Management of Back Pain

Most of the time acute back pain improves within few weeks even with home remedies and treatment at home. Over-the-counter pain medications and judicious use of heat as well as ice may be all that is required to manage most cases of acute back pain. And in most cases bed rest is also not required.

It is recommended to continue your routine and regular activities even if you have pain and do them as much as you can tolerate. Routine activities such as walking and other physical activities required for daily living should be encouraged. Avoid activities that increase pain and do activities that do not increase pain. But do not avoid activities out of fear of pain. If home management do not work and pain still persists even after few weeks, consult your doctor.ID-100396024

Medications for treatment of back pain:  

Depending on the severity and type of pain your doctor may recommend these medications for back pain,

  • Over-the counter pain medications are the first choice of medications for mild and acute back pain. Acetaminophen, NSAIDs (non-steroidal anti-inflammatory drugs such as ibuprofen, naproxane etc. that are available OTC) are commonly used. Just because these drugs are available OTC does not mean they do not have side effects. They may have serious side effects if overused and one should always use them as advised by a doctor. If back pain do not improve with these medications, your doctor may use prescription pain medications.
  • Your doctor may use muscle relaxants if your pain do not subside with OTC pain medications. Muscle relaxants can provide good pain relief.
  • Your doctor may prescribe pain medications used topically such as creams, ointments etc.
  • Antidepressant may be sometimes prescribed by your doctor to reduce back pain. Relief from back pain by antidepressants is not related with their effect on depression.
  • Your doctor may prescribe injectable drugs for pain relief. This is done if commonly used pain medication fail to improve back pain. NSAIDs injections, injections for numbing the area of spinal cord or certain steroid injections may be used for pain relief. However, these are not permanent solution and pain me reappear again.
  • Your doctor may also use certain narcotics for pain relief in back pain, such as codeine and this is done only for short duration and under direct supervision of a doctor.

Exercise and physiotherapy for back pain:

Physiotherapy is more important than medications or surgery in management of back pain. Various forms of physiotherapy along with exercise is the only long term solution for back pain. Heat, cold, ultrasound, electrical stimulation, muscle release technique etc. are used in combination depending on the type of pain and cause of back pain. When pain reduces you can start exercise to improve flexibility and mobility. Regular physiotherapy and exercise can prevent reappearing of back pain.

Surgery for back pain:

Only a minor percentage of patients with back pain require surgery and show result with surgery. Generally surgery is done for back pain due to structural problems such as prolapse of disc, herniated disc, or spinal stenosis as in these cases other management modalities may not work.

Patient education for back pain:

This is an important part of management of back pain as well as for prevention of back pain from arising. Patients need to be taught about the management of back pain and also prevention of back pain by teaching them correct postures and avoiding wrong postures.


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