Management of Acute Back Pain

Self care

For acute cases that are not debilitating, low back pain may be best treated with conservative self-care, including: application of heat or cold, and continued activity within the limits of the pain. Firm mattresses have demonstrated less effectiveness than medium-firm mattresses.

Activity

Engaging in physical activity within the limits of pain aids recovery. Prolonged bed rest (more than 2 days) is counter indicated. Even with cases of severe pain, some activity is preferred to prolonged sitting or lying down - excluding movements that would further strain the back. Structured exercise in acute low back pain has demonstrated neither improvement nor harm.

Physical therapy

Physical therapy can include heat, ice, massage, ultrasound, and electrical stimulation. Active therapies can consist of stretching, strengthening and aerobic exercises. Exercising to restore motion and strength to your lower back can be very helpful in relieving pain and preventing future episodes of low back pain.

Medications

Short term use of pain and anti-inflammatory medications, such as NSAIDs or acetaminophen may help relieve the symptoms of lower back pain. Muscle relaxants for acute and chronic pain have some benefit, and are more effective in relieving pain and spasms when used in combination with NSAIDs.

Spinal manipulation

A 2004 Cochrane review found that spinal manipulation (SM) was no more or less effective than other commonly used therapies such as pain medication, physical therapy, exercises, back school or the care given by a general practitioner. A 2010 systematic review found that most studies suggest SM achieves equal or superior improvement in pain and function when compared with other commonly used interventions for short, intermediate, and long-term follow-up. In 2007 the American College of Physicians and the American Pain Society jointly recommended that clinicians consider spinal manipulation for patients who do not improve with self care options. Reviews published in 2008 and 2006 suggested that SM for low back pain was equally effective as other commonly used interventions. A 2007 literature synthesis found good evidence supporting SM and mobilization for low back pain. Of four systematic reviews published between 2000 and 2005, one recommended SM and three stated that there was insufficient evidence to make recommendations.

Source : wikipedia