
Pain relief & professional treatment for back pain
As well as exercise and watching your posture, you may want some pain relief (painkillers). If so, take it regularly, as that is more likely to ease the pain enough to let you exercise and stay active. Pain relief will not completely take the pain away but it will take the edge off it.
- Anti-inflammatory pain relief medicines can help to manage back pain short-term. Examples include ibuprofen, diclofenac, and naproxen. Never take more than the recommended dose.
Some people should not take anti-inflammatories, for example, people with asthma, stomach problems, high blood pressure, kidney failure, or heart failure. If you are not sure, ask your GP or pharmacist.
- A stronger pain relief medicine, such as codeine, is an option if anti-inflammatories don't suit you or don't work well. You should only use codeine for short-term pain relief, and under the supervision of your GP.
Codeine often causes constipation, which may make your back pain worse if you need to strain to go to the toilet. To prevent constipation drink lots of water and eat foods with plenty of fibre.
If you feel that pain relief medicines aren't helping, talk to your GP about other options.
Physical treatments
You may want treatment from a chiropractor, osteopath, or physiotherapist, to help you recover from your back pain. All three are very similar and can be effective – choose the one that suits you best.
You can expect whichever health professional you choose to thoroughly assess you, advise you on how you can help yourself, and give you an individual treatment plan. This plan will include exercises and manual therapy.
If you don't get significantly better within five to six treatments, talk to your therapist or GP about what other options you have.
Structured exercise programme
Your exercise programme might include flexion (bending forward) and extension (bending backward), strengthening, aerobic exercise (like walking, swimming or cycling), general fitness, or a combination of these. It might include supervised exercise sessions, or exercises you can do at home.
Manual therapy
Manual therapy includes spinal mobilisation and spinal manipulation.
Manipulation involves moving a joint in your spine more than it would normally move. Mobilisation involves moving a joint in your spine within the range it would normally move. Once they have examined you and talked about the options, the therapist may use one or both of them.
Manual therapy may also include massage, techniques to reduce tension, and checking how well the joints in your spine are working.
What happens next?
If after five or six treatments your back pain is not beginning to get better, talk to your health professional about other treatment options.
If your pain lasts for more than three months the information in the persistent pain section may be helpful.
On the next page: How to stop low back pain coming back
Written by HealthInfo clinical advisers. Endorsed by Canterbury Initiative low back pain workgroup. Last reviewed March 2017.
Sources
The information in this section comes from the following sources, some of which may be clinically complex or not available to the general public.
ACC – Non-specific acute low back pain, part 3 – return to work (http://www.acc.co.nz/PRD_EXT_CSMP/groups/external_providers/documents/guide/prd_ctrb113162.pdf), retrieved March 2017
Bell J.A., & Burnett A. (2009). Exercise for the primary, secondary, and tertiary prevention of low back pain in the workplace: a systematic review. Journal of Occupational Rehabilitation. 19:8-24. DOI: 10.1007/s10926-009-9164-5
Choi B.K.L., Verbeek J.H., Tam Wai-San, Jiang J.Y. (2010) Exercises for prevention of recurrences of low-back pain. Cochrane Database of Systematic Reviews 2010, Issue 1. Art. No.: CD006555. DOI: 10.1002/14651858.CD006555.pub2
Christiansen D., Larsen K., Kudsk J.O., Vinther N.C. Pain responses in repeated end-range spinal movements and psychological factors in sick-listed patients with low back pain: is there an association? J Rehabil Med 2009; 41: 545-49.
Wong J.J., Coté P., Sutton D.A. et al. Clinical practice guidelines for the noninvasive management of low back pain: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Eur J Pain 2016; 21: 201-16.
Hides J., Jull G., Richardson C. Long-term effects of specific stabilizing exercises for first-episode low back pain. Spine 2001; 11: e243-e248
Larsen K., Weidick F., & Leboeuf-Yde C. (2002) Can passive prone extensions of the back prevent back problems? Spine. 27(24):2747-52
Martimo et al (2008) Effect of training and lifting equipment for preventing back pain in lifting and handling: systematic review. British Medical Journal published online 31 Jan 2008; doi:10.1136/bmj.39463.418380.BE
Muller et al (1999) The influence of previous low back trouble, general health, and working conditions on future sick-listing because of low back trouble. Spine. 24(15):1562-1570
Roffey D.M., Wai E.K., Bishop P., Kwon B.K., Dagenais S. Causal assessment of occupational sitting and low back pain: results of a systematic review. Spine J 2010; 10: 252-261
Stanton T.R. et al (2008). After an episode of acute low back pain, recurrence is unpredictable and not as common as previously thought. Spine . 33(26):2923-2928
Williams M.M. & Grant R.N. A comparison of low back and referred pain responses to end range lumbar movement and position. 1992
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Review key: HILBP-103167