The National Institutes of Health estimates that approximately 25% of adult Americans will experience one episode of back pain within a three month period.1 Individuals may experience back pain for several reasons including a strained or pulled muscle, a bulging disc, arthritis, poor posture, pinched nerve, a fall, etc. Fortunately, there are many simple self-treatment tips that any person can easily implement to help reduce the pain.
1. Give your body time to heal and take it easy for a while. If you give your back time to heal and not overdo it there is a good chance you can heal yourself. Unfortunately the reality is that the daily demands of working and managing a household may continue to aggravate your back problem, especially if you have a physically demanding lifestyle. In order to help facilitate the healing process you need to take it easy for at least a few days and avoid heavy lifting and other strenuous activities. This doesn’t imply that you have to sit or lay all day long because that could cause stiffness and weakness but you should do activities to your tolerance based upon your pain level. I have seen many individuals that kept pushing themselves when they experienced a back injury in hopes of just working thru it and in the end they kept prolonging the problem. To help facilitate healing if an activity causes increased pain you should try to modify it in order to make it easier and if it continues to cause more pain then try to avoid it if possible.
2. Decide to use ice or heat. Usually for recent injuries I recommend using cold agents such as an ice pack or cold gel pack for the first few days. Constant pain that is always there usually indicates the presence of an inflammatory process. When an individual is suffering from constant pain I usually recommend to consistently use cold agents. A bag of frozen peas or corn works like a bag of crushed ice as long as you shake it up before applying it. A gel pack can also be made by using a 3:1 ratio of water to rubbing alcohol. Simply put 3 cups of water and 1 cup of rubbing alcohol in a sealed Ziploc bag and place it in your freezer until it turns into a soft solid. In a few days once the pain has subsided you may switch to a heating agent such as a heating pad or microwavable hot pack. On the other hand, if you are experiencing mostly stiffness versus actual pain then you may apply a heating agent right away. Individuals that suffer from chronic pain, such as arthritis, typically get more pain relief with heating agents. However, some patients with chronic pain still experience better pain relief with ice packs and you may consistently use cold agents on an ongoing basis if that works better for you.
3. Apply the ice pack or heating agent in a proper manner. When using an ice pack or cold gel pack you need to have at least one barrier protecting your skin such as your clothing or a pillow case. Apply the cold agent to the involved area for 20-30 minutes at a time and do this several times throughout the day. When using heating agents you also need to have an adequate barrier protecting your skin. If you are using a microwavable hot pack you may need to use several barriers such as thin towels in order to avoid burning yourself. Always use enough barriers to provide a comfortable heating effect but be careful to not burn yourself. If you lay on a heating agent you will likely need more barriers to protect your skin. Apply the heating agent to the involved area for 20-30 minutes at a time and you may do this several times throughout the day. You can usually find a gel pack that can be used for both heating and cooling purposes in the pharmacy or health section of department stores.
4. Try to maintain good posture and proper body mechanics. Slouched sitting or standing with poor posture puts excessive strain on the muscles and joints in your spine. When individuals experience a back injury they sometimes develop a slouched posture or lean their trunk forward when walking due to the pain. At first this may help lessen the pain but in the long run this will usually cause more problems. Maintaining perfect posture is unnecessary but if you avoid slouching and strive to keep your neck and back in a straighter position you will significantly reduce the stress on your spine. Striving to perform bending and lifting tasks with proper body mechanics is also imperative in order to help promote healing and minimize pain. During lifting tasks try to keep your back straight and bend at your hips and knees. This promotes your thigh and buttock muscles to do the majority of the work instead of your back muscles. In addition to keeping your back straight you also want to avoid twisting motions when performing daily household tasks. Many individuals do not realize that twisting your trunk when putting away dishes or folding laundry can put repetitive stress on your spine and ultimately result in a back injury. When turning you always want to pick up your feet when you turn your body. Basically you want your feet and shoulders to turn together at the same time to help minimize rotational stress on your spine. Finally, when you get in and out of bed try to use the log roll method. To use the log roll technique you lie down on your side using your arms and then roll onto your back while keeping your trunk straight. In order to get out of bed simply roll to your side and then use your arms to help push yourself up to a sitting position.
5. Try using a back support brace to help protect your back and reduce the pain.
I frequently utilize back support braces for patents that are experiencing significant back pain or for patients that have to perform repetitive bending and lifting tasks. A back support brace can help facilitate the healing process by reducing pain and it helps protect your back from further injury. Using a back support brace can help you lift and bend properly while also providing stability to your spine. You can easily find a wide variety of back support braces online or in the pharmacy or health section of any department store.
6. Modify your sleeping position to promote better sleep. Patients that are suffering from back pain often have trouble sleeping and research supports that lack of sleep can prolong the healing process. One of the most comfortable sleeping positions is to lie on your side with 1-2 pillows between your knees and try to sleep on the side that has less soreness. If you tend to roll onto the sore side when you are sleeping wedge a small pillow or rolled towel behind you. This helps prevent you from rolling onto your sore side when you sleep. For individuals that like to sleep on their back place 1-3 pillows underneath your knees. This bends your knees when you are sleeping which helps position your low back in a more neutral position. Sleeping on your back with your legs straight is typically uncomfortable because this position promotes your back to be slightly arched which in turn causes more stress on your spine. Sleeping on your stomach will likely make the condition worse because this will arch your low back and place more stress on your spine. Therefore I usually recommend avoiding stomach sleeping but if an individual prefers this position then they should lie on 1-2 pillows placed perpendicular under the pelvic or waist region. This will help minimize the arch in your low back when sleeping on your stomach. Most importantly use plenty of pillows and try different positions in order to find the most comfortable position.
7. Progressively ramp up your activity level in order to slowly return to your prior level. Once the pain has subsided and you have given your body time to heal it is crucial to gradually increase your activity level in a progressive manner in order to help avoid a flare-up. After the back pain has noticeably subsided many patients are eager to complete all of the daily projects and chores that were put on hold. I have worked with many patients that once their back pain is better they will do 7-8 hours of yard work or housework in one day. Often times these individuals may experience no symptom exacerbations during these activities but unfortunately later on they may experience delayed onset muscle soreness (DOMS) which can occur anywhere from 1-3 days following physical activity. When an individual has been sedentary for a while DOMS can easily occur when you start to do more physical activity. In order to help avoid DOMS you need to gradually build up your level of physical activity when you are recovering from an episode of back pain. For example, if you have a lot of housework or yard work to get done ideally do just a few hours at one time rather than doing 7 or 8 hours straight. When you are returning to your prior exercise routine try doing 25% of your exercise routine at a lighter intensity and then reassess how you feel the next day. If you did not experience any significant soreness then increase the intensity a little more and trying doing 50% of your exercise routine and again reassess how you feel the next day. If you experience noticeable soreness then just stay at that same level until you are ready to increase the intensity level. Gradually increase to doing 75% of your exercise routine and eventually return to the intensity level of your prior exercise routine.
- 1. National Institutes of Health – Online. Handout on Health: Back Pain. Available at http://www.niams.nih.gov/Health_Info/Back_Pain/default.asp. Accessed February 3, 2014.
- This information is only intended for general medical advice and is not intended as a substitute for personalized medical care.
- If you are experiencing back pain that does not resolve within 1 week you should see a physician or a licensed physical therapist.
- If you are experiencing any symptoms that include numbness, tingling, burning, or shooting pains this may indicate the presence of a pinched or compressed nerve. If this is occurring you should see a physician as soon as possible.