Flexible Physio

Treatment of back pain
date added: 21/09/2010

Self-help

There are many things you can do to help yourself.

• Stay active - return to your usual level of physical activity as soon as possible. This may hurt more at first, but it will help you get better and reduce your risk of getting simple back pain again.
• Bed rest - if the pain is so bad that you can't get moving, keep the time you stay in bed as short as possible. Lying in bed can do more harm than good.
• Stay positive and set yourself goals - this will help you get back to your usual levels of physical activity.
• Heat therapy - apply a hot water bottle or heat pack directly to the affected area, or take a hot bath.
• Ice therapy - apply a cold compress, such as ice or a bag of frozen peas, wrapped in a towel. Don't apply ice directly to your skin because you could damage it.
• Pace yourself - be careful not to overdo it when your pain improves.

Medicines

Taking a painkiller (such as aspirin or paracetamol) or anti-inflammatory medicine (such as ibuprofen) is often enough to relieve simple back pain and can help you keep active. You can also use creams, lotions and gels that contain painkillers or anti-inflammatory ingredients that can be applied directly onto the painful area.
If your pain continues, your GP may prescribe stronger medicines such as diazepam, morphine or tramadol. However, these aren't suitable for everyone because they can be addictive and cause side-effects.
Your GP or pharmacist will advise you which treatment is the most appropriate for you. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your GP or pharmacist for advice.

Transcutaneous electrical nerve stimulation (TENS)

TENS relieves back pain by delivering mild electric pulses to the painful area through electrodes on your skin. These stimulate your nerve fibres and block the pain signals to your brain. TENS isn't suitable for everybody and isn't always effective. You should check with your GP before you use TENS and make sure you know how to use it properly.

Physiotherapy

Physiotherapists can assess and treat your back pain, and teach you exercises to do at home that will increase your mobility and help you manage your pain. You should only see a physiotherapist registered with the Chartered Society of Physiotherapy.

Manipulation

Osteopathy and chiropractic are treatments involving manipulation of the body, mainly focusing on the spine. They are most useful if you have had back pain for less than three months and can provide short-term (most often) or long-term pain relief. These treatments aren't suitable for everybody and aren't always effective, so it's important to speak to your GP first. You should only see an osteopath registered with the General Osteopathic Council or a chiropractor registered with the General Chiropractic Council.

Pain clinics

If your pain continues, your GP may refer you to a pain clinic. Pain clinics offer a range of treatments that are known to be effective and can also help you deal with your pain by changing the way you think about it. Treatments at pain clinics are often combined and tailored to suit your needs.

Injections

Painkillers and anti-inflammatory medicines (usually steroids) can be injected directly into the epidural space (the space around your spinal cord) or around the joints of your spine to ease pain and decrease inflammation. These injections are only given by specialist doctors in hospitals. Epidural injections are usually only done if other treatments don't work.

Surgery

Surgery is considered as a last resort in the treatment of back pain. The type of surgery you're offered will depend on the cause of your pain and each type has different risks and success rates. Your surgeon will discuss the different options with you in more detail.

Complementary therapies

The following complementary therapies may help with back pain in some people. You should talk to your GP before trying them as he or she may be able to refer you to a specialist practitioner experienced in treating back pain.

• Acupuncture.
• Counselling.
• The Alexander Technique - becoming more aware of your body's balance, posture, and movement.
• Herbal remedies.
• Massage.

Prevention of back pain

Good back care can greatly reduce your risk of back pain. To look after your back, make sure you:

• take regular exercise - walking and swimming are particularly recommended
• try to reduce your stress levels - use relaxation techniques
• bend from your knees and hips - not your back
• maintain good posture - keep your shoulders back and don't slouch