Contents
Medical treatments for low back pain
Rest the back
In phase of sharp pain, we try to control the pain. It is important to avoid sudden movements and to rest your back. 48 hours rest is recommended. Afterwards, it is imperative to mobilize, even if the pain is still present. Strict bed rest that was prescribed in the past has been proven ineffective and even harmful.
Medical treatments for low back pain: understand everything in 2 min
The positions which best support the lumbar spine are as follows.
- Layer on the side, knees bent, a pillow under the head and another between the knees (pregnant women can add a pillow under their belly).
- Layer on the back, without a pillow under the head, with one or more pillows under the knees and a rolled up towel or small cushion in the hollow of the lower back.
The application of a hot water bottle or a heated lumbar belt helps reduce pain. Some people prefer to apply ice, but studies have shown that the effect on pain is less significant.46.
It’s important to do not unduly extend the rest period beyond 1 or 2 days and resume activities as soon as possible. As a general rule, bed rest should be avoided or be as short as possible, as this is a factor that contributes to making low back pain chronic. Inaction and immobility indeed contribute to atrophy and weakening of the back muscles. They can compromise the normal mobility of the joints in the lumbar spine. |
pharmaceuticals
Acute low back pain
To control the pain temporarily and for a short time, it is advisable to takeacetaminophen (like Tylenol®). The nonsteroidal anti-inflammatory drugs (Aspirin®, ibuprofen, including Advil®, Motrin®) or the muscle relaxants (for example, Robaxacet® or Robaxisal®) over the counter can also relieve pain. If the pain is severe and persistent, your doctor may prescribe painkillers more potent (opiates). It is important to obtain effective pain relief because suffering can lead to fear of movement, which contributes to the chronicization of the pain.
Chronic low back pain
benefits cortisone injections near the painful area are sometimes given in cases of chronic pain.
benefits Antidepressants Tricyclics may also be prescribed to relieve some chronic back pain. Indeed, they have an analgesic effect. If necessary, they can also be used to treat a depressive syndrome, which can make the pain worse.
Physiotherapy and exercise
The exercices and the physiotherapy are not useful for pain in acute low back pain1. On the other hand, people with subacute or chronic lower back pain who maintain physical activity (stretching and strengthening exercises, walking, etc.) recover faster.1,2. A physiotherapy program is therefore often recommended in the event of subacute low back pain (lasting for more than 4 weeks). At the beginning, the sessions may be limited to gentle movements and the application of heat to the lumbar region. Gradually, the patient will learn a series of exercises that he will be called upon to repeat daily at home in order to readjust and re-educate the muscles and joints of the lumbar spine. The massage therapy can be useful.
Afterwards, walking, swimming and road cycling (with a bicycle well adjusted to its size) are recommended, as these are gentle sports for the back. Yoga is also effective in relieving lower back pain in the long run. See the Complementary Approaches section.
Body-mind approaches (mind-body)
When pain are chronic, you often have to make major changes to your way of life : change of work, giving up certain activities, learning new postures, adhering to an exercise program, etc. In addition, the link between emotions and lower back pain seems increasingly clear to the eyes of back specialists. Thus, believing in your recovery and giving less importance to pain (by learning how to manage it better) increases the chances of recovery.
Body-mind approaches can help make this important shift. The author of a synthesis of studies on pain control mentions that these approaches constitute a complementary treatment valid for treating chronic lower back pain3. In addition to reducing the intensity of pain, they allow you to better manage stress, learn to relax and have a more positive attitude.3,4. The cognitive-behavioral therapy seems effective.
Lumbar belt
There is no clear recommendation about lumbar belts (wide belts that wrap the lower back), as the data on their effectiveness are contradictory53. In some cases, a kidney belt can help relieve pain and help the person return to normal activity quickly. It also makes it possible to reduce the need for medication and to limit recurrence thanks to a reminder action to avoid “false movements”. In chronic low back pain, wearing a lumbar belt is also controversial. It is generally recommended only for certain situations that may rekindle the pain: long journeys sitting down, shopping, etc.
surgery
when nerf is compressed, it can be decompressed by surgery. The operation will be performed in the acute phase if a nerve related to the sphincter of the bladder or the anus is affected. Otherwise, if the affected nerve is causing muscle weakness in the legs or feet, doctors usually only consider surgery when the situation does not improve with time and other treatments. Usually, a decision is made not to operate if the compression causes only pain, without muscle weakness. According to studies, this type of surgery does not provide effective pain relief in the long term.
Replacement drives are currently being researched.
Reinstatement at work
If the low back pain has caused a prolonged absence from work, help can be obtained from organizations that facilitate the return to work. Among other things, they will ensure that the requirements of the job are well adapted to the physical capacities of the person. They can also offer advice on ergonomics. Check with your doctor.