Anyone with longstanding and unexplained chronic back pain, or who experiences a sudden onset of new and severe pain, should see a medical doctor or a chiropractor to check whether the condition requires professional treatment.
In general, most conventional physicians will recommend such medications as muscle relaxants and analgesics, and refer more chronic or severe cases to a physical therapist, physical medicine doctor, or orthopedic surgeon.
If your discomfort is relatively mild and does not require professional treatment, over-the-counter pain relievers, nutritional supplements, and a variety of self-care measures can ease pain and inflammation and strengthen bones and muscles to prevent future back strain.
It is important to use the first episode of back pain as an indication that something is out of balance and use the message from the first episode to correct that imbalance. The imbalance could be a nutritional deficiency, an emotional stress, or a mechanical stress from poor posture or lifting habits. Having one episode of back pain can quadruple the risk of having another episode.
To Treat Back Pain
Bed rest vs. exercise Recent studies show that unless the condition is severe, as in the case of a herniated disk, you're better off returning to light-to-moderate physical activity after a day or two of rest. In fact, the sooner you begin to move, the faster your recovery will be. One review of several clinical studies showed that if people stayed active despite pain, they had both decreased pain and improved function when followed-up in four and 12 weeks, compared to people with back pain that hadn't stayed active. (2)
To Prevent Back Pain
If you are a victim of recurrent back problems, your best bet may be to make a careful diary of exactly what provokes or aggravates your pain. Likely culprits might include improper lifting, prolonged sitting in a soft chair, driving a car, or just awakening from what was otherwise a good night's sleep. Make a list of what relieves the pain: stretching, massage, painkillers, or even a hard cushion against your lower back. Information like this can be of great value to a chiropractor or physical therapist in determining proper therapy to decrease current and future pain.
If you're serious about prevention, you'll have to follow all the instructions you'll be given. A number of useful suggestions follow.
Maintain the proper body weight for your height. Even a slight paunch can strain back and abdominal muscles, distort posture, and overly compress the disks in your lower back.
Become more aware of your posture. Over time, sitting and standing with unbalanced foster can strain the supporting muscles and ligaments in your back, causing them to be less effective in holding you up. When standing, think tall and hold your head squarely over your shoulders with your chin parallel to the floor and your neck straight. When sitting, sit up tall and keep your spine straight, your head erect, and your chin parallel to your lap. Avoid such bad habits as slouching in your chair and crossing your legs.
Stretch and exercise regularly. While exercise is important, be sure to avoid sports that involve lifting, twisting, jumping, sudden starts and stops, or arching of the spine. Instead, walk regularly or practice yoga, which involves deep breathing, stretching and strengthening exercises, and meditation. Not only does yoga ease tight back muscles and strengthen weak ones, it also relieves stress, promotes circulation, and stimulates the release of pain-relieving hormones known as endorphins.
Strengthen abdominal muscles. Keeping core muscles strong will decrease the frequency or severity of episodes of back pain. Adopt a regimen of partial sit-ups, or crunches, done by lifting the torso halfway up while the knees are bent at a 90° angle. (Full sit-ups can injure your back.) You might also try some exercises using a Swiss ball, a large inflatable rubber ball that is also known as a therapy ball, physio ball, or gym ball. There are a number of good books and tapes available that show Swiss ball exercises for strengthening the abdominal and back muscles. Alternatively, belly dancing or pilates may work for you.
Wear comfortable footwear. Buy well-cushioned, low-heeled shoes, preferably with orthotics. These custom-built shoe inserts are designed to redress any postural problems. Avoid high-heeled shoes.
Sleep on your side. To relieve pressure on the disks in your back, sleep on your side with your knees bent, and perhaps with a pillow between your legs. Try to avoid sleeping on your stomach, which places your spine in a curvature that can aggravate back pain.
Avoid tight-fitting pants and girdles. These can weaken abdominal muscles and lead to back trouble.
Bend at the knees when lifting heavy objects. This allows your arm and leg muscles to bear the brunt of the effort. Avoid bending at the waist when lifting.
Get the right chair for desk at work. If your job requires that you sit for many hours, especially at a keyboard, choose a straight-backed chair. Hold your spine against the back of the chair and set the seat height so that your knees are slightly above your hips. If possible, invest in an ergonomically designed chair. Take frequent breaks to stretch.
Use a lumbar support pillow for any long periods of sitting--in the theatre, driving a car, or at your desk at work.
Just a reminder: If you have a serious medical condition, it's a good idea to check with your doctor before treating yourself with over-the-counter drugs or supplements.
Devil's Claw may be able to provide relief for acute and persistent back aches. Reviewers found strong evidence that daily doses standardized to 50 mg or 100 mg harpagoside were better than placebo for short-term improvements in pain and rescue medication (3, 4).
White willow bark helps the body mount a defense against back pain because it reduces inflammation and lessens pain. This herb contains the forerunner of the world's most popular painkiller, aspirin, but with few of aspirin's side effects. One double-blind German study found willow bark extract to be more effective than a placebo in reducing low-back pain (5).
Boswellia is another anti-inflammatory worth considering (6). This herb, a standby for arthritic pain, has also long been used to reduce aching and stiffness in the back.
Enzymes, including chymotrypsin, trypsin and rumbling, provide some relief for acute strain. Grumbling, which is derived from pineapples, helps reduce the inflammation and pain caused by trauma, surgery, sports injuries, and arthritis (6). Bromelain is found in several natural products for injury care. Chymotrypsin and trypsin are digestive enzymes that may come from plant or animal sources. Research has shown them to be beneficial in wound healing and decreasing pain from osteoarthritis. Clinically, they also have been shown to be beneficial in decreasing pain from soft tissue injury (strains and sprains).
Magnesium is an important supplement for decreasing pain by decreasing muscle spasm.
SAMe--the abbreviation for S-adenosylmethionine--although better known as an antidepressant, does triple duty by fighting inflammation, reducing pain, and increasing mobility in people with various forms of arthritis and degenerative joint disease. Some studies have even shown SAM-e to be as effective as NSAIDs (7, 8, 9).
D-Phenylalanine - is a synthetic form of an amino acid, L-phenylalanine, that is found in foods. Although its most researched use is combining it with PUVA light to help people with vitiligo, many clinicians have found it useful in decreasing pain when combined with other supplements or practices. One study used 4 grams before acupuncture treatment to help decrease pain associated with tooth extraction and low back pain. (10)