There are many ways to treat low back pain. In this report, doctors from three large medical schools in the United States review the nonsurgical methods. Education, medication, activity and exercise are described and discussed. The use of physiotherapy, massage, magnets, and manipulation are also included. Traction, injections, bracing, acupuncture, and behavioral therapy are other conservative treatment choices.
Many studies on the treatment of low back pain have been done. Many of these treatment approaches are moderately helpful. Others have no proven effect. Some have never been scientifically studied. So far, we know that some medications such as muscle relaxants and antiinflammatories work better than placebos (pills with no drug in them).
Exercise and activity are much better than bed rest. Researchers haven't been able to show that one exercise is better than another to speed up recovery. Dealing with negative emotions and thoughts through behavioral therapy has been shown to improve quality of life (QOL). Improved QOL helps patients stop taking pain relievers.
Manual therapy can reduce symptoms if used in the first six weeks. This type of spinal manipulation is usually performed by a chiropractor or physiotherapist. No benefit has been found with the use of magnets, prolotherapy, or bracing. Until more research is done, acupuncture is not advised as the first treatment to try. Acupuncture is usually used as part of a whole treatment program for patients with chronic back pain.
Education and activity have been given top billing for the treatment of acute and chronic low back pain. Education includes proper posture, lifting, and ways to reduce painful symptoms. Activities should be monitored to avoid protective postures and protective movement patterns. Patients who are afraid to move because they might hurt themselves can end up in a downward spiral of pain - inactivity – and more pain.
The bottom line is that patients who stay active recover faster with fewer problems.
Francis H. Shen, MD, et al. Nonsurgical Management of Acute and Chronic Low Back Pain. In Journal of the American Academy of Orthopaedic Surgeons. August 2006. Vol. 14. No. 8. Pp. 477-487.
