how to manage back pain

Managing back pain at home

Rest and Activity Modification

One of the first things you can do is rest after an injury or an intense flare up. However, complete bed rest can be counterproductive, even working against recovery and reduction of back pain of symptoms. Prolonged rest and inactivity can weaken the muscles that support your back and worsen stiffness and pain. Experts agree that staying as active as possible within the limitations of your pain is a good strategy.  Undertaking limited activities such as walking and light stretching can be helpful in recovery.

Ice and Heat Therapy

Applying ice packs 20 minutes at a time several times a day can reduce swelling and help numb the pain after a sprain or strain. Once the pain and swelling subside, after a few days, try applying gentle heat in short intervals to soothe and promote blood flow to the area. Heat may work better for chronic back pain to relax the muscles and soothe pain. Alternating heat and cold works for some people for their recurrent pain. The change between and cold can help with pain and inflammation. There is no one size fits all when it comes to heat/cold therapy. Everyone is different and you have to find what works for you. Heat and cold therapy offer temporary relief from symptoms. They don’t solve underlying issues. Talk to a doctor first if you have heart disease or diabetes.

Over-the-Counter Pain Medications

Acetaminophen helps with pain but doesn’t reduce swelling or inflammation. NSAID (non-steroidal anti-inflammatories) such as Ibuprofen or Naproxen are effective for pain, inflammation and swelling but can have serious side effects. They carry a risk of ulcer and gastrointestinal bleeding and should be taken in low doses first.

Topical Pain Relievers

Topical pain relievers come in a variety of forms: creams, patches, gels, sprays and ointments. Each attempts to reduce pain by blocking or masking pain. Some examples are salicylates, anesthetics, menthol, capsaicin and arnica. Some work by dilating blood vessels, others by providing sensations of hot or cold or creating numbness. All are for very temporary pain relief and don’t address underlying causes of pain.

Exercises and Stretching

Exercise and stretching is very important in managing and preventing back pain. But talk to your chiropractor first about exercise and movement because it is extremely important to understand if your pain is acute (short-term) or chronic (long-term). This knowledge and understanding of the underlying condition/cause will determine the exercise plan or regimen he/she will recommend. A supervised exercise plan is highly recommended.

Specific exercise recommendations will be provided based on location and cause of pain. For example core strengthening exercises, aerobic and flexibility exercises are very different and need to be managed according to the cause of the pain.

Several small pictures here of people in simple yoga poses

Ergonomic Changes

We are all spending more time at desks and computer stations. The setup of your workstation is incredibly important in preventing back pain and injury. Little things can make a big difference such as making sure your chair allows your feet to be flat on the floor with your legs at a 90 degree angle. Your chair should provide lumbar support or you can use a pillow between your chair and your back for support. The top of your computer screen should be at eye level. Invest in a monitor stand or use a pile of books. Consider an ergonomic keyboard and mouse to rest your hands and wrists comfortably. Consider a sit-stand desk where you can alternate sitting and standing. Get a headset if you are on the phone a lot so you don’t cradle the phone with your head and neck.

Stress Management

• Stress and muscle pain are in a debilitating feedback loop. Stress causes muscles to tense up, contract, causing pain, stiffness and even headaches. That pain and discomfort adds to stress, accelerating the cycle. Breaking this cycle is essential to your physical and mental health.

• Mind-body techniques like deep breathing and targeted muscle relaxation address stress responses in the body helping muscles to relax promoting a sense of calm.

• Movement such as walking or swimming release endorphins, a natural painkiller, which improves circulation to tightened muscle fibers.

• Stretching can improve stress induced muscle tightness and reduce pain. Gentle yoga is a great choice.

• Massage for targeted muscles can bring relief from stress and tightened muscles. It also

helps relaxation and reduces stress.

Sleep needs to be a focus. 7 to 8 hours of sleep reduces stress which lets your body rejuvenate and heal.

How a Chiropractor Can Help with Back Pain

Chiropractic Care

Chiropractors use specific adjustments and manipulations of the spine to improve spinal alignment and range of motion. Chiropractors use quick, controlled thrusts to specific joints in the spine. The goals are to:

• Improve alignment and improve range of motion

• Reduce pressure on nerves causing pain

• Reduce inflammation and muscle tension

Chiropractic asserts that vertebral subluxation, misalignment or restriction of spinal joints  interferes with the nervous system contributing to pain and restriction. Spinal manipulation addresses pain by reducing restriction of spinal joints and reducing pressure and irritation of nerves. This potentially lessens pain signals sent to the brain improving communication between the nervous systems and the body. Other research Indicates that spinal manipulation may influence how the body processes pain, turning down the volume of pain signals reaching the brain.

Chiropractic appears to be similarly effective at reducing pain as other pharmacologic and non-pharmacologic therapies.

Physical Therapy

At the heart of physical therapy is the understanding that movement is medicine. A skilled therapist creates an individualized plan based on exercise, stretching, strength training, therapeutic tools and training on ergonomics and body mechanics.

A strong core is essential to stabilizing the spin and reducing pain. Exercises might focus on gentle controlled movements like pelvic tilts and progress to strength training, exercises tailored to each the strength and capability of each individual.

Stretching is pivotal, along with exercise, to relieving muscle tension and improving flexibility in the hips, back and legs. Tightness in the hips and legs can cause or exacerbate back pain. Basic yoga poses such as cat-cow, child’s pose and others can stretch these important areas decreasing stress on the back.

Strengthening your core muscles is critical to long term pain management. The core stabilizes and braces the spine, preventing injury and pressure on nerves. Try yoga or pilates. Both are great for your core. 

A good physical therapist is very much a teacher, who can teach you to understand ergonomic principles of standing, sitting and lifting. He can help you understand body mechanics to help you move efficiently and with less risk. Understanding the ergonomics inherent in everyday life will help you master the techniques to keep you safe and injury free.

Myofascial Release Therapy

Myofascial release therapy is a manual therapy gaining widespread recognition for its role in managing back pain and facilitating healing throughout the body. Haven’t heard of fascia or myofascial release? Recent research has underscored the importance of fascia in understanding and managing pain.

What is fascia?

Fascia is a thin web-like structure that encases our muscles, organs, blood vessels and bones throughout the body. It is flexible and stretches but when stressed can dry out, tighten up and are subject to adhesions, knots and damage. Fascia is packed with nerves and can cause and transmit pain. Because it is an interconnected, vast web, a contusion in a shoulder may manifest as severe lower back pain.

Myofascial Therapy

Myofascial therapy involves light sustained pressure with hands or specialized tools to affected areas of the fascia, which may or may not be where pain is felt. This light pressure and massage is meant to release the tensed or knotted fascia, lengthen and rehydrate. It is a manual unwinding of the fascia and connective tissue.

How does myofascial therapy help pain?

Myofascial therapy causes the following changes.

• Improved soft tissue mobility

Improve range of motion and decrease muscle tension.

• Reduced inflammation

Reduced inflammation can reduce pain.

• Enhanced circulation

Brings increased blood flow to damaged tissues promotes healing.

• Pain perception   

Early research points to modulation of pain and how the brain process it.

Other Treatments

Massage therapy

A Review in Pain Medicine found that massage therapy was effective for reducing both short-term and long-term back pain as well as improving function for people with chronic low back pain. Massage targets tense, aching muscles, lengthening and relaxing them while reducing stress. Massage also promotes blood flow, bringing oxygen and nutrients needed for healing to an area of damaged tissue. Massage therapists employ a variety of techniques depending on the purpose, the injury and expertise of the therapist. These may include Swedish Massage, Deep-tissue massage and Trigger Point Massage.

Acupuncture 

Acupuncture holds promise for the treatment of back pain and has been used in the far east for centuries. The mechanisms for why acupuncture may work are not well understood. 

The Pain-Gate theory holds that inserting very thin needles into the lower back may release endorphins and block pain signals. Some research suggests acupuncture may decrease inflammation.  Other theories suggest that acupuncture calms and relaxes spasming muscles and promotes healing circulation.

Injections and medications (in more severe cases)

A variety of steroidal and anesthetic injections can be employed for very short term relief in acute cases. Injections and pills (NSAIDS) can have side effects which should be discussed with your practitioner. None of these medications address the underlying cause of the pain nor fix it longer term.

What is the bottom line on back pain?

Back pain is not often caused by a single culprit. Spinal imbalances, muscle damage, nerve impingement, joint inflammation, tendon and ligament tears, and fascial knots often occur in combination. Often one induces or contributes to another. 

The causes of back pain are numerous, from injury to obesity to repetitive motion to disease (arthritis), stress, depression, poor sleep, poor posture and inactivity.

A combination of at-home care, lifestyle changes and professional treatment may be needed to address your back pain.

Most importantly, treat the symptoms, but find the cause. There are many therapies available, but understanding the source and reason for the pain will help you and your therapist address the cause so that a strategy can be devised to eliminate the pain from your life.

Learn more:

Back Pain Basics

What to Know About Migraines, Balance Problems, and Dizziness

How to Find a Chiropractor