Acute low back pain is a severely painful back pain which usually comes on suddenly from a movement such as bending over or twisting. It often results from a chronic or long-term back injury which flares up worse from time to time.
Initial treatment of acute low back pain is to make the patient as comfortable as possible and reduce pain and inflammation as quickly as possible. Below we outline some simple steps to help relieve acute low back pain.
Treatment for acute low back pain
The first thing to do is get into a position of most comfort. This could be lying on the back, on the side or front. Whatever is least painful is best and may be different for each individual. Some people may find keeping moving gives most pain relief. The psoas position lying on the back with the knees bent and up on a chair can often be the best position. Avoid any movements or activities which make pain worse. Bed rest may help but not for more than two days as resting for too long can make back injuries worse. Often movement is needed after the initial pain and inflammation have gone.
If a muscle strain or ligament sprain is suspect, if there is any swelling or bruising then applying a cold pack can help reduce painful symptoms and swelling. Never apply ice directly to the skin as ice burns can occur. Cold should be applied for 10 minutes every hour initially and reduced as required. If symptoms get worse with cold therapy then discontinue. Later on when the initial bleeding has stopped applying heat or alternating hot and cold may be more beneficial. This is usually after the first 24 to 48 hours.
Using a back support or back brace can provide some relief from back pain, as can sports taping or kinesiology taping. A back support will compress the muscles and other structures in the lower back taking some of the stress off them and relieving pain, particularly if the patient is required to stand. A doctor may prescribe pain-killing medication or NSAID's (nonsteroidal anti-inflammatory drugs) to relieve pain and muscle spasm. Always check with a doctor before taking medication as some medicines such as Ibuprofen should not be taken if you have asthma.
Electrotherapy such as electrical stimulation (TENS), Ultrasound therapy or magnetic field therapy may be useful in relieving back pain symptoms. Tens or transcutaneous electrical nerve stimulation passes electrical signals into the muscles which can block pain signals to the brain and stimulate the muscles into a movement which may also relieve symptoms. Ultrasound therapy passes high-frequency sound waves into the tissues providing a micro-massage and pain killing effect, also relieving spasm in the muscles.
Light massage techniques may help reduce pain, particularly if muscles have gone into spasm. Massage will help flush tissue fluids and blood through the muscle, warming them and reducing and painful muscle tension which may be contributing to the back pain. Use of an inversion table may help relieve symptoms. The patient lies on a board and is partially or fully inverted allowing gravity to apply gentle traction to the spine releasing pressure on the tissues and structures of the lower back.
Avoid sitting for long periods of time. This can cause muscles to go into spasm as they are not used and blood does not flow through them so easily. Adaptive shortening of muscles can also cause posture problems long term.
A full rehabilitation program consisting of back exercises for mobility and strength should be started as soon as possible to avoid any muscle wasting and long-term consequences of the back injury. See a sports injury or back pain specialist who can advise on treatment and rehabilitation. If any back exercises are painful they should be discontinued.