It has to be one of the most searched health topics on Google: “How do I reduce back pain?” So many people are afflicted by back pain everyday. Some are in the throes of an acute episode that just started. Some have been dealing with it in some form or another for years. I want to talk about some steps you can take to help take the edge off, whether your pain is acute (recent onset) or chronic (greater than 3 months).
1. Don’t panic
Less than 2% of back pain cases are from serious conditions. And most of that 2% is from fractures, which may sound dangerous, but they usually heal on their own and rarely endanger life or limb. The rest—things like cancer or bone infection—are quite rare. So even though it might hurt a lot, it’s unlikely that it’s anything serious. That’s important to keep in mind, because fear can increase pain and increase the chances that an otherwise short episode of back pain could become chronic. If you’re very concerned, get it diagnosed by a physician or physical therapist. In most cases, a thorough history and exam can rule out serious conditions without the need for MRIs.
2. Don’t stop
Intense pain can make you want to lie down and be completely still, especially if you fear it’s something serious. Now that you know it probably isn’t, you can feel confident that you can move without damaging anything (even though it hurts). Bed rest is not a helpful treatment for back pain and now we know it actually prolongs back pain and can make it more intense. Resist the strong desire to just lie down. Instead, you need to try to keep moving as much as possible. Don’t be afraid to do back movements that are mildly painful, but also don’t feel you need to force yourself into an intensely painful position. A little bit goes a long way.
Speaking of that, my most frequent advice to people with both acute and chronic back pain is to set an alarm for 30 to 60 minutes and when it goes off stop what you’re doing, stand up, and move your back. Sitting and being sedentary for hours a day will ensure that your back stays sore. Doing frequent, short bouts of movement will help lubricate joints, restore circulation, disperse some of the inflammation (if present), and take some stress off of sore muscles. The movement you do is up to you. Many people will discover that one movement is painful while others feel okay. You can do the non- or less painful movements, though eventually you will want to gradually expose yourself to the painful movement.
Do NOT underestimate the importance of this simple advice to move often.
Additionally, continue doing any exercise that you like to do and can do. It could be walking, cycling, lifting weights, tai chi, etc. As long as it isn’t clearly increasing your pain during or in the few hours afterwards, then you can rest assured it’s okay to continue. The “Big 3” back exercises are usually a simple and pain-free way to start.
3. Treat yourself to some good feelings
Many people will try ice or heat on their back. Either is appropriate. Neither is contraindicated. Choose the one that feels best to you. I find that doing some gentle back movements in a warm shower is a good way to start the day and loosen up.
Acupuncture, chiropractic manipulations, transcutaneous electrical neuromuscular stimulation (TENS), and massage are all options to help reduce pain. None of these treatments “fix” anything, they usually don’t out-perform placebo, and their effects are short-lasting. Therefore, if you want to try them then choose the ones that feel best to you. These passive therapies are adjuncts NOT replacements for movement and exercise.
4. Focus on overall health
Quality sleep, mental health, and a healthy diet are hugely important for reducing back pain, especially when it has become chronic. If you’re having difficulty sleeping because of your back pain, talk to your doctor about sleep aids. Inflammation can be worse at night, so you might also benefit from anti-inflammatory medication. Again, talk to your doctor. A physical therapist can provide guidance on finding comfortable sleeping positions.
An unhealthy diet can contribute to systemic inflammation, which may be a contributor to your back pain. Diet advice is outside of my expertise, but this is definitely a subject worth discussing with an expert if you’re experiencing chronic pain.
The contribution of stress and anxiety to pain is well-established at this point. If you feel that you are stressed and have difficulty dealing with it please reach out for professional help.
These three areas are often overlooked because most people don’t realize their connection to pain and they are lifestyle level, so they are just harder to address. They are so important, though, that you ignore them at your own peril.
5. Have realistic expectations
Most new onset back pain goes away on its own within 2-6 weeks. But that doesn’t mean you should assume it’s something serious if it lasts longer than 6 weeks. Also, setbacks are common and are also nothing to panic about. Even if your pain has become chronic it can still greatly reduce or go away with a comprehensive treatment plan.
Back pain is like the common cold. No matter what you do, it is likely that it will happen again. However, by staying active, managing stress, sleeping well, and eating healthy you may be able to reduce its frequency and intensity.