Mild ex­er­cise can help pain

Daily Freeman (Kingston, NY) - - YOUR DAILY BREAK - An­thony Ko­maroff Ask Dr. K

I have fre­quent back pain. I usu­ally take ac­etaminophen (the Tylenol brand), but I hear it may not be ef­fec­tive for back pain. Is there any­thing to that?

If you’d asked me that ques­tion even a year ago, I would have said, “Ac­etaminophen works fine for most peo­ple.” Lots of peo­ple are both­ered by back pain. When it strikes, all you want is re­lief — and fast. Many folks turn to over-the­counter pain re­liev­ers like ac­etaminophen and non-steroidal anti-in­flam­ma­tory drugs, or NSAIDs (ibupro­fen, naproxen and as­pirin).

Most doc­tors I know would have shared my im­pres­sion that ac­etaminophen works for back pain. I re­spect the opin­ions of sea­soned doc­tors, but I also know that there is no sub­sti­tute for ac­tu­ally study­ing a ques­tion. In­deed, a re­cent study has chal­lenged my long­stand­ing as­sump­tion about the value of ac­etaminophen for back pain.

Re­searchers wanted to know if ac­etaminophen short­ened the time from the start of acute back pain (back pain that comes on sud­denly) to com­plete re­lief. What they found was sur­pris­ing.

For peo­ple who used ac­etaminophen only when their back pain both­ered them, it took about 17 days to get com­plete re­lief. For those who took the med­i­ca­tion three times a day, it also took about 17 days for full re­lief. And for those who took a placebo — a sugar pill with no medicine at all — the time to re­cov­ery was 16 days. In other words, the med­i­ca­tion made no dif­fer­ence in how fast back pain went away and stayed away. In ad­di­tion, all three groups had sim­i­lar ex­pe­ri­ences in terms of the sever­ity of their pain, dis­abil­ity and func­tion.

Does this mean that you shouldn’t bother to use ac­etaminophen for back pain? Not nec­es­sar­ily. Ran­dom­ized stud­ies like this can tell you the re­ac­tion of the av­er­age per­son in the study. But peo­ple are all dif­fer­ent. It may be that some peo­ple re­ally do get good re­lief from ac­etaminophen, even if the av­er­age per­son doesn’t. So if it works for you, stick with it.

But ac­etaminophen does have its own risks and side ef­fects. Tak­ing too much ac­etaminophen can se­ri­ously dam­age the liver. Ideally, the av­er­age healthy adult shouldn’t take more than 3,000 mil­ligrams a day.

The safest op­tion is to try to get through the worst of your back pain with­out med­i­ca­tion:

• Use cold com­presses or an ice pack, not heat, im­me­di­ately af­ter an in­jury. About 48 hours af­ter back pain hits, heat may be more help­ful. The warmth soothes and re­laxes ach­ing mus­cles.

• Try to keep mov­ing. A lim­ited amount of ac­tiv­ity is bet­ter than ly­ing in bed. Ask your doc­tor about ap­pro­pri­ate ex­er­cises to start sooner rather than later. Ex­er­cise ther­apy can help heal acute back pain and help pre­vent a re­peat episode.

• Chi­ro­prac­tic ma­nip­u­la­tion, acupunc­ture, mas­sage or yoga pro­vides re­lief for some peo­ple with acute back pain. Sev­eral stud­ies sup­port us­ing these al­ter­na­tive/com­ple­men­tary ther­a­pies.

Many peo­ple can re­lieve their back pain with these sim­ple mea­sures. If they don’t pro­vide com­plete re­lief, then non-pre­scrip­tion NSAID medicines of­ten will do the trick.

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