Understanding Low Back Pain
Most people have low back pain now and then. Low back pain can be short-lasting (acute or subacute) or long-lasting (chronic). Chronic pain is pain that lasts after your body has mostly healed from an injury (usually 3 months or longer). Chronic low back pain can affect all parts of your life. It may make it hard for you to do physical activity, make you more stressed, or make it difficult for you to sleep or rest. Low back pain is affected not only by physical things, but also by what you think, feel, and do when you are hurting.
In many cases, low back pain isn’t serious, and self-care can help. Sometimes it can be a sign of a bigger problem. Call your healthcare provider if your pain returns often or gets worse over time.
Causes of back pain
For most people with low back pain, it is not possible to identify a specific cause of the pain. For most, low back pain is a complex condition that is influenced by things including emotions, worry, relationships, deconditioning of muscles, low levels of physical activity, being overweight, and other health conditions. Less common causes of low back pain include diseases or conditions such as infection, fracture, or cancer.
Treatment for low back pain
Treatment begins with ways you can help manage your own pain. You can also ease the effects the pain has on other parts of your life. This is called self-care. Self-care includes taking care of yourself in ways other than taking medicine, having surgery, or using other medical treatments. It is important to engage in active self-care that is addressing re-conditioning weakened muscles along with addressing negative moods that might accompany the pain.
Here are some suggestions for self-care:
Cold and heat
Cold reduces swelling. Both cold and heat can ease pain. Protect your skin by putting a towel between your body and the ice or heat source.
For the first few days, put an ice pack on the area for 15 to 20 minutes, several times a day. To make a cold pack, put ice cubes in a plastic bag that seals at the top.
After the first few days, try heat for 15 minutes at a time to ease pain. Never sleep on a heating pad.
Exercise can help your back muscles strengthen and become more flexible. This helps keep you from having more back pain in the future. Ask your healthcare provider about exercises for your back. Physical therapy can help to develop a home exercise program. Many individuals benefit from engaging in tai chi or yoga for an exercise program, including being mindful of their body posture. If you have anxiety or fear that keeps you from exercising, it is important to talk with your healthcare provider. They can tailor an exercise program to your current level and ability.
Mental health approaches
There are some mental health approaches have been shown to be effective for treating chronic low back pain. Cognitive Behavioral Therapy (CBT) for chronic pain focuses on changing unhelpful thoughts and behaviors that continue the experience of chronic pain. It also teaches a variety of coping skills, such as relaxation training. Additionally, mind-body treatments (for example, mindfulness and meditation) have also been shown to be helpful in treating chronic pain. Addressing any underlying mental health problems such as depression, anxiety, or PTSD can also be helpful.
Some medicines can also help ease low back pain. These include anti-inflammatory and antidepressant medicines. If you have acute low back pain, using a muscle relaxant for a short time may be helpful. When taking these medicines, follow your healthcare provider’s directions. This will help lower your chances of harmful side effects.
Bed rest should be avoided for most types of back pain. Staying active and engaged in your usual activities helps keep your back healthy. It also helps your back heal from a new pain or keeps your chronic low back pain from getting worse. Taking short breaks while engaged in an activity may help you to stay active longer without overdoing it.
Opioid medicines and invasive treatments have been commonly prescribed by healthcare providers for many types of back pain. However, these treatments have not been shown to be beneficial in the long-term and also have risks. If your healthcare provider recommends these treatments, make sure to discuss all the options and ask about the safety and likelihood that the treatment will help you in the long run.
When to call your healthcare provider
Seek medical care right away if:
You can't stand or walk.
You have a temperature over 100.4°F (38.0°C).
You have frequent, painful, or bloody urination.
You have severe abdominal pain.
You have problems with bladder or bowel control.
You have unexplained weight loss.
Your back pain started after a fall or injury.
You have a history of cancer or osteoporosis.
You have numbness or weakness in your legs.
You notice that the pain isn’t starting to improve after 3-4 weeks.
For more information
The back pain information page from the National Institute of Arthritis and Musculoskeletal and Skin Diseases.