Fortunately, most episodes of back pain—about 90%—clear up with little or no treatment in about six weeks, reducing the need for medical intervention. As long as you are not experiencing severe back pain or other symptoms (such as severe nighttime pain or pain that worsens when lying down, weight loss, bowel or bladder dysfunction, or fever) that might indicate a health condition like cancer, infection, cauda equina syndrome, or an abdominal aortic aneurysm, you can safely try self-treatment.
You can take the following steps to help ease a backache.
Back relaxation exercises—which involve gentle stretching to relax back muscles, lengthen the spine, and relieve compression of the vertebrae—are effective for alleviating stress and strain on the back. Ask your doctor for a referral to a physical therapist or for printed instructions on how to safely perform the exercises. Performing back exercises in water also can be beneficial.
Rest Your Back
Lying down takes pressure off the spine and usually lessens pain. The best postures in bed are lying in the fetal position with a pillow between the knees, or on your back with knees flexed, using a pillow to support the legs. Most experts advise limiting bed rest to one or two days, however. The inactivity associated with longer periods of bed rest may do more harm than good by weakening muscles.
It’s better to get out of bed and move around as soon as you can do so with reasonable comfort, even if some pain persists. Until the pain fully disappears, you should avoid lifting, bending, vigorous exercise, or other activities that place stress on the back.
While it may seem risky to move around when you are still experiencing back pain, medical research supports limiting the amount of bed rest. One study, for instance, found that people with acute back pain who continued ordinary activities recovered more rapidly than those for whom bed rest was prescribed. In fact, within a week, just 20% of the normal-activity group were still absent from work, compared with 41% of those on bed rest. After three months, people in the bed-rest group accumulated an average of approximately nine sick days, compared with five sick days in the normal-activity group.
Ice Your Back
After a sudden back injury with pain limited to the back area, immediately applying ice can be therapeutic. In addition to relieving pain, ice reduces internal bleeding and swelling by decreasing blood flow.
An ice bag, commercial cold pack, or even a package of frozen vegetables should be used for 10 to 20 minutes every two hours for the first 48 hours after injury (while you’re awake). The 20-minute limit is important to avoid the risk of frostbite. Another approach to relieving pain is to massage the painful area with an ice cube.
Apply Heat to Your Back
After an acute back injury, it’s best to wait 48 hours before applying heat. However, chronic back pain or a more widespread backache that begins some time after a back injury may be eased by relaxing muscles with a hot bath, a heating pad, a heat lamp, or hot, moist compresses.
Over-the-counter Medications for Back Pain
Nonsteroidal anti-inflammatory drugs (NSAIDs)—for example, aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), or ketoprofen (Orudis)—or the pain reliever acetaminophen (Tylenol) may help alleviate discomfort, reduce inflammation, or both. Be sure to read the labels and follow instructions carefully. Even over-the-counter medications can cause side effects if misused.
Traction, Corsets, and Back Braces
Little evidence supports the use of traction or corsets, although temporary use of a corset with built-in supports may be helpful during the recovery period following surgery or during activities that have to be performed even when you are still experiencing pain. Whether back braces help in treating back pain is unclear, and seemingly contradictory findings continue to be published.