What can I do? I have pain in my lower back
In the previous two articles on lower back pain, I discussed what structures may cause your lower back pain and why the back pain may have begun. In this article we will discuss what you can do to help the pain in the early stages.
What can I do? I hurt my lower back this morning!
The first thing to remember is that in the vast majority of cases no damage has occurred to the back and it is most likely that the pain has been a warning signal from the spine to the brain. The brain is then responding by protecting the area the pain signal is coming from.
Approximately 98% of cases of lower back pain are referred to as non-specific lower back pain. This is pain that is not directly attributed to a specific pathology such as a disc prolapse or fracture. This form of back pain will generally improve within 6 weeks without the need for strong medication or surgical intervention.
The best approach for these pains is to get moving early and to avoid bed rest. The use of heat packs, regular panadol (paracetamol) and/or nurofen (ibuprofen) is very effective in controlling your pain. It is unlikely you will require stronger pain relief that this if you follow the recommended dosage of panadol and nurofen.
The pain isn’t controlled by what you suggested?
If you find that the above isn’t effective in controlling your pain the next best approach is to visit your physiotherapist. A physiotherapist is able to improve the your movement and make it closer to normal. You would also be shown stretching exercises to help with controlling the pain and improving your movement. It may also be suggested that you go for a walk in a hydrotherapy pool. The heat of the water in a hydrotherapy pool can ease the pain and enable more normal walking.
A physiotherapist or the like is not able to “put your disc back in”. It isn’t out in the first place. A physiotherapist is able to help you get moving and that movement is what reduces the pain.
Most pains will be controlled by this approach without the need for stronger pain medication, injections or surgical intervention.
It doesn’t feel like it is improving?
Don’t forget that the majority of pains will significantly improve within 6 weeks and within 12 months pain levels are generally low. This is without the use of stronger interventions such as surgery, or opiod and neuropathic medications.
It is not beneficial for an X-ray, CT scan or an MRI unless the results are likely to change the management, such as for a serious condition eg: infections fractures or cancers. It is best to discuss the need for a scan with your physiotherapist. In the vast majority of cases I will not recommend an X-ray or scan.