Most lower back pain resolves in 6 weeks, but when you're feeling it, that isn't much consolation. So here is a guide to lower back pain and how to feel better. New severe or worsening back pain? Seek medical care immediately.
1) HEAT and ICE
2) MEDICATIONS (for adults)
3) GREAT TOPICAL (ON THE SKIN) THERAPY
4) MASSAGE
5) EXERCISES
6) WHEN TO CALL ME OR 911 (YIKES!)
1) Heat and ICE
In the first 48 hours, Ice can be a great way to help reduce swelling and discomfort. Use heating pad ($20 at Walmart) or hot water bottle for 20 minutes, every hour as tolerated. Have cloth barrier between hot water bottle and skin. DO NOT fall asleep on a heating pad it can cause severe burns. If heat is not helpful, apply ice packs to the painful area, for 20 minutes, every hour as tolerated. Have a cloth barrier between skin and ice pack. Rest on a firm mattress. After a few days, choose which helps more, ICE or heat and stick to that!
2) MEDICATIONS: These recommendations are for adults only after discussing them with me or another physician. Check with me or your physician before taking ANY medicaiton
The NSAID class of medications includes ibuprofen (Advil), naproxen (Aleve) and prescription meloxicam (Mobic). These medications work to relieve pain and also help reduce swelling. However, to get the anti-swelling effects of these medications, you often have to take a larger dose and for a few days around the clock. An average dose of ibuprofen for back pain is 600mg three times a day (!) with food. This is available in a prescription (a single 600mg pill) or you can take 3 pills with breakfast, lunch and dinner. Don't take any NSAID if you have ulcer disease, gastritis, recent stroke or bleeds.
For Meloxicam: Do not take ibuprofen (Advil) or naproxin (Aleve) with this medication. Do not take Prednisone or other steroid pills with this medication. Do not drink alcohol with this medication. Only take once a day. This comes in 7.5 mg and 15 mg (max dose)
Tylenol: Acetaminophen Is a great medication, and much more powerful than people think! It does not interact with the NSAID class, so you can take it while taking NSAIDs. It does not work to heal the muscle, but makes your brain feel less pain. This is a good choice as long as you do not have liver or kidney damage. Tylenol is not shown to be helpful for chronic arthritis or back pain.
3) GREAT TOPICAL (ON THE SKIN) THERAPY
Salon pas topical patch twice a day also can help! ( over the counter )
Tiger bam: I'm not sure what combination of magic ingredients are in Tiger Balm, but it provides great short term relief.
4) MASSAGE:
I'm a big fan of massage. It often helps, has very few side effects, and feels great. If you have a romantic partner, it can also be a great way to increase intimacy and communication skills. There are many professionals who specialize in sports massage and massage for those with a bad pack. Some patients have tried Healing Arts Massage in Pacific Beach - and say good things about their Sports Massage. For another option, try a mechanical massage. I particularly recommend this one having used it myself.
5) After 1-2 days of taking it easy, the best way to heel quickly is to keep your back moving and limber with stretching and exercises. Here are a few good examples of stretches and exercises. Physical Therapy is a good option should you not feel better after a few weeks.
STRETCHES:
Lie on your back with your knees bent and your feet flat on the floor. Gently pull one bent knee to your chest. Put that foot back on the floor, and then pull the other knee to your chest. Hold for 15 to 30 seconds. Repeat 2 to 4 times.
Pelvic tilt exercise: Lie on your back with your knees bent. "Brace" your stomach. This means to tighten your muscles by pulling in and imagining your belly button moving toward your spine. You should feel like your back is pressing to the floor and your hips and pelvis are rocking back. Hold for about 6 seconds while you breathe smoothly. Repeat 8 to 12 times.
EXERCISES
Press-up
Lie on your stomach, supporting your body with your forearms.
Press your elbows down into the floor to raise your upper back. As you do this, relax your stomach muscles and allow your back to arch without using your back muscles. As your press up, do not let your hips or pelvis come off the floor.
Hold for 15 to 30 seconds, then relax.
Repeat 2 to 4 times.
Alternate arm and leg (bird dog) exercise
Note: Do this exercise slowly. Try to keep your body straight at all times, and do not let one hip drop lower than the other.
Start on the floor, on your hands and knees.
Tighten your belly muscles.
Raise one leg off the floor, and hold it straight out behind you. Be careful not to let your hip drop down, because that will twist your trunk.
Hold for about 6 seconds, then lower your leg and switch to the other leg.
Repeat 8 to 12 times on each leg.
Over time, work up to holding for 10 to 30 seconds each time.
If you feel stable and secure with your leg raised, try raising the opposite arm straight out in front of you at the same time.
Knee-to-chest exercise
Lie on your back with your knees bent and your feet flat on the floor.
Bring one knee to your chest, keeping the other foot flat on the floor (or keeping the other leg straight, whichever feels better on your lower back).
Keep your lower back pressed to the floor. Hold for at least 15 to 30 seconds.
Relax, and lower the knee to the starting position.
Repeat with the other leg. Repeat 2 to 4 times with each leg.
To get more stretch, put your other leg flat on the floor while pulling your knee to your chest.
Wall sit
Stand with your back 10 to 12 inches away from a wall.
Lean into the wall until your back is flat against it.
Slowly slide down until your knees are slightly bent, pressing your lower back into the wall.
Hold for about 6 seconds, then slide back up the wall.
Repeat 8 to 12 times.
THE BEST WAY TO KEEP YOUR BACK STRONG IS TO START A GOOD GYM ROUTINE WORKING WITH A PERSONAL TRAINER. YES, IT CAN BE EXPENSIVE, BUT IT WILL SAVE YOU TIME AND MONEY IN THE LONG RUN.
6) WHEN TO CALL ME OR 911 (YIKES!)
Call 911 anytime you think you may need emergency care. For example, call if:
You have symptoms of a heart attack. These may include:
Chest pain or pressure, or a strange feeling in the chest.
Sweating.
Shortness of breath.
Nausea or vomiting.
Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
Lightheadedness or sudden weakness.
A fast or irregular heartbeat.
After you call 911, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself.
You have signs of a severe spinal injury. These may include:
Loss of bowel or bladder control (not being able to hold your urine or bowel movements).
Weakness in the legs.
Numbness or tingling in the rectal area, genital area, or legs.