Treatment of Low Back Pain

Low back pain is very common. It affects 4 of 5 people at some time during their lives. It is the leading cause of disability for those aged 19 to 45 and is the second most common cause of missed work days (after the common cold) for adults younger than 45. Low back pain becomes more common as people age. It affects half of the people older than 60 at any given time. Each year, the treatment of low back pain costs more than $80 billion, and insurance claims for disability due to low back pain exceed $8 billion. Thus, although low back pain rarely results from life-threatening disorders, it is a significant health problem. However, the number of back injuries in the workplace is decreasing, perhaps because awareness of the problem has increased and preventive measures have improved.

Treatment

* The main thing about most low back pain is do not worry - it will usually get better on its own, within a few days, or possibly a few weeks.
* Stay active, and if at all possible, stay at work.
* The pain may force you to rest, but this is a result of the pain, and not a good treatment for back pain. If you have to take to your bed, limit it, if possible, to a day or two at the most.
* Use simple pain killers, such as paracetamol or ibuprofen if necessary.
* Avoid activities likely to put unnecessary strain on your back.

Beginning treatment for back pain

Treatment of low back pain usually begins with a few basic steps. Before beginning any back pain treatment program, be sure you know your diagnosis, and discuss the treatment plan with your doctor. There are some conditions that cause back pain and require immediate treatment. For most cases of back pain, the first treatments are as follows:

* Rest
The first step in the treatment of low back pain is to rest the spine. Because most cases of back pain are due to muscle strain, it is important to avoid further irritation to the spine and the muscles that surroung the spinal column. Bed rest is fine, so long as this only lasts two to three days. Prolonged bed rest can actually lead to more persistent back pain. Once the acute back pain eases, avoid lifting, twisting, and physical exertion.


Treatment

Non-Surgical Treatments

Guidelines for management of uncomplicated acute low back pain include:

* Assessment: Carry out diagnostic triage and consider psychosocial factors.
* Drug therapy: prescribe analgesics at regular intervals, not p.r.n.
* Start with paracetamol (acetaminophen). If inadequate, substitute with NSAIDs (e.g. ibuprofen or diclofenac) and then acetaminophen-weak opioid compound (e.g. acetominophen+codeine)
* Finally consider adding short course of muscle relaxant such as diazepam or baclofen.
* Staying active: advise patients to stay as active as possible, to continue normal daily activities and stay at work; advise patients to increase their physical activities progressively over a few days or weeks.

Physical therapy and exercise

A physical therapist can apply a variety of treatments, such as heat, ice, ultrasound, electrical stimulation and muscle-release techniques, to your back muscles and soft tissues to reduce pain. As pain improves, the therapist can teach you specific exercises to increase your flexibility, strengthen your back and abdominal muscles, and improve your posture. Regular use of these techniques will help prevent pain from coming back.