Acute Mechanical Back Pain

How is back pain treated?

Non-surgical treatment with limited rest and over the counter pain relievers is sufficient treatment for most patients like you. In some people, a supervised physical therapy program for ongoing mechanical pain may be recommended. Talk to your healthcare provider to see which treatment is right for you.

• Bed rest: Short-term bed rest may be recommended for you if you have severe back pain and muscle spasms. Bed rest for more than 48 hours is rarely recommended.
• Physical activity: In some cases, healthcare providers recommend early physical activity to promote rapid recovery from back pain. For moderate to mild back pain, you may be encouraged to maintain a near-normal schedule from the onset.
• Ice and heat application: Applying heat and ice alternately to the lower back is helpful to relax the muscles and decrease muscle inflammation. In general, you are encouraged to apply heat for 20 minutes, and then apply ice for 20 minutes. If you find that one application is more helpful than the other, then use only that application. Generally, heat and/or ice should be applied two to three times per day.
• Medications: If you have muscle spasms, a muscle relaxant may be prescribed for a short time (three to four days). Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen are available without prescription and may be used to reduce pain. Stronger prescription pain relievers are rarely required.
• Physical therapy: In a few cases, physical therapy may be an essential part of acute back pain rehabilitation. It is important that you work with a physical therapist trained in this exercise approach to promote rapid healing. Active physical therapy can help shorten recovery time and return you to work and leisure activities as quickly as possible. Active physical therapy is an exercise program that may require home exercises as frequently as every two hours while you are awake. The exercises generally take about five minutes to do and do not require special equipment, nor do you need to go to a gym to do them.

What is the outlook for people with back pain?

The prognosis for complete recovery is excellent. Most people with acute mechanical back pain respond very rapidly to treatment. About 90% of people with acute low back pain are symptom-free in one to two weeks. Many of the remaining estimated 10% recover within three months.

Recurrences of back pain are common. Continuing your home exercise program may help reduce your risk of another episode.