Since most episodes of lower back pain will respond to conservative care, it is usually advisable to try self-care early in the course of low back pain. Depending on the severity of the pain and how it limits activity, treatment should center on a short course of rest (one to two days) along with ice and/or heat to the back to decrease inflammation.
The sooner a patient can return to their normal functional activities, the sooner the episode of lower back pain will get better. Walking is an excellent exercise since it is gentle on the back yet helps oxygenate soft tissues and stimulates a healing response. Low back exercises can begin immediately to remove the inflammatory wastes from the area by increasing circulation. NOTE: Before beginning any exercise program it is advisable to check with your practitioner.
Sitting will often aggravate lower back pain, since this position loads the back three times more than standing. This postition should be avoided. Reclining relieves pressure on the lower back and is often the most comfortable position.
If the symptoms do not start to abate within one to two weeks, medical attention should be sought from a chiropractor. The assessment of the patient begins with a history of the pain and includes questions such as:
Where is the pain?
Is there more back pain or more leg pain?
How long has the pain been present?
Does anything make it better?
Does anything make it worse?
What treatments have been tried?
Have there been other episodes of back pain?
A physical exam will also be done to assess the nerve function and motion in the lower back. Sometimes diagnostic studies (e.g. x-rays) will be recommended to better assess the anatomy of the patient’s spine.
Combining the information of the patient’s history, physical exam, and diagnostic studies, the health provider will then recommend a course of treatment. Conservative treatments are successful in 80% of cases; if these fail, surgical treatments may be a option.
