Rest is very crucial for patients with episodic attacks of back pain. Rest here may involve going home and lying down for a few hours, or it may be as simple as keeping the back straight and avoiding further stress to the back in the form of bending, lifting and sitting. In severe attacks, lying down for a day or two may significantly reduce the severity of the pain. If it does not, further bed -rest is not helpful.
Physical therapy is very important in the treatment and prevention of low back pain. In the initial period of acute back pain, combinations of heat, traction, manual treatment, and other techniques may help to rapidly reduce the severity of pain and stiffness. As pain subsides, exercises, to relieve stress and strengthen the back ,are gradually introduced. Regularity of such exercises can help to further reduce the pain, as well as protect the back from unhealthy stress and recurrent attacks of pain.
Different types of medications may be prescribed for different types of back pain.
In acute sciatica or leg pain associated with back disorders, the acute irritation of the nerve may be reduced by taking NSAIDS regularly for a short period of time. NSAIDS are often prescribed purely for pain relief rather than for anti-inflammatory effects. It is based on an as-required basis. These drugs are to be avoided if there is a history of allergy and kidney problems. In most cases, NSAIDS are well-tolerated, though most of them provoke gastric symptoms. The doctor must always be consulted.
Muscle relaxants help to reduce muscle spasm and stiffness that occurs during a pain attack. Sedatives and tranquilisers may be taken at night to ensure a restful sleep.
Ice packs, hot packs or heating lamps, ointments that usually contain methyl -salicylate and medicated plasters of various kinds may help.
30 - 40 % of patients suffer a relapse during the first few months following the attack. It is important to identify the factors that aggravated the pain.
I have severe back pain and sciatica that has not improved even with treatment. What should I do?
X-rays of the low-back should be obtained. Conditions like spondylolisthesis, infection and tumour should be excluded. Sophisticated imaging techniques such as MRI ( magnetic resonance imaging) may be required . MRI scans can show the severity of a prolapsed disc and more importantly , the degree of the nerve compression, if any. Other investigations such as bone scan, CT scans or myelograms may be performed in certain conditions.
