Back Pain

Back Pain Should Not Be Treated With Medication Initially

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It’s a debate that’s been going on for a while in the medical world: what is the best form of treatment when it comes to back pain?  For a long time doctors were under the impression that bed rest was essential for those suffering with a bad back and a week putting your feet up was often recommended in the 1980’s.  However, new research confirmed that prolonged bed rest is not so good after all and can actually do more damage than good.

Doctors then started prescribing medications such as muscle relaxants, nebulasation, pain relievers, and non-steroidal anti-inflammatory drugs (NSAIDs) as part of the initial treatment for back pain.  But earlier this year recommendations were made for doctors to reconsider this option as research has revealed that medications only seem to have a temporary and mild effect on the injury and not really worth some of the side effects that come with them.

Suggested treatments for new lower back pain (lasting less than 12 weeks)

  • Massage
  • Heat
  • Spinal manipulation
  • Acupuncture

If you’ve exhausted the above then it may be worth trying NSAID’s or a muscle relaxant, but only as a second option.

Suggested treatments for chronic lower back pain (lasting longer than 12 weeks)

  • Physical therapy
  • Exercise (including balance improvement, stretching and strengthening of the core muscles)
  • Programs designed to reduce stress or create ways to deal with it
  • Acupuncture

Other techniques that could also help include yoga, tai chi, and progressive relaxation techniques.  Again, if you’ve explored all of the above and are still in a great deal of pain then NSAID’s may be the next move, but again, only as a last resort.

Still in pain?

If you’re still experiencing a great deal of pain after trying both medication based and non-medication based treatments your doctor may want to refer you to have other tests such as an MRI.

Is it serious?

Back pain is notoriously well known for going away on its own accord regardless of what treatments are used, so just hang on in there.  The good thing is that 99% of people who report lower back pain don’t have a serious condition.  But, just to make sure you’re not in that very small 1%, your doctor will normally ask the following:

  • Do you use any intravenous drugs?
  • Do you have an abnormal immune system?
  • Have you suffered from a fever recently?
  • Have you ever been diagnosed with any form of cancer?
  • Have you suffered from an injury to your back recently?
  • Have you experienced bowel or bladder incontinence?
  • Have you lost weight suddenly?

The answers to the questions, along with a physical examination, will enable your doctor to identify factors that suggest your back pain is because of a tumor, infection, or some other serious issue.

Whilst this new approach may be somewhat different to the more traditional treatments used for back pain, research suggests that it is a better way to go.  However, nothing happens quickly in medical practice and if guidelines do change, it will be some time in the future. Discouraging medication is not something we’re used to, but if the usual medications we’re familiar with are no longer working, then it’s clear we need to try something new and accept there are better alternatives.

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