Treat a Backache

Back pain is a serious problem globally. It's estimated that about 31 million Americans experience backaches at any given time and 50% of workers admit to having significant back pain symptoms every year. There are many causes of back pain, but most cases are mechanical in nature — meaning not caused by serious conditions such as inflammatory arthritis, disc herniation, infection or cancer. For mechanical back pain, there are a variety of effective treatment options that include chiropractic care, physiotherapy, massage therapy and acupuncture. Understanding the cause and severity of your backache is crucial because it determines the treatment protocols you should follow.

Steps

Diagnosing Your Backache

  1. Give it time. Most achy backs caused by overwork or minor accidents (such as slip and falls) resolve on their own with a few days or so. As such, if the pain isn't severe, have some patience and the likelihood of your backache going away is actually pretty good with or without any kind of treatment.[1]
    • Severe pain combined with numbness or tingling in the legs is often a sign of a serious back injury.
    • It's important to seek professional help if your back pain also involves trouble urinating, fever or unintentional weight loss.
  2. Schedule an appointment with your doctor. If you develop back pain that won't go away after a few days of taking it easy, then schedule an appointment with your family physician. Your doctor will examine your back (spine) and ask questions about your family history, diet and lifestyle, and maybe even take X-rays or send you for a blood test (to rule out rheumatoid arthritis or a spinal infection). However, your family doctor is not a musculoskeletal or spinal specialist, so you may need a referral to another doctor with more specialized training.
    • Your family doctor may recommend over-the-counter anti-inflammatories such as ibuprofen, or analgesics (pain killers) such as acetaminophen to help you cope with your backache.
  3. Get a referral to a specialist. Consider seeing a specialist if your backache is not relieved by rest and medications. Mechanical low back pain is not considered a serious medical condition, although it can be very painful and debilitating, causing you to miss work or athletic activities. Typical causes include muscle strains, spinal joint sprains, spinal nerve irritation and spinal disc degeneration.[2] However, medical specialists such as an orthopedist, neurologist or rheumatologist may be needed to rule out the most serious causes such as infection (osteomyelitis), cancer, osteoporosis, spinal fracture, herniated disc, kidney disease or rheumatoid arthritis.
    • X-rays, bone scans, MRI, CT scan and ultrasound are modalities that specialists may use to help diagnose your backache.
    • The low back, or lumbar region, is more susceptible to injury and pain because it supports the weight of the upper body.
  4. Understand the cause of your backache. Make sure you get the doctor to clearly explain the diagnosis, especially the cause (if possible), and provide you with various treatment options for your condition. Only the most serious causes of back pain require surgical intervention, which is quite rare. Sometimes mild backaches resolve on their own within a few days, but for more debilitating back pain, treatment is recommended because it will likely reduce the duration of the pain and lower the risk of a recurrent (chronic) problem.
    • Pain from mechanical back pain can be severe, but it doesn't involve high fevers, rapid weight loss, bladder / bowel problems or loss of leg function, which are all signs of something more serious.
    • Common causes of backache include poor posture, improper lifting technique, obesity, sedentary lifestyle and mild trauma from athletic activities.

Treating Muscle Strains

  1. Take an Epsom salt bath. Muscle strains (or pulls) are the most common cause of backaches. The para-spinal muscles of the lower back are thick and powerful, but they become susceptible to injury when they get chilled, dehydrated or overworked. Soaking your entire back and legs in a warm Epsom salt bath can significantly reduce pain, swelling and muscle tension.[3] The magnesium in the salt helps the muscle fibers relax and heal, which sometimes provides surprisingly quick pain relief.
    • Make sure the salt bath isn't too hot because otherwise it will pull water from your body, dehydrate your muscles and increase the risk of further damage.
    • Backaches from muscle strains are usually described as dull and achy in nature and are not particularly debilitating. Some range of motion is restricted, but walking, sitting and sleeping are not usually impaired.
  2. See a massage therapist. A strained muscle occurs when individual muscle fibers are taken beyond their tensile limits and subsequently tear, which leads to pain, inflammation and some degree of guarding (muscle spasm in attempts to prevent further damage). A deep tissue massage is helpful for mild-to-moderate strains because it reduces muscle spasm, combats inflammation and promotes relaxation.[4] Start with a 30 minute massage, focusing on your low back and hips. Allow the therapist to go as deep as you can tolerate without wincing.
    • Always drink lots of water immediately following a massage in order to flush inflammatory by-products, lactic acid and toxins from your body. Failure to do so might cause a headache or mild nausea.
    • As an alternative to massage therapy, position a tennis ball underneath your body, near your backache. Roll on the ball slowly until the pain subsides.
  3. Talk to your doctor or a physical therapist about exercise. A muscle strain will improve faster if you begin gentle stretching and strengthening exercises as early as possible. Make sure you always perform exercises within a pain-free range of motion. If you have an acute muscle strain (an injury that occurred recently), beginning a gentle aerobic exercise program such as walking will be beneficial. If you feel pain at any time during your exercise, stop and consult your physician.
  4. Take muscle relaxants. Muscle relaxant medication (such as cyclobenzaprine) can certainly ease the discomfort of mild-to-moderate backache that's caused by injured muscles, but they tend to be hard on the stomach, kidneys and liver, so they should be viewed as short-term help at best. Keep in mind that muscle relaxants can make other muscles in your body feel strange because they circulate everywhere through the bloodstream, not just the back.
    • Side effects of muscle relaxant use include drowsiness, dry mouth, constipation and confusion.[5]
    • An alternative to muscles relaxants are anti-inflammatories such as ibuprofen.

Treating Joint Sprains

  1. Reduce your activity level. The first step is rest — stop all exacerbating activity in order to address your injury, at least for a few days or so. More rest (a few weeks) may be needed depending on the severity of your back injury. For a backache, laying on your back with your knees bent and legs slightly elevated is a good idea because it can take the pressure off the low back joints and provide some pain relief.
    • Laying on your back for hours at a time is not a good idea, either. Get up at least once an hour to move around even a little bit, and try going for a leisurely walk every day.
    • Avoid excessive sitting (more than 30 minutes at a time) because it puts more pressure on the low back joints and may further irritate them.
  2. Apply ice. Cold therapy (ice wrapped in a thin towel or frozen gel packs) should be applied to the injury as soon as possible in order to stop reduce inflammation. Ice should be applied for 10 – 15 minutes every hour, then reduce the frequency as the pain and swelling subside.[6] Compressing the ice against your back will help to further combat the inflammation.
    • Backaches from joint sprains are usually described as sharp and shooting in nature and they tend to be fairly debilitating. Most range of motion in the affected area is lost, and walking, sitting and sleeping are noticeably impaired.
    • People with spinal joint sprains usually walk hunched over and to the side because the muscles surrounding the affected joints quickly spasm to "guard" the injury.
  3. See a chiropractor or osteopath. Chiropractors and osteopaths are spinal specialists that focus on establishing normal motion and function of the small spinal joints that connect the vertebrae, called spinal facet joints. Manual joint manipulation, also called an adjustment, can be used to unjam or reposition facet joints that are slightly misaligned, which triggers inflammation and sharp pain, particularly with movement. You can often hear a "popping" sound with a spinal adjustment, similar in concept to when you extend your knuckles. Traction techniques or stretching of your spine may also help.
    • Although a single spinal adjustment can sometimes completely relieve your back sprain, more than likely it will take three to five treatments to notice significant results.
    • If uneven leg lengths or flat feet is deemed to be the primary cause of your backache, then your doctor or chiropractor may recommend orthotics, which are custom made shoe inserts that support the arches, promote better biomechanics when running or walking, and help alleviate back pain.
  4. Get a facet joint injection. A facet joint injection involves real-time fluoroscopic (X-ray) guidance of a needle through the back muscles and into the inflamed or irritated spinal joint, followed by a release of an anesthetic and corticosteroid mixture, which quickly relieves both pain and inflammation at the site. Facet joint injections take 20 – 30 minutes to do and the results can last from a few weeks to a few months.[7]
    • Facet joint injections are limited to three within a six-month time frame.
    • The pain relief benefits from facet joint injections typically begin on the second or third day post treatment. Until that time frame, your backache may get a little worse.

Treating Chronic and Degenerative Conditions

  1. Seek out physiotherapy. If your backache is recurring (chronic) and caused by weak spinal muscles, poor posture or degenerative conditions such as osteoarthritis, then you need to consider some form of rehabilitation. A physical therapist can show you specific and tailored stretches and strengthening exercises for your back, hips and abdominals (which can all be implicated with chronic low back pain).[8] Physiotherapy is usually required 2-3x per week for 4-8 weeks to positively impact chronic back problems.
    • If need be, a physical therapist can treat your sore muscles with electrotherapy such as therapeutic ultrasound, electronic muscle stimulation or microcurrent.
    • Good strengthening exercises for your back include swimming, rowing and back extensions, but make sure your injury is resolved first.
  2. Try acupuncture. Acupuncture involves sticking very thin needles into specific energy points within the skin / muscle in efforts to reduce pain and inflammation.[9] Acupuncture can be effective for many different causes of backache, especially if it's done when the symptoms first occur. Based on the principles of traditional Chinese medicine, acupuncture works by releasing a variety of substances including endorphins and serotonin, which act to reduce pain.
    • It's also claimed that acupuncture stimulates the flow of energy, referred to as chi.
    • Acupuncture is practiced by a variety of health professionals including some physicians, chiropractors, naturopaths, physical therapists and massage therapists.
  3. Try yoga and meditation. Yoga and meditation are other aspects of traditional Chinese medicine.Yoga may be an effective strategy for alleviating back pain by making people more aware of how they move their bodies. It also helps to stretch (elongate) muscles, improves flexibility and often has a calming or relaxing effect on people.[10] Meditation often goes hand-in-hand with yoga and acts to reduce emotional and physical stress, which are contributors to chronic back pain.
    • Mindful meditation has been shown to be effective in reducing pain. One study found that 3 sessions over 3 days for 20 minutes each was able to significantly reduce pain. In addition, pain was reduced after meditation, meaning the results lasted long after meditation was finished. [11]
    • People that are depressed or suffer severe trauma are more likely to experience chronic aches and pains.

Tips

  • It was once thought that total bed rest would help you recover from a backache, but it's now recognized that people who remain relatively active are likely to recover quicker.
  • Don't lift objects by simply bending over at the waist. Instead, bend your hips and knees and then squat to pick up the object, keeping your back straight and holding the object close to your body.
  • The best sleeping position for your back is laying on your side with your knees bent and a pillow stuck between the knees for support. Avoid sleeping on your stomach.
  • Quit smoking because it impairs blood flow, resulting in oxygen and nutrient deprivation to spinal muscles and other tissues.

Related Articles

Sources and Citations

  1. ↑ http://www.niams.nih.gov/health_info/back_pain/
  2. ↑ http://www.medicalnewstoday.com/articles/172943.php
  3. ↑ http://www.saltworks.us/salt_info/epsom-uses-benefits.asp
  4. ↑ http://www.pacificcollege.edu/news/blog/2015/02/19/benefits-massage-lower-back-and-neck-pain
  5. ↑ http://www.webmd.com/sleep-disorders/aches-pains-disrupt-sleep-6/treatments
  6. ↑ https://www.painscience.com/articles/icing.php
  7. ↑ https://treatingpain.com/treatment/facet-joint-injections
  8. ↑ http://www.spine-health.com/treatment/physical-therapy/physical-therapy-benefits-back-pain
  9. ↑ http://www.mayoclinic.org/diseases-conditions/back-pain/expert-answers/acupuncture-for-back-pain/faq-20058329
  10. ↑ http://www.yogajournal.com/category/poses/yoga-by-benefit/back-pain/
  11. ↑ http://www.spine-health.com/blog/mindful-meditation-vs-chronic-pain
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