Lower Back Pain Treatment - Acute Pain

What is the best lower back pain treatment for acute pain?

With the right lower back pain treatment the symptoms of back pain often settle quickly. When you first get acute lower back pain it can be very frightening. You may fear that you have seriously damaged your lower back and worry that the pain will never go away and you are going to be stuck like this forever. Remember, this is rarely the case, so try not to worry.

Days 1-5

Check with your doctor if you have severe leg pain or pins and needles and numbness or if you have any of the red flag symptoms listed here

Remember that 95% of low back pain sufferers have simple lower back pain and nothing seriously wrong with their backs.

Take good pain relief to control your symptoms. Your doctor may also prescribe a muscle relaxant for short term use if you have muscle spasm (tightness in the lower back muscles). The NHS Direct web site gives a good overview of the different types of pain killers available.
Try and keep as active as possible, avoid prolonged periods of rest. I would suggest you alternate gentle activity with short periods of rest in a comfortable position.
Try and get back to all your usual activities as soon as possible, including work.
Try not to worry that you have seriously damaged yourself. Pain is not a reliable indicator of tissue damage and it is known that avoiding activity through fear of further harm will prolong the problem and lead to poorer outcomes.
Don't

Take bed rest! The research findings(1) are very clear about this it will make you worse not better.

Years ago bed rest was the lower back pain treatment of choice, it was routine to be told to have a weeks bed rest and lie flat on your back if you had back pain. Many people (and some doctors sadly) still think this is the way to manage this problem. But modern day management of back pain does not include bed rest. When you lie in bed your muscles become weak and deconditioned, your joints stiffen up, your mood becomes low as you are not having much social contact and your mind can go into overdrive worrying about what you have done to yourself. Its best to avoid bed rest if you can.

Day 5 onwards

Increase your activity levels, try and get back to normal day to day life and work.
Do a few back stretching exercises to get your spine moving again and practice some back strengthening exercises to help strengthen the muscles that support your back.
Try and improve your physical fitness levels, go walking or swimming, cycling may help too.

Before starting any exercise programme or other lower back pain treatment check with your doctor or physiotherapist to ensure it is suitable for your individual needs.

Try not to worry if your back pain returns, its fairly common for this to happen and it doesn't mean you have any permanent damage in your back. The symptoms should resolve again with time and keeping active.

What normally happens?

So it's fairly likely that you will get back pain again - don't worry about this though - back pain does not necessarily need to cause you major problems

Pain and disability usually decrease rapidly within 1 month, and continue to decrease, although slowly, until about 12 months.
About 75% of people who are off work because of lower back pain are able to return to work within 4 weeks.
The risk of recurrence is about 25% within 3 months and about 75% within 12 months.

If you have had back pain for more than 5 days read Treatment for chronic back pain

Lower Back Pain Treatment -an overview of the differences between chronic and acute pain