How to address recurring lower back pain episodes
Q: I am 45 and relatively healthy. But about a year ago, I hurt my lower back while working in the yard. I felt a sharp pain and could barely walk. It took about a month to heal. Then about a month ago, I hurt my back again — this time while lifting my young son. The pain does not seem to be getting better. Is there anything I can do to speed the healing process? How can I prevent this from recurring?
A: Lower back pain episodes are common among adults, with about 80% of adults experiencing lower back pain at some point during their lives. Lower back pain is one of the top five reasons that individuals seek medical care. In many cases, it resolves on its own. Most people have significant improvement in their pain within 14 days, and symptoms usually resolve in four to six weeks.
Unfortunately, it’s not uncommon for lower back pain to recur. The biggest predictor of developing lower back pain is having a history of prior lower back pain episodes.
To ease your present lower back pain flare, there are a number of self-care steps you can take. First, maintain your usual activities as much as possible, but be cautious with movements that sharply increase the pain. Second, consider taking a nonprescription pain reliever. Anti-inflammatory medication, such as naproxen and ibuprofen, may be of benefit for short-term use. There are also some topical medications that people find effective at times, including counterirritants for heat/cold, lidocaine for numbing and anti-inflammatories for more local use.
If over-the-counter medications are not enough, talk to your health care provider about a muscle relaxant to reduce symptoms. The use of the medications is not to eliminate your pain but rather to reduce it to allow you to resume more movements and activities. Be aware that prescription medications may have more side effects, such as nausea, sedation and/or constipation.
Physical therapy during the acute episode can be an important part of treatment for lower back pain. It should involve teaching you to use heat and/or cold therapies, proper stretching exercises and the safest strengthening exercises — especially the abdominal core muscles. The benefit to starting a physical therapy program is to find out which approaches are best for you with your current symptoms and learn the proper technique for the exercises.
Additional passive interventions that may provide some short-term benefit for pain reduction include massage, acupuncture, low-level laser treatment and spinal mobilization. Other, more active interventions to consider are yoga, Pilates or an aquatic exercise program.
Once the pain goes away, take measures to reduce your risk of future lower back pain episodes. Use good posture and follow your health care provider’s instructions on how to bend, lift and move to ensure proper back biomechanics. When lifting heavier objects, it often is best to lift from the knees while you contract your abdominal muscles and keep your spine straight. As you lift, hold the object as close to your body as you can. You also may incorporate backfriendly practices into your daily life, such as using a chair that has good back support, or using a desk that changes levels to move from sitting to standing intermittently.
Regular exercise can strengthen your muscles, which makes it less likely you’ll have future lower back pain episodes.
Finally, if you smoke, stop. Smoking accelerates spinal degeneration, and that contributes to the development of back pain.