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Maj Spencer
For many years, it was thought that bed rest was an appropriate treatment for acute low back pain. However, lack of activity often increases stiffness, which can contribute to pain and prolong recovery. Dr. Patel, can you tell us about effective treatment solutions for acute low back pain?

Dr. Patel
Sure, Major Spencer. We now know that complete bed rest can actually aggravate the original problem, as well as cause muscle weakness, depression, and other issues. Some movement is necessary to heal properly. It’s okay to limit activity for a short time, but it’s important to get up and get moving as soon as possible. The longest someone should be on bed rest for acute low back pain is two days.

For many people, over-the-counter pain medications, such as acetaminophen, and non-steroidal medications, like ibuprofen and naproxen, can help reduce the pain. In other cases, providers may prescribe pain relief medications or muscle relaxants to ease discomfort.

It’s important to note that over-the-counter medications can interact with other medicines, nutritional supplements, and herbal remedies. For this reason, it’s good to talk with a healthcare provider or pharmacist about all of the medications that you are currently taking. Also be sure to take all medications as directed.

Most people only need to take pain medications for a few days, but some people might need to stay on them for a week or two. The good news is that most people will not need anything stronger than over-the-counter medications. When taking a non-steroidal anti-inflammatory drug, or NSAID, such as ibuprofen or naproxen, it’s important to take the medication as indicated on the container. Both NSAIDs and acetaminophen work to relieve pain and fever, but only NSAIDs contain anti-inflammatories. In order to get the most benefit from the anti-inflammatory medication, NSAIDs must be taken consistently.

In some cases, the application of ice or heat has been shown to help with back pain and relax tense muscles. Try taking a warm bath or shower, or applying a hot water bottle wrapped in a towel to the sore area. Apply moist heat for 15 to 20 minutes, two or three times a day. However, you shouldn’t use heat if you injured your back in a fall, or if the heat increases your symptoms. Also, be careful not to fall asleep using a heating pad because it can cause burns to the skin.

Spinal manipulation, when performed by a qualified professional such as a chiropractor, an osteopathic physician, or a physical therapist, is another safe and effective treatment option. Your provider’s staff can often provide a list of qualified practitioners in your area. Research shows that for some people with low back pain, receiving spinal manipulation within the first 16 days of onset can reduce pain and disability by up to 91 percent within the first two treatments.