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Watch Your Back:
Simple Suggestions to Manage Your Own Back Pain and Get
Back to the Activities that Matter to You
By John Lottes, PT DPT
As many of you know, low back pain is increasingly becoming a source of pain and
disability in our lives. After upper respiratory tract infections (common cold), low back
pain is the leading cause of missed days of work1.
Back pain can be intimidating and scary, especially when there is no specific event that
may have triggered the pain. In this guide, you will learn some simple bits of information
and advice that can help you manage your symptoms.
1. It improves with time
Most new occurrences of low back pain get better without seeking treatment or medical
advice within 4-6 weeks.2 This time frame is the same regardless of how intense or mild
the pain may feel.
2. It does not need imaging in the majority of cases
Don’t rush to get that x-ray right away. Recent studies have reported that imaging in
pain-free individuals will show “issues.” For example one study found 37% of 20 year
olds and up to 96% of 80 year olds have evidence of disc degeneration and were
completely symptom free.3
3. Bed rest is old news
While initially the symptoms may be too intense to get up and start moving around, it is
safe and good for your prognosis when you gradually return to activity and movement
as soon as you can tolerate.
4. Use OTC pain relievers and heat/ice as needed
Ibuprofen (Advil), Naproxen (Aleve), and Acetaminophen (Tylenol), can all be effective
pain mediators when the symptoms are intense. Care should be taken with use of
NSAIDs as prolonged/off label use may result in gastrointestinal bleeding. Heating pads
and ice may be used as well for symptom relief - whatever makes you feel better is the
way to go. Generally heat will help relieve sensations of stiffness and ice can help dull
sharp sensations of pain.
5. Motion is medicine
Stretching while lying down, leaning back/bending forward/twisting gently while standing
are all effective ways to decrease your pain and help return to normal. All motions
should be done with your tolerance in mind - i.e. do not move past the point of pain.
6. Massage can help too
Simple, gentle massage has been shown to be somewhat effective for short term relief
of pain and symptoms.4 No technique has shown to be superior to any other style of
massage so the simplest recommendation is have a loved one gently massage the
area. Going to receive a massage be beneficial as well, typically it is smart to hold off of
“deep tissue” massages.
7. Physical therapy can help
If managing on your own is not working as much as you’d like, or if you need more
information and guidance, physical therapy has been shown to decrease use of more
advanced and expensive health care associated with management of low back pain.5 In
New York State, physical therapists are permitted to perform spinal thrust manipulation,
and other manual techniques that can help, as well as continue to progress your
exercise and mobility program to assist you along your path to recovery.
Hopefully, this has shed some light and taken some of the fear out of low back pain for
If you have any questions or would like some help on your own recovery, call us at
(631)-328-2624 and schedule an appointment today.
Vallfors B. Acute, Subacute and Chronic Low Back Pain: Clinical Symptoms, Absenteeism and
Working Environment. Scan J Rehab Med Suppl 1985; 11: 1-98.
Menezes Costa Lda, C; Maher, CG; Hancock, MJ; McAuley, JH; Herbert, RD; Costa, LO (7
August 2012). "The prognosis of acute and persistent low-back pain: a meta-analysis.". CMAJ :
Canadian Medical Association. 184 (11): E613–24.
Brinjikji, W., Luetmer, P. H., Comstock, B., Bresnahan, B. W., Chen, L. E., Deyo, R. A., … Jarvik,
J. G. (2015). Systematic Literature Review of Imaging Features of Spinal Degeneration in
Asymptomatic Populations. AJNR. American Journal of Neuroradiology, 36(4), 811–816.
Qaseem A, Wilt TJ, McLean RM, Forciea MA, for the Clinical Guidelines Committee of the
American College of Physicians. Noninvasive Treatments for Acute, Subacute, and Chronic Low
Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern
Med. [Epub ahead of print 14 February 2017] doi: 10.7326/M16-2367
Fritz JM Childs JD Wainner RS Flynn TW. Primary care referral of patients with low back pain to
physical therapy: impact on future health care utilization and costs. Spine.