BACK PAIN TREATMENT

With any new episode of low back pain, first rule out serious pathology - see 'Cauda Equina Syndrome' page for signs and symptoms of serious pathology.

TREATMENT

Relative Rest

Gone are the days that complete bed rest is advised to manage low back pain. Ideally, what you really want to be doing is moving in to the maximum capacity that your symptoms are allowing you to. A period of taking things slightly easier and avoiding things that are significantly aggravating your symptoms is advised, however, moving in to tolerable levels of discomfort is also safe as well.

Pain Relief

Taking pain relief for a short period of time for an acute episode of back pain could be a good idea, particularly if your symptoms are affecting your ability to move and sleep. It is a common misconception that pain killers 'mask' the pain. They will be helping with recovery at a cellular level and if taking them for a short period facilitates easier movement then it could be worth considering. Movement is key for recovery.

Exercise

It can be an absolute mine field looking online for the 'right' exercises to do if you have back pain but I have some good news for you - any exercise is good exercise. There have been multiple studies done to try and work out which is the best exercise/s for low back pain and the literature consistently suggests it doesn't matter, just do something. There is good evidence that walking is equally effective as yoga, pilates, thai chi or cycling so try and find something that your symptoms are allowing you to do, preferably something you enjoy doing and be consistent with it. Start off, little and often, as your symptoms allow and gradually build up as your symptoms improve.

Heat/Ice

One or both of these can be a free and easy way to get some short term pain relief. There is a lot of confusing information online about which you should be using and what stage of injury. In truth, neither do a great deal to change anything from a tissue or cellular level but they can both help with pain modulation. Do which ever you feel works best for you, there is no right or wrong. Remember, they are likely to help with short term pain relief so the more frequently you use them the more likely they are to help.

Avoid Unnecessary Imaging

Most back pain is non specific which means it is often difficult to identify a specific tissue responsible for the cause of pain. Scans will always come back with findings regardless of whether they are responsible for your symptoms or not, they often correlate poorly with pain and are very unlikely to change your treatment plan, at least in the short term. Evidence suggests that early imaging is linked to more days of disability, more days off work and higher medical costs. See our 'MRI Education' page for more information on this.

Try Not To Worry

This is definitely easier said than done, but we know that psychology has a huge impact on all injuries. We know that catastrophising about the pain, worry, fear, stress, anxiety and fear of movement are all associated with with increased prognosis and delayed tissue healing. Take some reassurance from the fact that the majority of acute episodes of low back pain do resolve with natural history within 6 weeks.

Treatments NOT Recommended For Acute Low Back Pain

Belts or supports
Foot orthotics and shoes with rocker soles