What to Do About Back Pain

How to stop back pain and backaches. What to do when your back hurts.

By Elena Rover
  • Rest. Try lying on your back with a pillow under your knees to take the pressure off your lower back.
  • Take over-the-counter anti-inflammatories unless you have a health condition that precludes them.
  • Apply ice compresses to reduce swelling. Lie down and place an ice pack or a bag of frozen peas wrapped in a thin cloth or paper under your back. Apply for 15 minutes, and repeat hourly.
  • If ice doesn’t help, swelling is probably not the main problem. Try a heating pad or warm bath to improve circulation and speed healing.
  • If ice or heat seems to be working after two days, continue it.
  • Sleep on your side with a pillow between your thighs or on your back with a pillow under your knees.
  • Don’t lift anything heavier than 10 pounds — really. Weigh your handbag. Your back needs a break.

Step 3: Get Moving

Rest, the old prescription for back pain, actually makes you stiffer and weaker all over. So after 48 hours — or sooner if you’re feeling better — you can ease back into activity, even if it’s only a little stretching or walking.

  • Avoid twisting, which could cause another flare-up.
  • If stretching and gentle movement are still painful, get in the tub (or a pool) and stretch in warm water, which loosens the muscles and provides support.
  • Continue anti-inflammatories, warm baths, and the heating pad as needed.
  • Keep exercising, even when your back gets better.

Step 4: If the Pain Doesn’t Ease, Call a Doctor

If you’re not noticeably better in 48 hours or completely better within a month — or if this isn’t your first bout with back pain — consult a doctor. Back pain can signal a disc herniation, spinal arthritis, or underlying medical conditions such as a kidney infection or cancer.

Step 5: Ask Your Doctor for a Prescription for Physical Therapy

Think of it as getting a personal trainer and massage therapist for the price of a co-pay. "Evidence supports the idea that the earlier the intervention by a physical therapist, the fewer visits needed and the quicker the recovery," says Connie Hauser, DPT, a member of the board of directors for the American Physical Therapy Association. Physical therapy focuses on assisted stretching and strengthening to help you build a resilient and balanced core, manual therapy and massage to relieve tightness, guidance on moving properly, and sets of at-home exercises.

Step 6: Consider Alternative Therapies

Can herbs and spinal manipulations ease your aching back? "Generally speaking, we lack the kind of research we need and want, which is frustrating when you’re trying to decide about using any of these approaches," says Tracy W. Gaudet, MD, director of the Duke Center for Integrative Medicine at Duke University, in Durham, North Carolina. But she adds, "Lack of research doesn’t mean it won’t be helpful." In fact, more than 200 million Americans head to a chiropractor, massage therapist, or acupuncturist for back or neck pain. Gaudet recommends first asking your doctor whether an alternative therapy could cause harm, and if not, giving it a try. If you don’t get some relief after two to four weeks, however, move on; it shouldn’t take longer than that to see results.

Chiropractic treatment is now so common that many people no longer call it alternative — although researchers and your insurance company probably do. To date, there is some evidence that spinal manipulation, the most popular chiropractic treatment, works for low-back pain. If you want to try it, make sure the chiropractor you choose is a member of the American Chiropractic Association (amerchiro.org) or is on your insurance company’s provider list. Chiropractic treatment is not recommended for patients with osteoporosis or those who experience numbness, tingling, or pain in a leg or foot, which can signal nerve damage.

There is some good if not definitive data that acupuncture, the Eastern system of adjusting your body’s flow of energy (chi), is effective, according to Gaudet. The treatment may not relieve a sudden flare-up in your back, but repeated sessions have been shown to ease chronic pain.

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