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Treating lower back pain is not rocket science. If you have the right information and use proven treatment strategies, there’s no reason why you can’t completely recover or at least learn to take control of your pain.

So where do you start when you suffer an episode of back pain?

1. Stop aggravating your pain

2. Use strategic rest

3. Employ simple pain relief such as heat/ice or medications

4. Seek a diagnosis

When an acute episode happens, stop doing the things that hurt it. Take note of how your pain happened and avoid movement that gives sharp/severe pain. Bed rest is out – it has a detrimental effect and can prolong your pain, but what we call strategic rest is in. Keep moving in ways that provoke no pain or only minimal amounts. A good first step is focusing on painless ADLs (activities of daily living such as dressing, washing, housework etc), rather than returning immediately to marathon running and Olympic weightlifting.

Ice or heat?

Ice is a very effective pain reliever

Even with all the high tech medical options available, a simple ice application can still be one of the more effective, proven methods to treat a sore back or neck. Ice is typically most effective if it is applied soon after an injury occurs, or after any activity that causes pain, swelling or stiffness. Use anything from your fancy flexigel icepack to your plain old bag of frozen peas to reduce the swelling, especially in the first 24 hours. Try the ice for 10 minutes every 2-3 hours in the first day after injury to get the most anti-inflammatory effect.

Heat is great too

While the overall qualities of warmth and heat have long been associated with comfort and relaxation, heat therapy goes a step further and can provide both pain relief and healing benefits for many types of pain. Heat increases the blood flow to the area, which helps with healing as blood is the carrier of your body’s healing responses.

Dont worry if you think you aren’t sure whether to use ice or heat.  A simple rule is that if it is giving you relief, stick with it.  My only caution is heat on hot inflamed injury (think swollen/sprained ankle) is not advisable.  If it is swelling use ice.

Analgesia

Simple analgesics are useful.  Unless you have a medical condition that prevents you from taking paracetamol or anti-inflamatorys (NSAID’s) use them as recommended on the packet. Preventing pain at this chemical level can help you regain mobility and let you get on with some normality of life before you have time to seek a diagnosis of your pain.

Get diagnosed

Go and see a health professional trained in the diagnosis of back pain and find out what you’ve done. Most cases of back pain are due to strains and sprains of the muscles and joints and will often resolve within a couple of weeks if you do the right things. When you understand your injury better, you can make choices to speed up your recovery and prevent further injury or recurrence.

So why is a diagnosis important?  To start with, a diagnosis is used to to rule out the nasty stuff. Things like fractures, disc injuries, infections etc are significant injuries and need to diagnosed early on and treated accordingly. Secondly, diagnosing which parts of your back have been injured, guides us how and where to treat, gives you an idea of recovery time and what you can do to help yourself.  Stress and anxiety play a major role in pain production, so education and reassurance from a proper diagnosis will improve your recovery

As an example, a simple muscle strain will hurt a lot but will usually resolve itself within a couple of weeks if you take care of it with heat, ice and strategic rest. A joint and muscle  sprain on the other hand behaves a little differently, although the pain can sometimes feel similar. The muscular component can self resolve, but generally the joint injury won’t get better without some treatment. If the ligaments that support that particular joint have been damaged, they need 6-12 weeks to recover fully, all the while leaving that joint vulnerable to further injury. You can clearly see the value of diagnosis here, knowing what and where to treat, and having the right information to help you get and stay well.