Treatment for lower back pain depends upon the patient's history and the type and severity of pain. The vast majority of lower back pain cases get better within six weeks without surgery, and lower back pain exercises are almost always part of a treatment plan.
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If pain persists or worsens, more involved diagnostic and surgical procedures may be recommended.
- Rest. Ceasing activity for a few days allows injured tissue and even nerve roots to begin to heal, which in turn will help relieve lower back pain. However, more than a few days of rest can lead to a weakening of the muscles, and weak muscles have to struggle to adequately support the spine. Patients who do not regularly exercise to build strength and flexibility are more likely to experience recurrent or prolonged lower back pain.
- Heat and Ice Packs. Heat and/or cold therapy helps relieve most types of low back pain by reducing inflammation. Often patients use ice, but some prefer heat. Both may be used alternately.
- Medications. A wide variety of over-the-counter and prescription medications is available to help reduce lower back pain. Many medications reduce inflammation, which is often a cause of pain, while others work to inhibit the transmission of pain signals from reaching the brain. Each medication has multiple unique risks, possible side effects and drug (or food or supplement) interactions, which need to be evaluated by a physician.
- Exercise for Lower Back Pain. Exercise is a key element of almost any lower back pain treatment plan. Typically an exercise program will be developed and taught by a spine health professional, such as a physical therapist, chiropractor, or physiatrist, and will include three components: aerobic conditioning, stretching, and strengthening. The exercises are best done through a controlled, progressive program, with the goal of building toward a stronger, more flexible spine.
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- Low Impact Aerobic Exercise. In addition to exercises specific to the lower back, any low impact aerobic exercise, such as walking, is often an ideal exercise for the lower back because it helps bring oxygen to the soft tissues in the back to promote healing. Swimming or water exercise has the same effect and is an excellent option if walking is too painful.
- Chiropractic Adjustment (also called Chiropractic Manipulation) can help improve spinal function by decreasing pain and inflammation to increase range of motion and physical function. Manual manipulation is also commonly performed by osteopathic physicians.
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- Epidural Steroid Injections deliver steroids directly into the painful area of the lower back to reduce inflammation. The steroids do not heal the components of the back, but often provide enough pain relief to allow patients to move, exercise and heal.
- Surgery for Lower Back Pain Surgery is almost always the patient’s decision, and a qualified spine surgeon will be able to explain the pros and cons of each procedure. For sciatica, laminectomy and microdiscectomy have been shown to significantly reduce pain symptoms by relieving the pressure on compressed nerve roots. Fusion surgery, which is used to stop the motion at a motion segment, is a more extensive surgery but can be effective at relieving pain due to a painful motion segment.
The above is not an exhaustive list of all possible treatments for lower back pain, but does include the most common treatments. It is advisable for patients to seek a diagnosis from their primary care physician, chiropractor, or a spine specialist (such as a physiatrist) to determine the underlying cause of their lower back pain and seek appropriate treatment.