Treatment for Lower Back Pain – What actually works?
Education and Self Care – This is the recommended first line approach for treatment for acute and chronic low back pain. This should be geared toward helping you understand your problem and to know how to modify your activity to stay appropriately active. The back is big and strong and can heal relatively quickly. Often the best thing we can do is to keep it moving to encourage this healing. You may have heard this sort of thing from us here at Melbourne Osteohealth if you have visited us with low back pain.
Active recovery – This includes trying to do normal activities as much as is reasonably possible. Movement and activity can seem counter-intuitive when we’re in pain but gentle walking, which improves blood flow and speeds up healing, can help. Doctors now know that inactivity and rest lead to stiffness and more pain and is more likely to lead to ongoing back problems. Gentle stretching may help relax muscles, especially if you have muscle spasms.
Manual Therapy – Spinal manipulation, massage and acupuncture are recommended as therapies supportive to education and self-care. These therapies can help reduce nerve sensitivity, improve flexibility and reduce muscle tension, but your therapist can also help you learn about back pain and help you work out the best course of action for you.
Pharmacology – Treatment guidelines for low back pain advise for fairly judicious use of most medicines. Pain relievers are generally considered helpful when used alongside education and self-care, to support an active recovery. In certain, select cases muscle relaxants and anti-depressants may also be appropriate. Opioids like codeine are generally limited and used with great caution because, though they relieve pain in the short-term, the increase the likelihood of pain persisting for the longer-term – and nobody wants that!
The advice differs slightly between those with acute and chronic back pain but the overall message here is that low back pain requires careful and sparing use of prescription and over the counter medicines.
Surgery and other interventions – These are largely much riskier undertakings and as such are used very sparingly. Surgery is usually not recommended for acute low back pain and its effectiveness in chronic low back pain is also in question so the evidence suggests that surgery should be used only as an adjunct in chronic low back pain, and again used alongside education and self-care, to support an active recovery.