Lower back pain treatment: Self-management and expert advice

Lower back pain treatment is best applied using a multitude of therapies and interventions applied both at home and with a therapist - choosing which treatment to go for depends on a number of different factors and often there is no clear answer.

This page is all about you getting educated about your back pain, how long it could take to go and the lower back pain treatments focusing on what you can do yourself including specific exercises, ice, manual therapy and pain medication.

The first thing to do however is to being to reduce any anxiety and fear that inevitably comes with lower back pain. Understanding that it won't last forever is an important first step on your road to recovery:

Lower back pain can be scary especially if this is the first time you are experiencing it. But don't worry, the chances are you will be fine in no time at all: 60–70% of patients with lower back pain recover by 6 weeks. Use the advice on this page for your lower back treatment plan.

What is causing my lower back pain?

Low back pain is pain, muscle tension, or stiffness localized between the lowest ribs and above the lower folds of the buttocks, with or without sciatica.

Symptoms, pathology, and radiologic appearances are poorly correlated. Pain is nonspecific in about 85 percent of persons - translated this means that most of the time we can't really tell what is going on.

But don't fear, applying the following well researched treatment protocols can reduce your discomfort in no time and aid in a speedier recovery.

Types of lower back pain treatments and their effectiveness

A summary of research carried out in 2013 for lower back pain treatments came to the follow conclusions;

Exercise

Moderate evidence post-treatment exercise prevents recurrence at 1 year.

Choi et al. (2010) based on 13 studies only four of which were of high quality.

Massage

Beneficial for subacute and chronic low back pain when combined with exercises and education

Based on 13 studies only 4 of which were of high quality

Muscle relaxants

Better than placebo for acute low back pain, adverse events limit tolerability.

Van Tulder et al. (2003) based on 30 studies with 23 of a high quality

NSAIDs (ibruprofen etc)

Effective for short-term benefit, more toxicities than placebo, no long-term studies

Roelofs et al. (2008) based on 56 studies, 28 of which were considered high quality.

Heat or cold

Short-term pain relief with heat, no evidence of benefit from cold therapy

French et al. (2011) based on 9 studies only 2 of which were high quality.

Spinal manipulation

No better than sham manipulation

Rubinstein et al. (2012) based on 20 studies none of which were high quality.

Acupuncture

Better than sham for the treatment of chronic low back pain but no better than other conventional therapies, which have modest benefit

Furlan et al. (2011) based on 35 studies 14 of which were considered high quality.

Lower back support belts

While we don't usually recommend these to our patients, occasionally they can be a useful tool for managing pain and instability in the lower back - they are however no substitute for manual therapy, core strengthening and general exercises. Follow this link to read our opinion on the use of a lower back support belt.

Best practise: what the experts recommend. 

Physical activity and exercise

"Consider a structured exercise programme tailored to the person comprising up to a maximum of 8 sessions over 12 weeks.

A one-to-one supervised exercise programme may be offered if a group programme is not suitable for a particular person."

Manual therapy

Consider a course of manual therapy, including spinal manipulation, comprising up to a maximum of nine sessions over a period of up to 12 weeks."

This advice is recommended by the NICE guidelines for lower back pain: https://www.nice.org.uk/guidance/NG59.

How long will my back pain take to recover

Overall 60–70% of patients with lower back pain recover by 6 weeks from onset and 80–90% by 12 weeks.

If you've damaged your back more seriously for example a serious disk prolapse then you could be looking at more like 12-18 months for recovery although this is rare.

Acute lower back pain

In a study by Pengel et al. (2003) rapid improvements in pain, disability and return to work occurred in one month. Further improvement was apparent until about three months. 

Recurrence of lower back is likely though wit about 25 % of lower back pain sufferers having a flare-up within 3 months.

Lower back pain lasting longer than 3 months can be defined as chronic. 6 to 10% of patients with acute low back pain are expected to develop chronic pain.

Chronic lower back pain

For those who go on to develop lower back pain, the cumulative probability of being pain-free was 35% at nine months and 42% at 12 months and for complete recovery was 35% at nine months and 41% at 12 months.  

The risk of at least one recurrence within 12 months varied from 66% to 84% and after three years it was 84%.

Exercises for lower back pain

As Osteopaths ourselves, we use or advice some or all of the lower back pain treatments listed above in one session, therefore maximising our chances of success.

When it comes to exercises for relieving lower back pain here are some of the exercises we recommend for the initial, or acute phase of lower back pain.

Knee sways If you can, lie flat on your back and gently rock your knees from side to side allowing decompression and stretching through your lumbar spine. Follow this link for more info on knee sways.
	Knee hugs Knee hugs are a great way of gently stretching out your lower back allowing decompression of the vertebral disks. This exercise and the next are detailed on our mobility exercises for lower back pain page
Lumbar flexion Like the exercises above, incorporating flexion into the lumbar spine is a tried and tested way to reduce pain and spasming.

Walking as a lower back pain treatment

Got to keep moving, gotta keep walking! One of the best lower back pain treatments out there is walking, just don't push. Walk as far as you are comfortable and rest, try not to put yourself in any unnecessary pain

When your back is hurting it is important you don't hide away. Movement can be the key to recovery

The hard part about acute lower back pain treatment?

The hardest part when you've got acute lower back pain is that it hurts to move, but sitting still will do you no good at all. Having said that moving too much won't allow you to recover.

Ahhh what are you supposed to do then??

Try and get up and get at least 10 minutes gentle mobility exercise in every 20-30 minutes. 

It's a fine line between moving enough and moving too little.

Other strategies to apply if your struggling with lower back pain

Pain medication

If you're struggling with a bad lower back then you might want to try some pain medication, after consulting your doctor or pharmacist of course. The advantage of taking pain meds is that you are far more likely to MOVE, therefore reducing your recovery time. 

Ice

Ice and /or heat can do wonders for your back - typically we advise ice for pain relief as it can cause a numbing effect and reduce inflammation. There is a degree of personal experience about this so try both. A bag of peas will do, apply it for 5 minutes, then remove it for 5 minutes - keep going as long as you like (probably best not to eat the peas after though.

See an expert

Visiting your doctor and or  back pain specialist including osteopaths, chiropractors and physiotherapists can do wonders at putting your mind at ease as well as providing real pain relief and faster recovery time.

Don't worry, you'll be back flipping tyres in no time at all!

AUTHORS AND CREATORS

This page was written and composed by experts in their fields;

OLIVER WAKEFIELD M.ost
REGISTERED OSTEOPATH

Oliver is a registered Osteopath in the UK with a particular interest in sports and rehabilitation - he practises in Devon, Southwest England.

LOUISE PRATLEY M.ost
REGISTERED OSTEOPATH

Louise is a registered Osteopath, fitness model and enthusiast as well as a business and social influencer. She also practises as an Osteopath in Devon, UK.

Oliver and Louise specialise in helping people get over their pain and get back to living the lives they want to be living - follow this link to find out more about us.

We welcome any one who wants to get in touch with us here at the OFC for any reason - please use the form on our contact us page.

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All the information and advice in this website should be followed with common sense and expert help - follow this link for our full disclaimer.