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Back Pain Treatment

Conventional Pain Treatments

Hot and Cold Therapy

Cold: Good for reducing the initial inflammation of acute back strain or sprain. The cold also distracts from the back pain.

Wrap ice in a cloth and apply to area of back pain for 20 minutes every three to four hours. (Do not apply ice for over 20 minutes at a time to avoid frostbite)

After 4 or 5 days, heat can be applied.

*If you have circulation problems or nerve damage, do not use hot or cold therapies unless recommended by a physician.

Heat: Do not apply heat to an inflamed area.
Soothing heat applied to the back increases blood circulation to the back, speeding healing and helping the muscles to relax. The heat is also a distraction from the back pain. Apply heat 20 minutes at a time. Heat can be in the form of hot water bottles, heating pads, or a hot shower or bath. Moist heat penetrates more deeply and more quickly than dry heat.

*Wait at least an hour between heat applications. Do not sleep on a heating pad to avoid overheating the tissues.

Topical Rubs

Deep Heating Rubs, e.g. Creams applied directly to the problem area stimulate blood flow to the area applied, creating surface heat. The heat is mainly a distraction from back pain. Do not use deep heating rubs in conjunction with a heating pad or you may burn the skin.

Topical capsaicin cream: Capsaicin is an extract from red chili peppers that reduces a substance in the nerve endings that transmit pain to the brain. The effects are cumulative and it can take 1 to 6 weeks of regular use to obtain the full effect. The benefits seem to add to the benefits of pain medications and/or anti-inflammatory medications. Since the effects are not immediate, capsaicin cream is more commonly used for chronic back pain.


Pain Medications: Tylenol, Aspirin, and Advil are common non-prescription pain medications used in treating acute or chronic back pain. Tylenol is an analgesic (relieves pain but not inflammation). Aspirin and Advil are anti-inflammatory medications that relieve both pain and inflammation.

If pain is severe, codeine preparations may be prescribed. A tolerance to codeine preparations can develop if they are used regularly, rendering them ineffective. With chronic back pain, codeine preparations should be saved for days where back pain is at its worst.

Muscle Relaxants: In cases of severe acute back pain, doctors may prescribe muscle relaxants. In an acute back injury muscle spasms initially protect the back from further injury by preventing movement. But muscle spasms also cause pain, reduce blood flow and delay healing. Muscle relaxants can cause drowsiness. This may be beneficial if they are taken at bedtime. Anti-inflammatory medications may be just as effective in relieving muscle spasms (inflammation triggers muscle spasms).

Back Exercises

If you have suffered a back injury, ask your physician or physical therapist when to begin back exercises. Strength and flexibility must be built up gradually. Doing too much too soon is a common cause of muscle strain.

Stretching Exercises: Gentle stretching exercises are often recommended to help to loosen up tight muscles and increase mobility. Lower back stretches also increase the space between the vertebrae and can relieve pain caused by compressed spinal nerves. Be careful not to overstretch. Warm up with five minutes of walking or exercise bike before stretching to reduce the chance of injury.

Strengthening the core (lower back, abs, hips, and buttocks) can prevent and reduce chronic lower back pain and protect the lower back from injury. The core holds up the spine against gravity. A strong core prevents fatigue and back strain in the lower back. The core muscles also stabilize the spine (keep the spine it in its natural alignment during physical activity). Strengthening the core reduces the risk of injury to the structures of the lower back (muscles & ligaments, discs and spinal joints) during such activities.

Back strengthening and stretching exercises are also beneficial for back pain caused by other conditions such as herniated disc, sciatica, and osteoarthritis of the spine.

Low Impact Aerobics: Low-impact aerobic exercise tones the muscles that support the lower back without causing undue stress to the lower back. Low impact aerobic exercises such as walking also increase lubrication of the spinal joints and helps move fluids in and out of the discs.

Invasive Back Pain Treatments

Epidural steroid injections may relieve pain involving the irritation of a spinal nerve root. This type of pain is often felt as burning or shooting pain. In the lower spine, pain may radiate down the buttocks into the leg. In the neck, pain may radiate down the shoulders and arm. Other symptoms such as tingling and numbness may also occur.

Epidural Steroid Injections involve injecting a powerful anti-inflammatory combined with a local anesthetic into the epidural space of the spinal canal.

Complementary Treatments (CAM)

Complementary and alternative medicine (CAM) includes any medical treatment that is not currently considered to be part of conventional medicine. Complementary medicine is used along with mainstream medicine, while alternative medicine is used in place of it.

Some CAM therapies have more evidence than others of effectiveness and safety for the condition being treated. Chiropractic and massage therapy are popular complementary treatments for back pain.

Combining Treatments for Back Pain Relief

Sometimes a multi-dimensional approach is needed for sufficient back pain relief. When one treatment provides partial but not sufficient relief of back pain, a combination of treatments may be needed.

*Always consult your doctor before trying a new back pain treatment. Some treatments may be contraindicated for certain back conditions, e.g. massage therapy for those with severe osteoporosis (porous bones).