Help For My Back
If you are not improving
If you're not getting better after following the advice on HelpForMyBack.org, your doctor may recommend one or more of following to help you take care of your back condition.
Chiropractic and Physical Therapy
Chiropractic and physical therapy treatments include manual (hands-on) therapies, such as mobilization and manipulation of the joints and muscles, specific muscle techniques, and range of motion activities. These high-skill manual therapies are used to relieve pain, to restore normal motion, and to re-train the joints and muscles of the spine. Treatment will progress from passive therapy (work done on you), to active therapy (activity done by you), to promote strength and stability with the goal of relieving your pain and teaching you how to take care of back in the future.
Injections
When pain is severe, injections into the muscles, joints and around the nerves of the lower back can be helpful in temporarily alleviating acute lower back pain. With relief, it is often possible to begin physical therapy and exercise. It is important to note that injection do not correct the underlying problem with the back and should be used in combination with other forms of treatment.
Medications
For acute back pain, your doctor may prescribe anti-inflammatory medications (NSAIDs and steroids), and sometimes muscle relaxants. Muscle relaxants are really just mild sedatives, and may help you to sleep. Stronger analgesics, such as morphine and other opioids, are generally to be avoided, but may be used when pain is more severe, such as when one of the Red Flags is present.
Testing
Tests, such as x-rays, MRI and blood tests, are rarely needed when back pain is acute. However, certain Red Flag conditions may necessitate urgent testing. That's why you need to see the doctor right away in those instances. Otherwise, when pain started in the last few weeks, test results are often meaningless and not helpful in making treatment decisions.
Lifestyle Changes
Healthy habits, such as proper diet, weight management, exercise, stress management and good sleep habits are important for reducing and preventing acute lower back pain from becoming chronic. Speak with your doctor about making a durable commitment to your health. It will pay you back over and over.
Surgery
Surgery is needed for about 1% of patients with acute back pain. It is indicated especially for those with severe nerve compression causing leg weakness or difficulty with bowel and bladder control, and sometimes for spinal fractures.
Alternative and Complementary
There are no rigorously proven "alternative" therapies for lower back pain. But treatments like acupuncture are generally harmless and may help some people. Massage can alleviate muscle spasm and relax you. Use of vitamins and other supplements is of no proven value in treating low back pain.
Mental Health
If you have a history of chronic pain, depression, anxiety or other mental health condition, you may find it more difficult to deal with being in pain. Psychologists and others with appropriate training can help you to develop effective coping strategies and to reduce the worry and emotional distress that often come with pain. Be sure to tell your doctor how pain is affecting your mood.
Treatments to Avoid
Back pain treatment is a multi-billion dollar industry, filled with overpriced and ineffective treatments, and others which are merely unproven. For acute back pain, lumbar support braces, shoe insoles, customized analgesic creams, spinal traction, laser therapy, morphine-like pain relievers and electrical stimulation units have not been proven helpful and may be harmful.