How to Help with Lower Back Pain

By: Candice Price, DC • Posted on May 18, 2023

Low back pain can be disabling and tricky to deal with. Studies have projected that 84% of adults undergo low back pain at some point in their lives. Fortunately, most episodes of low back pain resolve on their own without any treatment.

Serious underlying causes such as cauda equine syndrome, metastatic cancer, or spinal infection are rare. Often non-specific low back pain is caused by musculoskeletal dysfunction.

6 Evidence-Informed Strategies for Self-Care of Lower Back Pain

1. Stay Moving

Avoid bed rest if possible. It is recommended that those suffering from low back pain return to their usual activities as quickly as tolerated. Bed rest often leads to slower recovery and more pain.

Those that do require bed rest due to severe symptoms should attempt to return to normal activity as soon as possible. Modifying one’s activity due to pain should be reduced as much as possible. The goal is to perform as many of one’s usual activities with as few adaptations as possible.

2. Apply Heat and Stretch

Heat can be applied to the back, and stretching can be performed because both can help reduce muscle spasms. When heating, use a heating pad on the low setting for 20 minutes every two hours. Heating can be followed up by stretching techniques that may vary depending on the exact location of the low back pain. A general rule of thumb is to stretch where it feels good to stretch- stretching should feel like increased tension not pain. If stretching causes increased pain, that stretching technique should be discontinued.

3. Try Over-the-Counter Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs) may help reduce pain and improve function in both acute and chronic low back pain in those without contraindications to NSAID use. Examples of NSAID’s include ibuprofen and naproxen. When using NSAIDs to address low back pain it is important to use the lowest effective dose for the shortest time possible. NSAIDs may help sometimes, but may not always be effective.

4. Seek Spinal Manipulative Therapy

Spinal manipulation is a type of manual therapy that focuses on restoring joint movement and function. It is often attributed to chiropractic care, but spinal manipulation is also performed by other healthcare professionals including osteopaths and physical therapists.

For acute low back pain, there is moderate quality evidence to support a reduction of pain symptoms and improved function. For subacute and chronic low back pain, spinal manipulation provides a small short term benefit of pain reduction and improved function compared to other intervention strategies. Spinal manipulation helps one to follow the first strategy - stay moving.

5. Seek Acupuncture

Acupuncture may be beneficial for patients with acute low back pain, but the evidence is limited. There is greater support for the use of acupuncture in chronic low back pain. When acupuncture is effective the benefit is typically seen within the first seven days of treatment. Acupuncture has few side effects and is generally considered safe for most individuals, so if it is available it may be worth trying.

6. Exercise/Seek Physical Therapy

Exercise and or physical therapy during the acute phase may help avoid reoccurrences of low back pain or development of chronic low back pain. All exercise programs are beneficial in subacute and chronic cases of low back pain because all forms of exercise generally have a positive effect on the abnormal neurologic and inflammatory processes involved in subacute and chronic low back pain.

Physical therapy can be beneficial for those seeking more education on how to avoid reoccurrences of low back pain, what would be a suitable intensity for activity, and what exercises should be started after the initial pain phase. Rehabilitation exercises for low back pain are most often assigned by Physical Therapists, but may be assigned by other health care providers including Chiropractors, Osteopaths, and Occupational Therapists.

Though there may be countless other strategies to help manage low back pain - the evidence is often minimal or still to be determined. The management strategies in this column can help improve low back pain and increase function. Maintaining functional activity and mobility is key to a pain free lifestyle! However, if symptoms worsen or there is an onset of neurologic symptoms one should immediately contact their managing doctor.

Those interested in spinal manipulative therapy or acupuncture treatment can schedule an appointment with one of our experts at the Cleveland Clinic’s Center for Integrative and Lifestyle Medicine at (216) 448-4325 (option 1). For rehabilitation exercise one can schedule an appointment with one of our rehabilitation specialists at the Cleveland Clinic’s Department of Physical Medicine and Rehabilitation at 216-636-5860.

Stay Moving, Stay Active, Stay in Charge!
-Candice Price, DC

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