Help for Back Pain
Simple ideas for back pain relief.
An estimated 50 percent to 80 percent of American adults will experience back pain. Whether because of a traumatic accident, a simple injury or arthritis, there are ways to find relief.
"About half the time, back pain gets better within two weeks," says David Borenstein, MD, clinical professor of medicine at George Washington University Medical Center in Washington, D.C. "About 80 percent of the time it improves within two months."
Discomfort in your back can sure be a pain, but hopefully, the following suggestions may help you get back on track.
Heat and Cold Therapy
Researchers at the University of Medicine and Dentistry of New Jersey – New Jersey Medical Center (UMDNJ-NJMC) discovered that the continuous (eight hours daily) application of low-level heat (104 degrees F) eased acute back pain better than either of two commonly used drugs, ibuprofen and acetaminophen. Heat may be dry or moist. Dry heat sources include heat lamps, heating pads or "wearable" disposable heat packs that you can find at most grocery stores or pharmacies. Moist heat sources include warm baths and washcloths soaked in warm water.
Soaking in a warm tub can be a good way to apply heat to all parts of the body at once, especially if you ache all over with fibromyalgia or if you have arthritis in several joints.
Applying a cold compress can reduce pain and swelling. Cold therapy also can numb the affected nerves and distract your mind from the source of your pain.
But, using ice for too long can cause stiffness. Dr. Borenstein recommends using cold for pain in the first 24 to 48 hours after pain starts. To avoid causing damage to the skin, apply cold packs for no more than 15 to 20 minutes at a time. Always put a towel between your skin and the cold pack.
Physical therapy can strengthen the muscles in your back to help relieve back pain or regain motion. Recent research shows that exercises designed to strengthen back muscles may be useful even if you don't have back pain yet. In a recent study of 50 women between the ages of 58 and 75, those who performed back-strengthening exercises suffered fewer painful fractures of the vertebrae than women who didn't do the exercises.
Warm water is a good place to stretch and strengthen your back muscles. Water allows your muscles to relax and acts as resistance to help build muscle strength. Buoyancy makes it feel easier and more comfortable to exercise. To get a full-body workout in the water, you'll need access to a heated pool. You can do warm-water exercise on a smaller scale in your own tub, spa or whirlpool bath.
In a study by researchers at the University of Miami School of Medicine, patients who received two 30-minute massage sessions per week for five weeks reported less back pain, anxiety and depression, and better sleep than a control group. They also demonstrated better low back flexibility and had higher levels of pain-relieving hormones.
Braces and Corsets
These elasticized, close-fitting undergarments support the hips, lower back and abdomen. Corsets are adjustable and elastic; braces are sturdier and have metal stays. Both reduce pressure on the discs -- small, circular cushions of tissue that act as shock absorbers between the vertebrae (the bones of the spine); provide back and abdominal support; and keep the spine stable while it heals. Braces are often prescribed for temporary pain relief. They are also prescribed as a way to restrict movement of the spine during recovery from a fractured vertebra or certain surgeries.
Yoga and tai chi are both excellent for back pain. Yoga's breathing exercises, postures and meditation practices, when performed daily, have been shown to improve flexibility and balance, regulate heart rate, lower blood pressure and decrease anxiety, which can worsen back pain. For people with osteoporosis, tai chi has the benefit of improving balance.
Rest in Moderation
"One of the major myths about back pain is that resting exclusively is the way to get better," says Dr. Borenstein. "We have come to realize that rest and activity actually go hand in hand. You can't just lie down for weeks and expect to get better, but this also isn't the time to go out and sign up for a high-impact aerobics class."
The benefits of weight loss are probably greatest for people with the most weight to lose, but even those who carry around an extra 10 or 20 pounds could benefit from losing weight. For most people, that means increasing your level of exercise, while decreasing the amount you eat.
Smoking decreases oxygen to the various tissues that have difficulty getting oxygen in the first place, such as the discs in your spine. Research has shown a high prevalence of spinal stenosis (a condition where the spinal canal is not large enough for the spinal cord) among smokers. Smoking also is a risk factor for osteoporosis, which can lead to painful vertebral fractures.
"Stress heightens our awareness and feelings of discomfort," says Dr. Borenstein. And feeling pain adds to stress. Relieve stress by journaling, talking with a counselor or by trying guided imagery, which helps take your focus off your stress and pain. You also can try progressive relaxation in which you progressively tense and relax your body's muscles from head to toe.
A National Institutes of Health panel concluded that acupuncture could help in the treatment of conditions such as back pain without the side effects of medications. Acupuncture involves inserting thin needles at particular points (called acupoints) on the body. Make sure your acupuncturist is certified by the National Certification Commission for Acupuncture and Oriental Medicine, is licensed by your state and uses sterile, disposable needles.
While most people don't need medications long term, using them for a short time can help ease your pain enough to get you up and moving. Medications for back pain include the following:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn)
- Analgesic (pain-relieving) drugs: over-the-counter acetaminophen (Tylenol), narcotic drugs such as acetaminophen with codeine (Fioricet) and hydrocodone with acetaminophen (Lortab, Vicodin)
- Antidepressants: amitriptyline (Elavil), nortriptyline (Pamelor)
- Muscle relaxants: cyclobenzaprine (Flexeril), carisoprodol (Soma)
- Topicals: capsaicin (Zostrix, Zostrix HP), salicylates (Aspercreme, BenGay, Flexall)
"What medications are supposed to do is make your back less painful so you can do the things you need to get better," says Borenstein.
Take Care of Your Feet
If you have back pain after standing or walking, take a look at your shoes. Wearing shoes with high heels or heels with uneven wear can throw off your posture and put unnecessary stress on your back – and your knee joints as well.
Consider a Chiropractor
Both chiropractors and osteopathic physicians use manipulation to ease back pain, although the way they do it varies. Osteopathic manipulation often involves massaging the soft tissues (such as muscles) about the spine, whereas chiropractic involves manipulating the ligaments and vertebrae of the spine.
If you have osteoporosis, osteoarthritis, rheumatoid arthritis or ankylosing spondylitis, talk to your doctor before seeing a chiropractor.