Lower Back Pain Treatment Overview
Care Plan
First steps to consider
- Mild to moderate lower back pain can usually be treated at home.
- Rest, ice and heat, ibuprofen (Advil), and gentle stretching can help back pain.
When you may need a provider
- Back pain does not get better on its own in about 4 weeks
- Moderate to severe back pain that affects your everyday activities.
Emergency Care
Call 911 or go to the ER if you have any of the following symptoms:
- New worsening back pain and you’re older than 60
- Fever
- Weakness in your leg
- Loss of control of your bowel or bladder or not able to urinate
- Numbness or tingling in your lower extremities (hip and below)
- Prior diagnosis of cancer
- Trauma in the past 48 hours (car accident or a fall)
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Treat
When to see a healthcare provider
See a healthcare provider for your lower back pain if you have tried OTC medications, rest, and ice, and your pain has not improved or has gotten worse. It can take about 4 weeks for pain to go away on its own after an injury.
Also see a healthcare provider if your pain is moderate to severe or making it hard to do your everyday activities.
Getting diagnosed for low back pain
Imaging tests such as X-rays, CT scans, and MRIs may be recommended if your back pain is not improving after 6–8 weeks and you have other symptoms that are concerning. Most people with low back pain do not need these imaging tests. Ask your doctor how the imaging tests will affect your care plan.
What to expect from your visit
Your doctor may also recommend a wait-and-see approach, and may suggest at-home treatments for 4–6 weeks. Most people with low back pain get better without any interventions like surgery.
- If your pain is chronic, your doctor may prescribe certain antidepressants, muscle relaxers, or antiepileptic medications that help reduce your body's response to pain and relieve muscle tension.
- Muscle relaxants work quickly—you may feel less tension within hours. Since they can make you drowsy, take them before bed.
- It can take 2–3 weeks for antidepressants and antiepileptic medication to lessen pain, so continue with NSAIDs until they start working.
- For severe back pain, your doctor may recommend steroid or anesthetic injections.
- Cognitive behavioral therapy (CBT) can help you manage psychological stressors related to low back pain and teach you coping strategies. It’s usually more effective for chronic pain.
- A physical therapist can teach you strengthening and stretching exercises. Physical therapy can help reduce pain, improve your movement, and prevent getting reinjured.
Prescription low back pain medications
- Duloxetine (Cymbalta)
- Cyclobenzaprine ( Flexeril),
- Neurontin (Gabapentin)
- Mobic (Meloxicam)
- Robaxin (Methocarbamol)
Alternative remedies for low back pain
There are several complementary therapies that may help relieve back pain and discomfort.
- Therapeutic massage can help release tight muscles that can be making back pain worse.
- Chiropractic care uses hands-on adjustments of the spine, called spinal manipulation, to treat back pain.
- Acupuncture uses thin needles to stimulate specific points on the body to change how the body reacts. It has been shown to reduce pain.
Types of low back pain providers
- A primary care provider can treat mild to moderate symptoms.
- An orthopedist is a doctor trained in treating bones, joints, ligaments, nerves, and tendons.
- A pain specialist is a doctor with special training in managing pain.
How to treat lower back pain at home
If you have mild to moderate lower back pain, you can often treat your symptoms by yourself. It is likely to get better on its own within about 4 weeks.Try to stay active with light activities (rather than lying in bed), and use OTC anti-inflammatory drugs and pain relievers. Gentle stretches and alternating with ice and heat packs may help.
For any back pain that is more chronic, lasting longer than 4–6 weeks, you still want to stay active with daily exercise and activities, and take OTC medications as needed.
OTC medications for low back pain
- Anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and naproxen (Aleve), reduce inflammation, pain, and stiffness.
- Topical (applied to the skin) medications like capsaicin cream or lidocaine patches can relieve pain.
- Acetaminophen (Tylenol) may be can be used in between taking NSAIDs for breakthrough pain or for those who cannot take NSAIDS
How can I get rid of low back pain at home
- Staying active is one of the best ways to relieve back pain. Try walking, swimming, stretching, and strengthening your core (muscles that stabilize your pelvis and spine).
- Apply heating pads to your lower back to increase circulation and help with healing. Heat also loosens tight muscles and can relieve spasms. Use a heating pad in the first few weeks after an injury (apply for no more than 20 minutes at a time).
- Apply ice or a cold pack within the first 24–48 hours of feeling pain to reduce swelling (for no more than 20 minutes at a time).
- NSAIDs may work better if you take them on a regular basis for 3–5 days (do not take more than 3,200 mg in a 24-hour period).
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