At one time, bed rest was considered an appropriate treatment for chronic low back pain. We’ve since realized, however, that lack of activity can actually increase back pain. Dr. Patel, can you tell us about how to effectively treat chronic low back pain?
Of course, Major Spencer. Movement is necessary for the back 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. And if you can, stay at work and make simple changes in how you do your job.
Over-the-counter, non-steroidal medications such as ibuprofen and naproxen can offer some relief for chronic back pain. Prescription pain relievers, anti-depressants, and anti-anxiety medications have also been shown to help.
It’s important to note that over-the-counter medications and prescriptions can interact with other medicines, nutritional supplements, and herbal remedies. Talk with a healthcare provider or pharmacist about all of the medications that you are currently taking, and be sure to take all medications as directed.
Research has demonstrated that chronic low back pain is often the result of weakened muscles. The muscles that stabilize the lower back are often inhibited after an episode of low back pain, and this inhibition leads to a condition known as disuse atrophy. Disuse atrophy means if you don’t use it, you lose it. Inhibited muscles won’t activate, even during exercises that target the back muscles. The affected muscles are not the large muscles we can see, but the smaller muscles that provide fine control of the spine.
Research has shown that 84 percent of people with low back pain that fail to target these muscles can have a re-onset of their pain within the first year, and 75 percent will continue to experience pain on and off for up to three years. However, simple exercises provided by a physical therapist or other rehabilitation professional can re-activate these muscles, after which regular exercises will continue to strengthen them.