care provider may need to recommend some changes in your
activities. You will want to talk to your health care provider about
your own personal situation. In general, when pain is severe, you should
avoid heavy lifting, lifting when twisting, bending forward and reaching,
and sitting for long periods of time.
If your symptoms are severe, your health care provider 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.
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.
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. 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 (magnetic resonance imaging) or CT (computerized tomography) scan
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.
About Surgery
Even having a lot of low 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 low 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.
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